A man with pain shooting up his back. (Zoonar/Thinkstock)
A man with pain shooting up his back. (Zoonar/Thinkstock)

Proctalgia Fugax Is A Pain In The Butt

You have pain in the butt which comes and goes. You see a doctor. You want to know if you have hemorrhoids or cancer. Well, what else could it be?

There are at least six common causes for rectal and anal pain: pruritus (itch), external thrombosed hemorrhoid (a blood clot), prolapsed internal thrombosed hemorrhoids, fissure (tear), abscess, and fistula (tunnel). Ok, you can add one more condition to the list – proctalgia fugax.

Your next question is, “Doc, what is proctalgia fugax?”

This condition was first described in Ancient Rome over 2000 years ago and still carries the Latin name which translates to “fleeting rectal pain.” It occurs in about 14 percent of healthy people. Seventy five percent of these are women.

Sufferers of this condition often describe waking up from a sound sleep with a sharp pain, often described as stabbing pain “like a knife sticking deep in the rectum.” The pain is usually brief – lasting less than 20 minutes – and disappears as mysteriously as it comes.
Proctalgia fugax falls under the category of “unexplained rectal and anal pain”. Other conditions under this group are levator ani syndrome and coccygodinia.

Let us try and understand some anatomy first.

Colon ends in the pelvis to become sigmoid, rectum and anus. Sigmoid and rectum act as storage area for fecal matter. At a socially convenient place, the anal sphincters (valves) relax to allow us to defecate.

Anal canal is surrounded by two circular muscles known as internal and external sphincters. Rectum is surrounded by and held in place by pelvic floor consisting of a group of muscles called levator ani. Coccyx is the tail end of the spine, not too far from the anal canal.

Proctalgia fugax can begin during sleep, defecation, urination, or intercourse. The character of the pain has been compared to a charlie horse. It may only occur once a year or several times a week. Pain may be severe enough to cause sweating and palpitation. There may be a desire to have a bowel movement, yet pass no stool.

It is thought that a sudden spasm of the levator muscle complex or the sigmoid colon can result in proctalgia fugax. It is believed that people who frequent the toilet are at greatest risk. Professionals, managers, and perfectionists are more likely to be afflicted. Stress and anxiety plays a role in precipitating the pain.

The diagnosis is based almost entirely on the patient’s history. Clinical examination is usually negative. Patients should undergo flexible sigmoidoscopy to screen for other causes of ano-rectal diseases. Careful pelvic and prostate examinations should be undertaken. Ultrasound or CT scan of the pelvis may be necessary.

Patients with levator ani syndrome experience pain for hours to days. The pain is most often constant or rhythmic and may be likened to sitting on a ball or feeling like a ball (or corncob) was inside the rectum. Pain may be caused by defecation, sexual intercourse, sitting for long periods, and stress or anxiety. The pain is probably due to spasm of the pelvic floor muscles.

Coccygodynia is a cramp or ache in the tailbone and typically results from injury to the coccyx or arthritis. Movement of the coccyx can reproduce the pain. Pain from proctalgia fugax, levator syndrome, and coccygodynia may be hard to differentiate.

Treatment is often unrewarding. Some of the measures worth trying are: reassurance, hot baths, bowel regimens, massage therapy, perineal strengthening exercises, pain killers, anti-inflammatory, muscle relaxants, topical nitrates, tranquillizers, calcium channel blockers, acupuncture, and psychiatric evaluation.

Unfortunately, proctalgia fugax is one of the many medical conditions for which there is no good explanation or treatment.

This article was mentioned in my video blog (Had Your Butt Checked Out Lately?) on September 25, 2011.

Topics on my website: Proctalgia fugax and Hemorrhoids.

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221 thoughts on “Proctalgia Fugax Is A Pain In The Butt”

  1. I have all the symptoms but mine as just happened for the first time and has been going on for over two months. I also have a problem where air gets sucked through my virgin and then blown out of the rectum and then and change direction and go the other way. I don’t know what is going on. I’ve been to the hospital and found nothing wrong but they also only examined with there fingers. It’s so embarrassing to go anywhere cause it smells and I’ve been doing it for two and a half months. Does anyone know of this problem. Some of my family thinks I’m actually going crazy. Please help.

  2. Wow, am i glad i’m not the only one! and Thank you God for this site! First episode EVER and i was paniked, in pain and without ANY idea on what it was or how to make the pain go away! Glad i’m not alone

  3. I have had this for 25 years, but waited many years before going to a GI doctor who instantly was able to describe what I was going through, no real treatment other then recommending warm sitz baths. I did not own a sitz bath so just filled my tub with the warm/hot water and squatted in it until the episode past. It started to get worse lasting hours, setting off a spasm in my left piriformis muscle which causes severe sciatica pain down my left posterior thigh. I went to another GI who gave me a script for nitroglycerin ointment. And it does work a great deal of time though the initial insertion feels as if I’d lit my rectum on fire for a few moments, ack! But better then the whole ordeal as now those spells will last over an hour if not treated, i.e. the nitro is no longer effective due to length of time opened and I failed to get it refilled. I’ve never had a headache from using it.

  4. I’ve had terrible gas pains that have been causing this pain in my butt. Laying in bed and doing pelvic floor exercises seems to help a little.
    Its terrible because I need to pass gas but seems anytime it gets close my butt has a spasm. Ugh.

    1. Have you gone to your doctor to get it checked out ? I have been experiencing this pain as well for two days now, only when I wake up. I’m scared and I don’t know what to do.

  5. I have experienced this phenomenon a few times every year for at least ten years. Almost all of the cramping descriptions above are correct in my opinion. It will usually hit me quite unexpectedly around 3 in the morning. Strangely enough it seems to start in a dream state which quickly turns into an AWAKENED state! The first overwhemling impulse is to have a bowel movement, but my experience tells me it is NOT a good idea to try this. For lack of a better response your mind is telling you bowel movement, but this will not happen and pushing to find relief will only make the cramp worse and last longer. The best thing to do – the only thing to do – is try to stay calm and wait for it to go away. Believe me, I’ve tried everything, and if you don’t push for a bm and just relax it will go away very quickly. It will be very uncomfortable for about 5 minutes, then a combination of subsiding cramping and your bodies own pain killers will all wash over you. Early on I used to think that if I could just have a bowel movement then the “problem” would pass. It just kept the cramp alive for as long as I continued to push. Good luck everyone, this is never fun. Last night I had my worst cramp yet, laid out on the bathroom floor in agony for a few minutes then WHOOSH gone.

    1. Has yours ever caused you to pass out? Mine did last night……
      I was fighting the pain, from laying on floor, to trying to have a bowel movement, to standing up pasing the floor…. All of a sudden felt light headed lend on wall and woke on floor! Then I was soooooo cold but pain was gone.

    2. I have gone light headed and passed out and hit the kitchen floor, also about 3am. It was cold hard tiles that I landed on and I had a bump on my forehead. I was so lucky that I didn’t catch the corner of a cupboard on the way down. Since then, whenever Proctalgia Fugax strikes, I try and stay on the floor

    3. I have never passed out from the pain, but I can easily imagine that happening. The initial pain can be quite sudden and overwhelming. The pain is very deep and un-reachable for the most part, so your mind tends to sort of panic to make it go away. I have often found myself standing up, sitting down, standing up, walking around – anything to either “escape” the pain or make it go away. As I mentioned in my earlier post, I’ve finally learned that it WILL go away on it’s own and usually fairly quickly (for me about 5-10 minutes). The natural reaction is to get out of bed, go to the bathroom, and sit on the toilet. Now that I know it is just a cramp of an internal muscle (and not the need for a bowel movement) I try to just lay in bed, breathe deeply and try to relax until it goes away. It always does, and you can rest assured that it will go away for you too without doing anything at all. If you are a fall risk or just worried about fainting, then try to stay in bed – DON’T PUSH – and wait for the cramp to subside.

  6. This is going to sound really strange, but every time I eat American cheese, like Kraft Singles, etc., I get this within a day or two. There are a lot of chemicals in that stuff, I think. Anyone else notice this connection?

  7. i have found that applying pressure between the anus and the scrotum relieves most of the pain .enough so that its bearable till the pain subsides.i have problems urinating i dont have any pressure and go just a small amount very frequently and all through the night .are these symptoms related?

  8. On the off chance that anyone will read this far down in the comments, I came across something that helps my pain-in-the-butt to go away. I found it on a health forum somewhere a few years ago. A woman said she drank a tall glass of very cold water as soon as she awoke with the pain, and it seems to start to alleviate the pain in about 5 minutes. It works for me 99% of the time. I hope this helps someone else.

  9. Found solution. After five years with this problem I found a solution. Simply you need to read the most boring book you can find. When the pain starts to begin pick up the book and just read the boring paragraphs within one minute of pain will start to go away from myself and the spasm seasons. This process has not failed for me for 10 years and about a hundred different episodes.

    1. Funny William. Reading this blog as I suffer seemed to help. I’ve been suffering from this since 12 and I’m now 51.. Often accompanied with constipation, I don’t see many of you saying the same. It seems with almost every episode There is some defecation.

      I’ll try heating pad and then the enema in that order. Haha….you just never know if it’s a 5 minute or 90 minute episode. I’m sorry ….yet happy to know I’m not the only one suffering.

  10. Does anybody try to smoke marijuana to alleviate the condition ? I heard it helps with different kind of pains so why not with this intense pains ?

    1. I suffered for 1 month with this pain it was 24/7. I smoked everyday for 2 weeks. I did have x-rays and saw a pain specialist . He wanted to give me steroid injection which I refused. I did my research and obtained medical grade weed. I am totally pain free and active again.

  11. Geez…I am sooo happy I ran across this. I just woke up (about an hour ago) hurting so bad in the rectum that I thought I had to use the restroom. I am also cramping. Went to the restroom and tried to go, the pain got worse, I started sweating like my blood pressure/sugar dropped, and wanted to vomit. So I decided to try to make it back to my room to lay down and ride out the pain. Instead I got even more dizzy, ran into the wall with my face (because I couldn’t see anything anymore) and passed out. Reading that I am not alone has made me feel better. I will be going to my Dr in the am for sure. Stress could be a trigger right now as I have a son in the hospital.

  12. What Causes and Relieves Proctalgia Fugax Pain

    Inside the rectum, there are numerous muscular structures, there are even different types of muscles forming layers on top of other muscles. There’s an elliptical band of muscle fibers around the anal canal near the internal sphincter. It is the largest, longest and strongest portion. These bands of muscles pull on other muscles. This area is also rich in nerve fibers which is why the pain of PF is so severe. As with any muscle in the body, it can cramp or have a spasm. If it happens in your leg muscle, it’s easy to reach the area to massage, apply hot or cold packs or stretch the muscle to stop the spasm. When the spasm happens inside the rectum, you can’t reach it for massage or stretch it or apply hot or cold packs. Sitting in a tub of hot water won’t work because the heat can’t get directly to the muscle. Medications may work but take time to relieve the pain. I’ve heard of a lot of crazy cures that people have suggested but to be honest, it’s not what they’re doing that works, it’s that the pain has usually run it’s course and stopped on it’s own.

    There is absolutely no reason to suffer through the agonizing pain of PF when there is such a simple way to stop it. It’s called the “hot water enema method” and it’s guanteed to work everytime. The reason why it works is because it’s the only way to get the heat directly to the area. The instant the hot water hits the muscle, it stops it’s spasm immediately. Some people have responded by saying things like, “I don’t think I’m qualified to use an enema” or “I don’t like the sound of that” while complaining that the pain is so bad they wanted to die.

    I’m really surprised that they would rather endure that kind of pain than squirt a little water up there. If you have reservations, check with your doctor first. Just please, don’t say that you’ve tried everything or you’re willing to do anything to stop the pain if you haven’t tried or you’re not willing to try the hot water enema method. Everyone who’s tried it, has said it worked and stopped the pain in less than a minute.

    Here’s how to do it:
    Get yourself a rectal enema from any drug store (not a disposable one) and as soon as you feel that attack coming on, fill the enema with hot water, (not burning hot), (just as hot as you can handle touching the water with bare hands). While sitting on the toilet, insert the tip of the enema up into your rectum (You can use some petroleum jelly if you like) and gently squeeze out all of the hot water up inside your rectum. Remove the enema, but hold the water inside you. Instantly, you will feel the pain and spasms relax and go away. After that, go ahead and let the water out (into the toilet) All the pain will be gone… I promise this is true.

    Make sure to always keep your enema clean, and ready the next time you need it.
    Please let us know how well it works for you.
    Best of Luck

    1. I’m not sure how it works but taking vitamin D3 daily seems to have helped eliminate my symptoms. Give it a try and report back. It can’t hurt to try.

    2. Thank you I will try this it’s been happening the past couole nights wakes me right out of my slep i’ve never had that pain in my life, i’m gonna go to the store tomorrow and get an enema and try it, i’ve never used one but definitely willing to try thank you!

    3. Thank you! I will try this the pain is unbearable! Hit me in the middle of the night out of nowhere

    4. First time I had this I thought I was going into labor again after having my child. I found many of my family had suffered from this spasm. I wake up from an organism usually with this pain. If I go do an enema presto it is gone immediately.

  13. This has been occurring to me for about 30 years now, usually about every 2, 3 to 5 months a year. I have found that standing and taking a walk is the only thing that makes it go away. I was astounded to see that “reassurnace” was one possible tonic. Once, when I was at a new job it hit me very severely. After 20 minutes it was getting worse. I had taken aspirin but nothing was working and I was really incapable of performing any work. Then I thought to use my mind by thinking to myself; “it is passing, it is going away, it isn’t real, it’s just stress and I am in control.” Within a few minutes it was over. If that was just a coincidence I can’t know. Still, strange to see that reassurance is a way to combat it. Try this if you suffer from it. Also, I’m not at all shocked to see that it can occurr in the middle of sleeping. Think NIGHTMARES! I think that the type A personality brain may have something to do with this. I am, no pun inteneded, ANALytical.

    1. When I feel it coming on – and I know the feeling so well – I generally come immediately alert; I get up and start walk it off. For me, the pain is less severe and the duration shorter when I walk. If I stay in bed or go sit on the toilet (instinctual precaution) to wait it out, the pain is more severe and last longer. If I do not walk, I will get nauseous, sweat and nearly pass out. I’ve heard some people try to achieve an erection…thats no possible with me during an episode. I immediately get out of bed and start walking. That has worked the best for me over the last 30 years.

  14. Thanks a million for this website. I am 61 years old, and woke up tonight (about 11:30 pm) after what felt like a really good sleep. Man I experienced this excruciating pain for the first time in my life. I didn’t know what was going on. I was at first thinking that it could be described as somebody hitting me on my rectum with a baseball bat. But, I think maybe a Charlie horse in the rectum sounds better. I started thinking maybe it was cancer or some horrible situation like that. Then I found this website. This website is a God-send, that’s for sure. Without knowing anything about this, I first tried a bowel movement on the toilet, that helped a little, but still couldn’t get back to sleep. So then I took some Tylenol, and am now drinking some hot water. The pain has been going on for about an hour and a half now, but does some to be getting better. I will try and go back to sleep after this post. Again thanks for this website.

  15. I’ve had similar pains for the past 10 years of my life, I’m 29 now. I used to think the pain and spams were caused from cheese/dairy, excessive alcohol consumption, diet cola, energy drinks and/or orgasming too frequently. At age 25 i went to the doctor and expressed my concern. They had sent me to see a specialist. I had a tube stuck up my butt, awful experience by the way, to tell me everything was okay. I guess i was okay with that. At the time my diet was awful and I did not exercise at all. Drinking alcohol every other night in excess and having diet soda and energy drinks like they were going out of style. I finally cleaned up my act by age 27. Diet soda and enery drinks no longer in my life. Alcohol on occasion. Clean eating, plently of water and exercise yet it still happened. Being able to ‘last long’ was a goal of mine. Stupid goal but I think it was the root of my problems. The frequency of orgasms were just too much. If there are more than two days in a row of intense orgasms I’m sure to have multiple episodes for the next couple of days. Once it happens I clench my butt checks together as hard as I can. The pain seems to subside. I live very cautiously for a few days. But I truley believe the chemicals from diet sodas and energy drinks also play a roll in this mix. After reading this article and posts from everybody. I’m very determined to figure this out and help others who are in the same boat. Like a spasm log or something along those lines

  16. I have similar problems. Pain after orgasm, or suddenly comes on in the middle of the night. I have found sitting on a hard, flat surface like the edge of the tub releases pain much quicker.

    1. I have found rubbing on voltaren emugel as soon as I feel it coming on alieviates the pain.
      Having a little of the ointment on a finger and inserting it internally helps but can burn a bit so dont use to much.

  17. Hi, I think I may have this proctalgia-fugax problem; it seems to happen nearly always at night and last up to an hour about once a month. My cure for this and I always feel the pain ebbing away once this happens is, to try and get yourself to pass wind as much as possible, try turning on your side, then turn on your other side and see if it helps you pass. Do this aslong as it takes until u feel the urge. What’s even better I find is lying on my back and tapping my stomach (palm resting on your tum and tapping with my fingers) until I finally break wind. I have even walked up and down my stairs in the middle of the night and found this did the trick sometimes. From my perspective, once I pass wind the pain lessens with every F**t 🙂

    1. lol it helps sitting on a cushion or something doft then taking painkillers annd walking in circles yeah that how much it hurts

    2. I find that passing gas is usually a sign that the episode is coming to an end (no pun). I almost always pass gas during an episode. But as others have said…you are not going to defecate so don’t try to do it.

  18. I get this pain occasionally and it’s awful. I will have weeks where it flares up nightly then leaves for months. It always happens at night and makes me feel like I need to use the bathroom but I don’t. I have found taking an extra strength Ibuprofen and laying on a heating pad usually helps it pass fairly quickly if I can catch it when the flare up first starts. I sympathize with those who experience it more frequently.

  19. Am in my 30’s now, and have had this for a long time, maybe 20 odd years. Mother and sister also suffer, I think they still do to this day. At the time doctor gave us suppositories but they didn’t really work. Sometimes the pain is bearable and only last ~20mins, but I’ve had ones that near make me pass out and last a few hours. I’d say average time is around 40 mins. As others have mentioned, mine mostly during the night but do get the odd episode during the day, sometimes at work. I put it down to stress, tiredness, but has also come on randomly after sex or defecating.

    To ease the pain I get into a squat position and rock back and forward, or get onto my knees and face on the floor and try and get things stretched and pass some gas. It is such a hassle of a condition, as you can’t talk to people about it, and when an episode occurs you just want to be left alone.

  20. Man, I get this all the time around the time of my period and it totally doubles me over and I can’t breathe it’s so bad! Good to know other people have it as well and it is not serious (just unpleasant!)

  21. I get this occasionally but it’s only after I eat too much, usually the day after. How much are you eating? Are you really stuffing yourself? For me the key to avoiding this pain is to just not eat huge meals with desserts and appetizers. But I do understand what works for me may not work for you. One other cause of this pain for me is when I take ibuprofen and I engage in intercourse after. It never fails to cause great pain. Good luck.

  22. Wow! I am not alone……… Having read people’s comments, I find many of my symptoms described exactly. Waking in the night with a really deep rectal pain. Even though I know I will not be able to open my bowels I often find that a period of straining on the toilet really helps. My symptoms last only about 30 minutes and passing some gas, even if only a little, does appear to relieve the situation . I too, often feel like I am going to pass out and have nearly fainted before. I get this only about 5 times per year but do see a link between my stress levels e.g. having been up working late at night on a deadline piece of work

    So my self-diagnosis of what is happening has led me to the following conclusion (quite possibly incorrectly, and certainly not particularly clinically informed). As the bowel pretty much shuts down through the night, any gas requiring relief cannot travel through and creates a bottleneck, once it reaches a critical point, the pain mechanism wakes you up and the bowel is kick-started. Awaking very quickly from a deep sleep whilst your blood pressure is quite low, and exerting yourself combined with the pain and the blood being demanded by the bowel to kick-start, leaves the brain without sufficient blood (hence nearly/actually passing out/fainting).

  23. I just notice pain just above my anus just a month ago… when i get up from sitting i can feel the pain, but the pain is tolerable. But the pain i felt is not permanent sometimes i didn’t feel the pain at all but still it worries me… I’m 44 now…

  24. Anyone who has this condition needs to try the medication hyoscyamine. hyoscyamine is a smooth muscle relaxer. It’s cheap, just have your physician write a prescription for you. I carry a little pill vial around on my keychain with three of these any where I go. If I even remotely start to feel an episode coming on, I’ll pop them under my tongue and let them dissolve. This usually either completely eliminates the episode, or makes it much less worse than it would be otherwise (i.e., I don’t vomit or pass out from the pain). If it occurs when I am home, I will also run a hot bath and sit in it for a few minutes until everything relaxes, but when you’re out and about, you just can’t run to take a bath. I’ve been out jogging before and had an episode come on and ended up passing out in a strangers yard by the sidewalk from the pain. There is nothing more embarrassing than having people come up to you asking if you’re ok, and you just want them to go away so you can try to relax and hope it stops soon.

    1. After suffering from severe levator ani pain every few months for 25+ years, my doctor finally prescribed hyoscyamine and I agree with Ed — it’s a life-changer! I’ve only tried 1 tablet at a time under my tongue, but it can either stop the pain if I catch it quickly enough, or greatly reduce the pain if I’m too late to stop it. When I say reduce, don’t get me wrong — it’s still miserable, but 1 tablet usually pulls me back from the edge of passing out, and shortens the duration of the episode from about 2 hours to 45-60 minutes. I also lie face down on the floor on a heating pad either below my stomach (since the “hot poker” seems to go through my body from the rectum to just below my belly button) or I sit on the pad if I can manage to sit. Before hyoscyamine, usually all I could do was pace around, hyperventilating, trying not to pass out from the pain (but kind of wishing I would), wondering what I did to deserve this in my life. Now things are at least a bit more manageable, although still irritatingly mysterious. I might try a couple tablets next time to see if that works even better. One note: my doctor said the medicine basically relaxes the gut, and I can feel it doing that for several hours. I’ve even used it once (from my keychain supply!) when I was away from home and started getting an upset stomach and it calmed the whole thing down, so whatever it does, I’m glad my doctor recommended it.

  25. My story is pretty much the same as Andy Mack’s above. I’ve been dealing with this ailment for about 10 years now. Comes on to a varying degree about once every two or three weeks on the average.

    I have learned over the years how to cope with it. First, my opinion is this problem is gas related as I am somewhat gassy in nature. Maybe it’s something I eat that makes me this way. Not sure but my youngest son is also gassy so I think it may run in the genes.

    Basically the remedy is to pass some gas to relieve the pressure. The reason the attacks usually come on at night is because gas builds up during the night. I have also found that sitting on the floor, pulling my knees up to my chest and doing a rocking motion on my rear helps massage the pain away. It helps to sit on something like a rolled up towel so the pressure can be focused on the anus area. Sometimes I just do sit ups on the rolled towel. This way I relieve the pain and get some good exercise too. Normally when I’m doing my rocking or sit ups I end up passing a small amount of gas and then the pain is gone completely.

    Next time you have an attack, try it yourself. Works for me every time.

  26. Wow!!! Im not dying!!! I have had this since I was 18, Im now 40. Doctors really need to figure this out. I have had so many tests over the years and nothing ever found. The doctors seemed to always think I was making it up in an attempt to get pain medication or something. I have dealt with pain so severe that I thought I was going to pass out at times ranging from 1 hour to 4 hours and it mostly wakes me up in the middle of the night but it has come on at all different times but mostly about and hour or two into sleep. I believe stress and large amounts of aspartame from diet drinks are big causes of mine. I have also experienced it after bowel movements, sex, and sitting for long periods of time.

  27. I’m a 44 year old male. I’ve been dealing with this for 25 years. It was very frustrating since I, nor anybody else, knew what was wrong with me. I didn’t know what it was until I stumbled upon it online. What brings it on for me is when I defecate when I don’t have to go badly. This means that I have to wait until I really have to go before defecating. Also, sex with my wife occasionally brings it on. The pain doesn’t start until after we’re done. It has lasted from 15 minutes to 5 hours, but that’s rare. It’s nice to know I’m not crazy or dying.

  28. I have had this pain since about 20 years old. It happens most often at night I have found sleeping on my side or on the stomach night it is worse. Therefore I have made an effort to sleep flat on my back. sleeping on my stomach will induce it within an hour of going to bed. sleeping on my side will also cause it but not as often. Sometimes having a bowel movement will cause it also. I’m not sure to type of pressure because time sometimes passing gas relieves it. Pain is so great that I almost want to pass out. I have found relief in a hot bath. Running water almost as hot as you can stand it. It can take from 20 minutes to several hours to go away completely. My biggest fear is getting durin a meeting or when I’m at work. And it has happened and I have to excuse myself at those times and I have found and drinking large quantities of very hot water helps. Sexual activities and sometimes also bring a problem. No one seems to understand this pain and I have talked about it and they have not thought of anything to say to me. It can occur as frequently as twice in a week or once a month.

    1. Andy you appear to have identical experiences to me. The drinking of very hot water must affect you in the same way. What I did was place my hands in very hot water, as hot as I could stand, and this gave such a sharp shock to the system that the pain abated. I must confess that I’ve never experienced proctalgia fugax outside of night/bed-time.

  29. I describe my pain as a rectal Charlie horse. I’ve had about 5 episodes in about 5 years and they last about 15-20 minutes. Mine never happen at night. Either I have been shopping or I just went to the bathroom. Neither my doctor, or my acupuncturist, knew anything about it, yet didn’t seem concerned when I asked them. Knowing others have it, and reading this site, has eased my concern and worry.

  30. I couldn’t sleep tonight because this has been worrying me too. I’m a 30 year old male, and this has been getting more frequent for me. Extremely painful for a brief period of time if during the day. If it wakes me at night, it is painful to walk and very painful to urinate. It feels like its in the anus, up a few inches I guess. Sometimes it radiates to the bottom of my male parts. It has brought me to my knees before. Passing gas does releive the pain. Flexeril before bed seems to help too. I notice when I am lifting too much it happens more frequent. Just glad to know its likely this and not prostate issues or a bladder or kidney stone. Thanks for everyone sharing!

  31. I’ve discovered relief by sitting in a bath of water. The water needs to be as hot as you can bear and I guarantee you’ll get relief

  32. This has been happening to me for years…what I do is put Prep H there right away and it takes away the pain…sometimes is makes me want to crawl with pain…thank God I found this to see other people have this…

  33. It’s such a relief to find this page and read the above comments. I’ve gotten these pains since my late teens and their bloody awful. One thing I found that helps after trying a bowl movement is ponstan it’s for period pain but it helps my butt pains 🙂

  34. I have been suffering from this problem for years. I am 56 years old now and it is normally always at night that it comes on. I had it last night and it was really bad on and off for around 3 hours. It is such a relief that others are talking about the same thing as me – that makes it far more easier to deal with. I had a colonoscopy a couple of years back and spoke to a Doc about it, who said it was because I was a naturally nervous person. I didn’t think much to that at the time but there is safety in numbers!
    I always feel better if I can pass wind or go to the toilet and can spend a lot of the time back and forwards to the loo. It always wakes me out of sleep. Sometimes I can get relief from it, only for it to start again later on. I used to get it close to my menstrual cycle, which is a bit erratic now but it still seems to have an effect.

  35. I am so glad I found this site. I am a 50 year old woman and over the past 10 years have become healthier and more fit than I have been in my entire life, so I was pretty sure this was not a fibre or bowel issue. In the last few months these ‘pains’ have occurred now 3 times. Last night was very bad. I woke up at 3 a.m. with stabbing pains, I also felt constipated and having a bowel movement seemed the only way to ease the pain. In tears, I sat, shaking and sweating, wondering what I should do next. I then got very nauseous. Great! Before I could decide to sit or stand I found myself waking up on the bathroom floor curled up in a ball. Pain was gone. I was scared! Not exactly sure how long I was there. Not that I am glad anyone else has ever gone through this but glad to know that it is something that is documented and nothing to worry about. I know now that next time (hopefully not) to use pressure and drink water! Thank-you all for sharing.

  36. I knew I wasn’t crazy. I’ve had this going on (always at night) for 7 years. I’ve inquired with my obgyn (thinking it could be related to a prolapsed uterus or other gynological abnormality), but she offered no thoughts or help. I’ve searched the web for answers, but could never come up with anything that seemed 100% an explanation. I finally typed in “rectal pain at night waking me up” (after losing another 1.5 hours of sleep over a 15 minute bout last night), and was led here. I’m a worrier (health related anxieties). My husband has told me to seek out answers via doctors if I feel compelled, but if this was something like cancer…wouldn’t I be quite advanced with it after 7 years(?). Good point. I feel completely assured after reading this that this is what I am experiencing. Thank you, thank you, thank you!

  37. I too have suffered from this pain in the bottom for years, always during the night. Same as most other people it wakes me up & it is very painful. Its impossible to go back to sleep. I only just recently heard the name proctalgia fugax. I even saw a specialist and my dr a couple of times and they didnt mention it. So ive had years of stressing that i have had some horrible condition. I generally do a bit of stretching, squating. Think massaging t area with abit of pawpaw cream helps abit. Try to relax & just wait it out. Its a huge relief to know its quite common. I just bought some Fiorinal today which was recommended. Pain relief,muscle relaxant so next time i get it im going to give them ago


  38. Finally I have found out what has been happening to me for years several times a week. Middle if the night pain that almost makes me vomit from the nausea only relieved by sitting on the loo! Thankyou for finally giving me the answer 🙂

  39. I’m about 19 years old and I had just woke up about 10 minutes ago with a headeach kind of pain in my behind and the only thing that seemed to make it go away was to try and have a bowel movement. It scared me because I had no idea what was going on with my body so, I googled it and came across this! It’s been very helpful and I’m going to consult my doctor asap!

  40. I have had this since my early teens. For me the pain is so debilitating. It lasts for and hour or more and feels like nerve pain. Very sharp, shooting pain it brings my to my knees and takes my breath away. I have a hard time standing or moving from point a to point b. Trying to have a bowel movement helps but is extremely painful too. The pain shoots me right off the toilet. It just usually takes time to run its course I guess.

    1. My mom has this same pain that you describe. She says that she’s constantly in pain every single day. She takes pain meds and it only takes a slight edge off of the pain. She has had two colonoscopies and the doctors cannot find anything wrong. I have watched her cry day in and day out and she even has to go to the hospital for shots to ease the pain. All the doctors treat her like an addict and have no sympathy for what she is going through. This is a woman who for years didn’t even take Tylenol. I wish I knew how to help her she just turned 51 and has been dealing with this for the past 5 years and it is debilitating.

  41. I concur with Jamie & Martin. I had this last night, but thankfully, it only occurs once a year or so. When it does, the pain can only be described as like someone putting a hot poker up my backside – it is an extreme ‘burning’ sensation type of pain. It usually occurs in the middle of the night, but also occasionally when having a bowel movement. It can be mild (still very painful), or severe, when it is very debilitating and I can almost pass out (very nearly did once). The only thing that seems to help is to try to have a bowel movement, i.e., stressing the anal muscles. Sorry to hear this is so common, but at least I know it’s not just me! I’d be very interested if anyone has found anything that seems to trigger this, or has found anything that helps.

    1. Hi….I have suffered with this problem for ages….I use Vick vapour rub….It soothes the pain away…and find it works

  42. I have ask doctors about this pain and not one of them has told me about this condition . I’ve had it for about 10 years or more and the one thing that helps me is to try to have a bowel movement most times I can’t but it seem to help a lot . Also getting a towel and make it into a circle or into a ball and sit on it . It puts pressure on the retcum and relives a lot of the pain . I have had test and everything’s is good and this problem is word for word how I’ve tried to explain to my doctor and my husband what’s going on when I wake up in this horrible pain . Glad to know other people have the same type of symptoms . .

  43. I’m so glad I was able to find out what the name of this condition is. I’m 23 years old. I don’t get it very often but when I do, it usually happens at night. The last time I had it was a few days ago and it woke me up around 5:30 am. It usually lasts about 20 minutes to half an hour for me. It’s not sharp or excruciating pain but it does hurt and it’s very uncomfortable.

    1. for me the pain is much more debilitating. it is not a pain which you can apply a hot water bottle or cold compress to and, as such, a mild panic overtakes me. It leads to an increase of the anxiety and the pain On a few occasions I have actually lost consciousness. This website has given me confidence to even mention it to my doctor who knew what it is. That is reassuring.

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