Medical Questions > Conditions and Diseases > Digestive and Bowel Disorders Forum

Extreme Pain In the Rectum. Randomly Appears. (Page 1)

This is probably going to be a bit wordy, so please bear with me here.

The first time I noticed the symptoms i'm about to describe was when I was in the fourth grade. I am now 30. It is a very severe pain in the rectum/anus that sometimes only lasts for a few minutes. The longest it has ever lasted has been several hours. It usually brings the urge to deficate, though many times, I don't even have to go. The pain is usually centered on one localized area (usually one side of the wall on the inside of my anus), though the area that it affects seems to be random.

Sometimes, the pain results in a non-sexual erection, and when I was younger, masturbation sometimes ended the pain. Since i've gotten older, masturbation sometimes (more often than not) makes it worse. The pain comes more often in the night, usually in my sleep. It is so severe, it will wake me up out of a dead sleep. It is also almost guaranteed to show up if I stay up for a very long time, or if I only get a few hours of sleep. About 75% of the time that I drink coffee or energy drinks, the pain comes back.

Sometimes, I will go a couple of months without ever feeling the pain. Other times, I will have the pain several times in one week. Sometimes, I can get rid of the pain by simply taking my mind off of it (read something that truly grabs my interest... Or think of anything at all that takes my mind away from the pain).

The farthest up this pain will reach is my tailbone, and stressful situations always make it worse. I've had broken bones that didn't hurt as bad as this does.

I did some research and found something that sounds exactly like what I have, but I don't like to jump to conclusions, being vastly uneducated in the medical field. It's called "proctalgia fugax" and this how the medical site describes it:

definition: proctalgia fugax refers to pain (sometimes severe) in the rectum. It can last from a few seconds to a few minutes and often occurs spontaneously during the night. Pain sometimes accompanies orgasm and there may be an urge to defecate. The pain is sharp and gripping but remains localized. Relief is spontaneous but some people find also relief from warm baths, or ice cubes (anything to disrupt the spasms). Medications, such as diazepam, may be prescribed in cases that are very regular and/or severe.

There is no known cause for the condition but it is not thought to be psychological in origin. There is no specific treatment, simply relief measures. Proctalgia fugux is associated more with people with irritable bowel syndrome and there may be some association with caffeine, artificial sweeteners or food additives.

My question is, is this something that i'll have for the rest of my life, if indeed this is what I have? And the description above mentioned diazepam and/or other medications. I am not one to take medication... Ever. But this is so severe and so regular that i'm considering asking about it with my doctor. Does anyone have any more information on this disease/condition or the medications associated with easing the pain?

I appreciate any feedback, or even your own symptoms and means of relief. Thanks in advance.
Did you find this post helpful?
First Helper michaeld

replied December 4th, 2004
Extremely eHealthy
See your doctor.Patty
Did you find this post helpful?

replied April 20th, 2011
Rectum Pain or Spasms, fainting
I have had this problem as well for about ten years, and it just happened 2 nights ago, and I lost conciousness, and awoke on the floor not knowing where I was. I have had about 8 episodes in 10 years and have fainted 3 times, and always know when I'm going to pass out--so I get on the floor so I don't hurt myself. This problem of anal pain has happened several times during an orgasm too. I do believe it is proctalgia fugax, but it has never officially been diagnosed. All I know is that the pain is severe, and the fainting is scarey.
Did you find this post helpful?

replied November 20th, 2012
Hello...i have had this same problem for years and it feels like a spasm up my rear end and it is so intense i cant even talk and instinctively i have to get on all fours and rock back and forth..i don't even think labor was this bad and it still lasts for up to 5 mins. i am a 42yr old female and i just found out i have malrotation of my upper and lower bowels which now makes sense due to chronic bloating,constipation and diarrhea and abdominal pain but i am not sure as yet if malrotation can cause this rectal pain but im leaning toward the possibility...i have not talked to my doc yet about this congenital abnormality so i will update on this soon..please anyone with malrotation and rectal pain/spasms like me?
Did you find this post helpful?

replied November 23rd, 2012
Having suffered from these same symptoms for 31 years, with no help from doctors, I tried removing all diary products from my diet. It worked. If I am really vigilant with keeping milk, cheese, yoghurt, cream, sour cream etc out of my diet, I don't get any spasms. I can handle butter. Its worth a try.
Did you find this post helpful?

replied July 3rd, 2007
Re: Extreme Pain In the Rectum. Randomly Appears.
Just a Guy wrote:
This is probably going to be a bit wordy, so please bear with me here.
I appreciate any feedback, or even your own symptoms and means of relief. Thanks in advance.

Hi, I am 63 and have suffered, more or less, exactly as you describe. It has been happening for many years, perhaps ten. The pain, or severe ache, is sometimes almost impossible to bare, I take Ibuprofen to try to lessen the pain, usually 400g, capsules. This, if taken early at the signs of coming pain, can work, but not always.

I have tried walking around which can give mild relief but the only way is to let it run it's course, finally falling asleep as it subsides. Mornings after can leave an uncomfortable feeling around the anus area, but not always.

Overall it is very difficult to define or explain exactly where the pain emanates. I am reassured, though, that it must not be a serious condition as there do not appear to be long term problems i.e. it does not occur on a fixed regular time interval.

best wishes

Did you find this post helpful?

replied August 26th, 2007
Proctalgia Fugux
My dad & I both suffer this same ailment, so it may be hereditary. Ask your father or sons if they suffer from it.
Usually triggered by orgasm, but not always, so is somehow linked to the function of the prostate gland. Not known to be linked to cancer though.

The easiest treatment is an asthma inhaler, as the anal cramping is caused by a trigger, similar to an asthma attack.
This does not work on severe cases, which require a cold water enema.
Whenever I travel I always carry my enema bum pump with me. The cold water shocks the prostate and usually eases the cramps within a few minutes.
Really severe cases require two or even three such treatments.
Just sit on the throne and read a readers digest or time magazine.
Did you find this post helpful?

replied August 27th, 2007
Proctalgia Fugux - a Pain In the Arse

Published New Zealand GP Weekly 19 February, 1997.

First described late last century but identified as a particular malady by T E Thansen in 1935, Proctalgia Fugax remains somewhat of an enigma today. Incurable and benign it is of consequence only to those who suffer its most acute symptoms.
Thansen, in describing it as 'a fleeting pain in the rectum' had obviously never suffered from the affliction. The pain, colloquially known as 'anal cramp', can persist for as long as an hour with some victims experiencing nausea and cold sweats - fainting attacks have been recorded. The cessation of pain brings a feeling of well-being akin to the removal of an abscessed tooth.
D M Nidorf and E R Jamison in the December, 1995 edition of the American Family Physician describe Proctalgia Fugax as 'a fairly common but little known cause of rectal pain. It is a benign condition that has no known etiology'. They go on to say that 'Several treatments have been tried and found anecdotally to be effective, although reassurance is the most useful therapeutic option'.
This latter observation is surprising given that the same authors describe the ailment as 'Doctor's Disease - the disease of the perfectionist male physician'. One would have expected at least one of the varied treatments tried by these suffering doctors to have been accepted as a standard remedy.

Fugax 2
Research by Nidorf and Jamison using random sampling showed that about 15% of the population have experienced symptoms but few seek medical help due to its transitory and embarrassing nature. The embarrassment comes from attacks often being associated with orgasm. Gastroenterologist, W G Thompson, reported that of 2000 patients only 6 visited because of Proctalgia Frugax. Apparently men and women are equally affected. A H Douthwaite [British Medical Journal, July 1962] records that he had no spontaneous complaints from women but attributes that to women accepting it as a pain associated with the reproductive process and a normal part of life's difficulties. In men the attacks are usually at night but in women day-time attacks are more prevalent.
Douthwaite's conclusion is that 'Proctalgia Fugax is a pain which does not arise in the rectum but is occasioned by segmental cramp of the pubococcygeus muscle. It is harmless, unpleasant and incurable'.
Douthwaite records that coitus is not a provocative in females. However J A Mountfield [Canadian Medical Association Journal, 1986] in an article questioning the benign status of Proctalgia Fugax, reports a case of a woman who experienced attacks after every orgasm. His prescription of valium as a
possible preventative was refused and her marriage, and presumably all sexual activity, ceased.

Fugax 3
Many causes have been postulated ranging from chronic constipation, hypertension and stress to neuroticism and anal fixation. The few random studies however show that these conditions are equally present in non-sufferers.
Prescribed treatments are just as varied. Anelgesics do not work fast enough to be of any value.
Amyl nitrate, quinine, chloroform, phenobarbital, nifedipine, valium, ropantheline, oral clonidine and diltiazem have been tried without wide acceptance. Self anal-dilation has been used successfully by some doctors but is impracticable for most sufferers. Dr Eckert conducted a double-blind, cross-over trial in Germany [American Journal of Gastroenterology] with sixteen patients. He found that 'two puffs of Salbutamol [.2 mg aerosol] shortened the duration of severe pain, particularly in patients having prolonged attacks' but cautions that his trial group was small and more research is needed.
I was 28 when I first sought help. At this time attacks were months apart and invariably followed orgasm. The diagnosis from my GP was a prostate problem which probably required surgery and I decided to suffer. It was correctly diagnosed 6 years later when attacks were more frequent. By this time I had developed quite severe haemorrhoids as my only remedy had been a minimal defacation after much straining.
My new GP could offer little advice except that pressure applied to the anal area could give some relief.
Fugax 4
Some 5 years later a fellow hotel guest disappeared before dawn and arrived back late for breakfast. It transpired that he had been stricken with Proctalgia Fugax and had driven to a doctor acquaintance to be administered a 'cold water enema'. From that day my pain problem was solved. A bulb enema is more important than a toothbrush in my toilet bag. On being awakened with anal cramp I adjourn to the bathroom and toilet and can be asleep again within 15 minutes. Little or no faeces is passed so I can only assume the passage of water activates the cramped muscles. Relief is instantaneous and is accompanied by a small flow of urine. My haemorrhoid problem is now manageable and I have peace of mind at night. I recently met a man who had suffered similarly for 15 years and he has now successfully adopted the same practice.
One swallow does not make a summer and three success stories do not herald a medical breakthrough.
R W Penney [Practitioner, 1970] rejects the enema solution along with many others but gives no supporting research data or alternative treatments. GPs are in the best position to research this line of treatment.
If Proctalgia Fugax is as common and unreported as research suggests, it should not be difficult for any practitioner to build a small database of patients. Douthwaite built up his trial group of 21 male and 27 female sufferers by asking leading questions of all patients, irrespective of their other health problems.
None had previously mentioned the problem to him. Regrettably, he could offer little more than
reassurance to his group.
Fugax 5
Reassurance that the condition is benign and will cease at death or age seventy, whichever comes first, should surely be accompanied by a treatment which can or may alleviate the extremely painful symptoms. A cold water enema [100mls] or Salbutamol are treatments any GP can offer with some hope of success.

Assistance from the staff of the medical libraries at Christchurch and Palmerston North Hospitals is gratefully acknowledged.

Published New Zealand GP Weekly 19 February, 1997.


Since this was written I have trialled salbutamol [Ventinol] with mixed success. In mild attacks the pain gradually eased before disappearing 10-15 minutes later. With severe attacks the pain eased but returned. A second dose 10 minutes later was successful on some occasions but on others I resorted to my proven remedy, the cold water enema. In practice now if I awake to mild pain, I use the inhaler. If it is severe I use the enema and am back to sleep in 15 minutes.
Obviously the inhaler is the simpler approach as to many the idea of an enema is repugnant but patients should be told that it is a viable option and in my case at least the most reliable.

B W Judkins Phone 07-362-0015
R39 State Highway 30
Lake Rotoma email – [email protected]
RD 4
New Zealand
13 October 1998
Did you find this post helpful?
Users who thank 3garina for this post: investit 

replied November 30th, 2007
Pain In the Arse Remedy - Proctalgia Fugax
I have found the perfect treatment for this.
Take 1 x 25 mg tablet of Voltaren 25 (Diclofenac Sodium 25mg - an anti inflammatory) at the onset of this pain.
The pain disappears in less than 20 minutes - what a godsend.
Beware if you have a stomach ulcer or similar, as this drug can aggravate the stomach lining.
Did you find this post helpful?

replied December 8th, 2007
Proctalgia Fugax
Gidday, The only thing that I found relieves it is sit on the edge of your bathtab on on something hard that presses that painful sprot. It does work for me. Cheers.
Did you find this post helpful?

replied July 12th, 2008
my best tactic
Oh I know this Fugax thing! Cool name for a twisted condition.

I have had bouts with this from time to time. Not often, but once every few months.

It is like a slow build up cramp in the butt. My brother says he gets it too. Very aggravating.

The first time I got it a few years back, I was like what is this?

You can get it coming on if YOU FORCE A BOWEL MOVEMENT when you do not feel like going. So don't do that. Just let nature take its course.


The best way to deal with it..........3wonders is partially right. Sit on the edge of tub or if no tub and your in a airport bathroom is to get your finger wet and put it up your butt. If your on the tub keep running warm water and rinse finger and do it several times, go as far as you can but make sure you lube the finger well. You might pick out some small feces but thats good! Just keep doing that, it will either want to make you feel like a bowel movement or just instant relief. It will go away quickly. Putting your finger in will feel like a stool and straighten things out.

Try it guys, you will be ok.
Did you find this post helpful?

replied July 15th, 2008
I am 24 years old and i have been going through the same thing since i was about 9. i always thought it was something stupid and brushed it off but i think maybe i should probably get treatment for it. its very painful! it helps to know im not alone. Smile

Andrea headstand Rolling Eyes headstand
Did you find this post helpful?

replied February 15th, 2009
Proctalgia Fugax
Now I know what it's called!
I am 61, female and have suffered from this condition on and off since my late twenties. The painful spasms occur almost only at night and wake me. I have never understood why, when one's muscles are normally relaxed in sleep, the muscles of the lower digestive tract should cramp.
My first attempts to get medical help or at least information were not successful. It was not until I asked my gynaecologist a few years ago that she said, 'Oh yes it's called (I'd forgotten what until now); nobody knows what causes it, but it's harmless.'
That didn't relieve the pain, but at least it relieved my fears that it might be something really serious.
I hadn't heard of the cold water enema idea before, but it's worth a try.
Did you find this post helpful?

replied February 15th, 2009
I have had this for 4 years, and just found out what it is an hour ago. TGFTI~! (thank gollywogs for the internet!)
Anyway, has anyone tried a chiropractic solution? Also, calcium administration might be a help as lack of calcium can cause muscle cramps, the average age of onset (45) almost makes sense as one stops producing calcium by then. Wow! I'm going to start experimenting, who knows.
I've tried warm enemas to no effect, but going to try cold now. Massaging for my only delays the onset, which seems more intense than if I'd leave it.
I've also found that ignoring it, not caring about it, as the onset begins lessens the intensity.
I always thought it was because I broke my tail bone some years back.
Did you find this post helpful?

replied February 19th, 2009
Proctalgia Fugax
I have had this for about five years now , as did my mother befor me.I had suspected it might be hereditary.(Onset at 55)
Slow build up of pain leading to sweating from head to toe, nausea and collapse on the bathroom floor.
Never really understood how painful it was for my mother, until I started to get it.
It always happens at night.
I take ventolin each day as I am asthmatic, so I can't see that working, although I may give it a try next time.
The calcium theory also sounds interesting, so I may well try that.
Did you find this post helpful?

replied March 3rd, 2009
I've also suffered from this since I was 15 - I'm 34 now. I've seen various doctors, all who scratched their heads and told me i had IBS. I stopped eating wheat and gluten and dairy which all helped a little, but stress brings the attacks on and I get them during the day and night. I usually pass out from the pain and it exhausts me. It renders me useless if the attack is over an hour. I have tried everything but see some suggestions here that I have not. I'm concerned the enema will make it worse. I once administered one before and it brought the cramping on. Does anyone know if Ventolin is only available via prescription? I've found a heat pad to be somewhat successful and some anti spasm meds from the UK, but only if I take immediately and sometimes that is impossible. I'm relieved to know I am not alone. I have felt taht way for years! Thanks for that at least.
Did you find this post helpful?

replied May 6th, 2009
Anal cramps
I am so happy to hear that I am not the only one in the world suffering from this disconfort. I am a 64 yesar old woman and I just had a crisis during my sleep last night. I have been suffering from anal cramps since I was 18. At that time the pain was so severe that I will faint every single time it occurs. Doctors never found the cause and told me that I should rest more!!!!!! One day I met a woman who told me of an exercice easy to do to stop the pain quickly. I am happy to share it with you hoping it will help you as it did and does help me. When the pain starts, I quickly get up(It always happen during my sleep) and lay on the floor on my back. I then raise my legs, my bums and my hips in the air as high as I can supporting my lower body with my hands at my hips. I rest on my elbows and shoulders and move my legs on a pedalling motion like I will do on a bicycle. One minute or two of this exercice had always remove the pain. Good luck.
Did you find this post helpful?

replied May 28th, 2009
I found these posts looking for something else...and am so thankful to have found it.

I am 50, female, and had my first occurance in my early 20s. I went to a doctor several years ago, complaining of these pains, and ultimately had ultrasounds, with an "all clear" report. Obviously my doctor was very uninformed, for my symptoms match what I'm reading here.

Interestingly....when I was in labor with my first child, one of these cramps kicked in. The pain was far worse than labor. The epidural knocked it out.

Over the years, thankfully, the duration of the episodes has decreased. Sometimes I can get relief by inserting my thumb in my vaginal and smoothing the rectal wall...

I am SO GLAD to read that this is a fairly common malady. I thought I was the only person in the world.
Did you find this post helpful?

replied May 28th, 2009
Anul Cramps.
I have to say I tried the legs in the air pedaling on my last attack, and IT WORKED.!!
Thanks to the lady who passed that tip on.
Did you find this post helpful?

replied June 5th, 2009
extreame pooplike pains
i am a 19 year old male and my first occurance was about a half our ago or what i think happened. I tried to go to the bathroom and the pain just got worse so i laid on my back in the hallway untill the pain went away then when i got up it slowly came back. My mom thinks its my apendex and wanted to take me to hospital but all the pain is gone now im just hesitant to go back to bed the pain i woke up to was almost unbearable. I hope it does not happen again but the leg thing will be my first resort.
Did you find this post helpful?

replied June 21st, 2009
Louisette thank you for your tip, I haven't logged in for a while so it's good to read of an alternative route to relief.

I could never try most of the other remedies.
Did you find this post helpful?

replied July 6th, 2009
Extreme Pain In the Rectum. Randomly Appears: relief technique
(38 yr old male)

I have had this problem intermittently since I was 13. It was miss-diagnosed several times, and I finally gave up. The pain comes and goes, sometimes several times a week, always at night. Then, it wont happen again for months.

Recently, I was desperate to alleviate the excruciating pain, so I tried something completely different.

I massaged the inside of the anus with the handle of a battery powered toothbrush. âspam�Oral B,âspam makes a battery powered one with a very smooth and water-proof handle. I just lubed it up, and pressed it inside. I immediately found the pain spot, and pressed the vibrating handle gently against the site. I suspect it was very near the prostate. The pain was gone in two minutes with this technique. Occasionally, the pain comes back in 10 mins and I have to repeat. I realize this may not sound very pleasant, but, it my case, it really did work! I suspect a mini-vibrator from a sex shop would do the same thing,

Now, when I am awoken at night with pain, I can stop it and be back asleep within 10mins.

I hope this technique works for someone else.
Did you find this post helpful?

replied September 17th, 2009
Proctalgia Fugax
I've just been diagnosed with porctalgia Fugax and I was looking for more information about it.
Did you find this post helpful?
Must Read
Chronic pain affects more than 70 million Americans. But what is pain? And how can pain management help relieve different types of pain? Basic facts here....
How does the nervous system work to register pain? And what are the major causes of acute and chronic pain? Plus, who's at risk of pain here....
Acute and chronic pain manifest different symptoms. Learn the difference here and know when to seek medical help for pain....