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Anorectal pain

Authoring team

Because the pathophysiological mechanisms and indications for treatment may differ, the following terms are used in connection with anorectal pain: (1)

  • Acute proctalgia - proctalgia fugax (PF) (‘fugax’ means fugitive or fleeting in Latin).
  • Levator ani syndrome (LAS).
  • Unspecified functional anorectal pain (UFAP).

Proctalgia fugax is thought to occur due to spasm of the anal sphincter, levator ani syndrome is thought to be due to spasm of the pelvic floor muscles, and the aetiology of UFAP is unknown. There is considerable overlap between the three conditions. (2) It is essential to conduct a thorough clinical assessment to exclude other pathology before offering reassurance. Only a third of people of those who experience these conditions consult a healthcare practitioner. (3)

Causes of anorectal pain include ischaemia, fissures, thrombosed haemorrhoids, inflammatory bowel disease, and intramuscular abscess.

Reference:

  1. Carrington EV, Popa SL, Chiarioni G; Proctalgia Syndromes: Update in Diagnosis and Management. Curr Gastroenterol Rep. 2020 Jun 9;22(7):35.
  2. Rao SS, Bharucha AE, Chiarioni G, et al; Functional Anorectal Disorders. Gastroenterology. 2016 Mar 25.
  3. Chiarioni G, Asteria C, Whitehead WE; Chronic proctalgia and chronic pelvic pain syndromes: new etiologic insights and treatment options. World J Gastroenterol. 2011 Oct 28;17(40):4447-55

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