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.

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!

253 Replies to “Proctalgia Fugax Is A Pain In The Butt”

  1. Thank you for this . It’s a relief to know others are experiencing what you called Proctalgia Fugaxartical. Though horrible, I’m now not in a total panic. The ‘ball’ description is exactly what I go through. The percentage of people that have this is probably higher, as I be a lot of women just won’t mention it! Thanks again.

  2. I just spoke with my Doctor to find that I experience Proctalgia Fugax and knowing this will assist in how I can deal with such episodes. Since episodes have in the past been far between I actually didnt want to bother making a specific appointment for this but my most recent attack was so severe that I had to check it out .. I felt really strange trying to describe the events of an attack but the Doctor soon assured me of the ailment. Just knowing has put me at ease and that in itself is important.

  3. this is going to sound weird, but trust me it works. its all about prevention, because once it starts it has to run its course. the anus is a dry place, so intercourse, sitting or what ever forces the anus “out of place” thats when the cramps start. so if this is what I do. everynight before bed I use KY jell to lube my anus, allowing it to slide back into the natural position, therefore cramps never start. I went from having 10 events a month to maybe 3 or 4 a year. try it youll see.

  4. fantastic and helpful article. I experience this a couple of times a year, no more than 4 tiimes. Aspirin is the only thing that helps along with stretching and walking around. Taking your mind off of it is a big help, distraction and not thinking about the pain makes it go away.

  5. Thank you so much, it sounds like I have proctalgia fugax. I actually told the doctor about it and she just looked at me funny and sent me home without saying anything about it at all. Needless to say… she is not my doctor anymore. However, I never got up the nerve to try to explain the episodes to my new doctor. Anyway. they happen about 3 times a year. I just had an episode where it woke me up out of my sleep and it lasted for about 17 minutes. I am really relieved to know that it is not something really serious. This article helped me a lot. Thanks.

  6. I have been doing a lot of research on this myself. After the birth of my son in Dec 2008 (I had a long, painful labour that ended up being an unplanned c-section), I began experiencing these painful spasms on a daily basis. I guess I have the chronic condition called Levator Ani Syndrome. I’ve had several diagnostic tests done to rule out anything ominous, so am starting physiotherapy, but am unable to find a therapist (would it be a physiotherapist??) who is familiar in treating this specific condition.

  7. Wow thank-you so much for enlightening me on this subject. For years I have suffered and never got an answer from any doctors.
    Just recently I went to naturpathy doctor and he came out with the name right away. For me it has been a live and learn experience. With a couple of episodes in the past and having such excruciating pain to the point of fainting. I have found the only relief I get is to supress it before it reaches that point with very hot compresses until it subsides.
    Somtimes I get awoken from sleep. long periods of sitting somtimes brings it on, or during intercourse. Usually less than 6 times a year.

  8. I cant believe i have actually found the answer to my problems. My symptoms are exactly that, i wake up in the middle of the night with stabbing pain in my butt. I always just ignored it and hoped it would not happen again, i would take advil and just wait it out and it would go away. I always was trying to thing of ways to explain it to a doctor but all i could think of is that it felt like someone was stabbing me in the but with a knife. I now find out that, that is how people describe it. It is nice to know i am not the only person going through this.

  9. Hi, I also have been really worried about this. Especially with the Farrah Facet cancer story circulating. Actually my pain which only happens occasionally is more stabbing and then it feels like a dull ache that radiates. It is really uncomfortable. I have been really worried about it and have been tested in the past with nothing coming up. I guess it is time for me to have a more thorough exam to make sure it is nothing serious. I am really relieved by all these informative posts. Thanks for sharing. I guess none of us are alone.

  10. Wow, I’ve had this off and on for years and now it has a name. I always called this “the pulling pain,” because it feels exactly like someone is trying to pull all your internal organs out through your anus and vagina. You instinctively want to put pressure on your anus to hold everything in but I found that just the opposite helps a lot. Bear down really hard like you are trying to defecate…it helps a lot!

  11. BABY ASPIRIN–I discovered by trial and error that one baby aspirin, chewed well and not swallowed immediately ( so that it gets into your blood sublingually and therefore almost immediately) will abort the pain of proctalgia fugax very quickly–under five minutes. I keep a bottle of baby aspirin beside my bed . The old-fashioned kind of baby aspriin, orange-flavored, and not the newer coated type, is best because the taste is not bad when chewed.This has never failed for me. I have an attack every couple of months.

  12. I have had this condition (I think) for years and it occurs about monthly. About four months ago I somehow made a connection to how I sleep. I often roll over onto my stomach and habitually pull my left leg up so I am sort of half on my side with one knee pulled up in a fetal like position, the other straight. I find it comfortable – always have. Because this wonderful “fugax” always starts in my sleep I am not really clear on my position when it starts. I used to think that I was maybe rolling over and pulling my leg up for comfort as it was coming on as I always seem to be coming awake in this position and in pain. Now, I slowly have started to realize that I feel a connection, a pull, between my raised leg and my anus and I have started to suspect that this sleeping position is actually bringing on the episode.
    So, for the last four months I have been making a concious effort not to do this. I either pull both legs up (a full side sleeping almost fetal position) or both legs straight. I have now gone four months without an episode. This is not conclusive, of course, but I am sleepless tonight and for once it is not connected to a pain in the ___ so I thought I would share this.

  13. Wow, my gynecologist couldn’t even diagnose this. I am like Lynda, but more specific, I have painful bouts if I orgasm while ovulating. My gynecologist did mention that a lack of testosterone after 35 and the weakening of my lining between vagina and anus may be the cause, but of what? I have almost passed out due to the pain but get through knowing I will live now that it has happened to me more than once. The first time almost killed me with fear.

  14. I Have had a problem similar to Lynda’s for many years. The episodes are infrequent but seem to be increasing in intensity and duration. Last night I had two episodes. The first was quite severe and was triggered by a bowel movement. I found myself doing a lot of pacing until it subsided. It was the first time it was so severe and lasted so long. I really did not know how to help myself. I usually just let it run its course. I am glad that I read the postings on this site and I plan to implement some of the suggestions next time.

  15. It’s true, it’s like stabbing or moving sharp glass on the skin make broses…
    I agree , it might be related to perfectionists or very sensitive personalities, where we are keeping any discomforting or annoying situations inside us and not releasing or venting it out…
    We need to change our ways of dealing with life, I will keep on trying…

  16. I am 26 yr old black female, I have never had an STD or any other medical problems in my pelvic area. I have been coping with chronic pelvic pain for 7 yrs. I have had paps, 2 ultrasounds, xrays and a colonoscopy but nothing has ever been found. Here are my symptoms: Throbbing pain in pelvic area (around where uterus and fallopian tubes are) Throbbing pain in lower rectum Pains sometime occur simultaneously Pain occurs before and/or after using bathroom Pain sometimes occurs during sex or after orgasm Pain occurs often during anytime of the day (including the middle of the night which wakes me) Pain is less frequent and not as strong during and immediately after menstrual cycle. Pain is immediate after eating spicy food. Pain occurs during exercise. Pain sometimes occurs when I am stressed. There is also a sharp pain when the wall between vagina and rectum is touched during sex or when I use those muscles down there ( sneeze, got to bathroom, pass gas)

    I usually experience relief a couple minutes after using the bathroom. Bowel movements are often small though it feels larger before passing. There has been blood in stool but only 3 times in 7yrs which all can be explained by constipation or diarrhea. I have gas all the time (fortunately there no odor) I feel nauseous from time to time and some times if feel faint and sweaty during an episode.

    I believe the issue is in my rectum because that’s where the pain occurs most often especially when I need to go #2. It is also affected by some foods, though I haven’t exactly figured out all of them. I just found out about proctalgia fugax online today and I think this is what I have. It makes me feel better already to know that I am not alone.

  17. Thank you for your article. My husband is having his second episode tonight and the pain is unbearable.

    My husband mentioned this to his Doctor at his last visit and the Doc said to take a dose of his Nitro spray. He said some people get this in their lifetime at times and called it "Phantom Pain". He said it may never happen again in my husbands lifetime. Well, here is his second episode. Oh, we changed Doctor's by the way as he was very uncaring and should have retired years ago.

    So, after reading these articles, my husband will use hot compresses, try to bear down, have a hot bath, luckily he has a morphine pill to take and we'll pray it doesn't last long tonight.

    Thanks everyone.

  18. This article and all of your comments have been so helpful. I am now 99% sure this is what I have.

    I have been getting these pains for the last year and finally decided that I had better see my doctor. When I had described all of the same symptoms that are in this articel she said, "Well, I've never heard of anything like that," and looked at me like I was nuts. When I insisted that the pain was real, she sent me for a prostate exam and an ultrasound. That was three months ago and I never heard word of any test results… I had come to the conclusion that I must be having some sort of OCD attack and that I was imagining things.

    Thank you for the article… I'm certainly going to be shopping for a new Doctor.

  19. I have the same experience when I take a few days off from training. I get it back quickly, and the awkwardness does go away too. I hear some folks can come back stronger even after taking 2 weeks off. I guess it depends on the person.

  20. What a relief to have found this article and related posts. I have suffered from this for 11 years now. The episodes are more frequent (from two a year to at least 2 a week) and painful then when they started. My doctor sent me for a colonoscopy, which revealed nothing , and I have just been dealing with the pain ever since as he did not have an explanation for the pain. It is difficult for others to understand what you are going through when you are pacing around whimpering and cursing at the mystery pain. I am glad to know there is a medical term for it, that others suffer as I do, and that it is not all in my head. I find bearing down helps for a bit, then when the pain starts to cut through that, I do the opposite and tighten the sphincter, and repeat back and forth until it is gone.

  21. HI,
    I am a 22 year old female and I have had these shooting pains occur sporadically for about 4 years. I passed out at work because of it once. I think more people have this than we think, because it is considered embarrassing to talk about, especially for women. Here is the interesting part: my grandfather has them and so does my uncle (who also passed out from it). My grandfather found, through experimenting with his diet, that if he ate processed meat the pain would happen. As soon as he cut out processed meat, the pain stopped happening. My uncle started doing this and same happened with him – he stopped getting the pain. A very health-conscious guy, my grandfather has decided it's the nitrates in the meat (who knows?). I have been trying to cut out processed meats and have the cramp very rarely. When I do get it, I think back to what I ate the night before and it's usually some sort of processed meat or meat at a restaurant. After talking about this with my boyfriend, he admitted to having the pain occasionally as well. He gets it a lot more rarely than me though. Hope this helps some of you. I would be curious to hear back about whether it makes a difference or not. My pain is shooting, sometimes unbearable, never lasts more than 30sec or so, and happens during the day.

  22. Hello. This is kind of an “unconventional” question , but have other visitors asked you how get the menu bar to look like you’ve got it? I also have a blog and am really looking to alter around the theme, however am scared to death to mess with it for fear of the search engines punishing me. I am very new to all of this …so i am just not positive exactly how to try to to it all yet. I’ll just keep working on it one day at a time Thanks for any help you can offer here.

  23. I have had these for years. I read that a puff or two from an asthma inhaler helps if its salbutamol and it seems to help. I know that hot baths and compresses help but they aren’t quick enough so what I do now is I keep a hair dryer close by. When I feel the pain coming I hit it with the heat from the hair dryer, as hot as I can take it and I massage the area aggressively. I helps to shorten the episodes and make them bearable cus with the dryer you can get heat on it right away.

  24. what a great forum to read others’ experiences – thank you especially to bill… i usually sleep with one leg tucked up under me, exactly as he described. i am so glad that i may have found a solution by simply sleeping with both of my legs straight. i’m a 29 year old woman, and have the attacks about once a month – i wake up from a dead sleep and they last about 30 minutes. i finally got the courage to talk to my husband about my pain; he is an emergency room physician and immediately told me the name of this condition. he said it’s more common than people think, because nobody wants to admit this kind of pain to their physicians.

  25. This has been happening to me for quite a while now, at least two years. Exact same symptoms as described above, during the night, extreme stabbing pain deep in the rectum. Quite scary at times. Even if there is no treatment or cure, after reading this article it is good to know that the condition is not serious and that I am not being paranoid with these symptoms.

  26. OMG I have searched so many times for this and never found this condition. This started for me about 6 years ago when it happened one night after masturbation. It occured once or twice a year either randomly at night or after sexual activity, over the last two years it has gotten to the point of happening randomly every few weeks to every few months. I have tried painkillers, hot showers to no avail. I find sitting on the toilet seems to help a little, but not much. All I found before was prostate issues, but this is definately my problem. I will bring it up with my Doctor at my next physical now that it has a name!

  27. I have suffered with this sort of pain since the early nineties. It was about once or twice a year at first. Then it got to be a lot worse over the years. Now I am having this pain almost weekly, in not at least every 8 to 10 days. Last night I had two episodes.

    I have been to one doctor after another. I have had every test you can think of and I hope I never have another colon test! After the last one in 2005, I passed out and my husband could not get a pulse for a few seconds. I was very sick.

    I am so tired of this. I had an MRI again and do have several bulging dics and a narrowing spine, and was sent to a neuritis surgeon who sent me away within five minutes. So, I still have the bulging dics, and I still have the back pain, and I still have the pain in the rear!

    I looked up different things last night. I now know what to tell the Doctor about this and hopefully they can help me. I find that I can’t even stand, or sit. I have to lay on my stomach with the heating pad on high! I just lay there and cry til it passes! I have it not just in the middle of the night, it can be in the middle of the day, early morning, or anytime!

    I have emailed my family doctor and asked questions.
    I am praying for some help.

  28. Eureka, I’m ecstatic to find a name for this hideous condition. I have been experiencing this awful condition for 13yrs or more. I had mentioned (awkwardly) to my Dr trying to explain symptoms and getting quite a vacant response but as I have changed Dr’s over the yrs finally my latest Dr who (honestly said she had know idea) has taken me more seriously and sent me to a specialist who also had know idea and I am presently waiting to have a colonoscopy done, so in the meantime I thought i will have another go at googling symptoms and after many searches FINALLY found EXACTLY my symptoms – 90% of the time I am woken in the middle of the night although I have experienced pain during the day. When it comes while I am alert I no exactly what I am in for and almost have an anxiety attack also as it usually is severe pain lasting around 45-60mins. I found quite recently if I can have a bowel movement or even expel gas it relieves it greatly otherwise I have slight relief by kneeling over my sofa for the duration of the attack. The pain will leave as quickly as it comes very bizarre. I have realised my attacks are definetly stress related and started around the time I seperated from my husband and now if I am experiencing emotional or overly physical stressful occasions it will bring on an attack. Now that I know I this Pain in the Butt has a REAL name Proctalgia Fugax (still struggling how to pronounce it though :)I can confidently go to my Dr and share the info with them to help all those other unknowing sufferers out there.
    Thank you

  29. OMG- I am 32 years old with 2 kids. I have been experiencing these same symptoms for several years now and every doctor tells me it is IBS (which means I really dont know)! I feel much relief reading the posts and seeing that I am not the only one going through this. This is a very painful problem, to the point I went to the ER and was given Morphine, which only helped for 7 minutes! I was starting to think that I was going CRAZY and I think my husband thought so as well. 🙁 Today is a GREAT DAY, since I have finally found out that I am not NUTS! lol. Thanks for all the posts…

    Good Luck to all.. 🙂

  30. I have been suffering with proctalgia fugax/rectal pain for almost 2 years. It does not wake or keep me up, but is painful all day after a bowel movement. I had an anorectal manometry and the balloon could not be felt at 20cc, 40cc, 60cc, or even 80 cc suggesting neurological deficit. As of 2 months ago, I now have peripheral neuropathy in my left foot. I am so desperate for help!

  31. My son had an episode followed by synascope, causing him to pass out breaking several of the bones in his faces, he had to have facial surgery. He has learned to notice the initial symtoms and that he can not get up no matter how bad he wants to get up until the pain passes.

  32. I am so happy to have found this site, because it’s described what I am feeling to a “T” (as in nothing happening in the Toilet) It’s three am and I was awokened once again from sleep (doesn’t happen often, a few times a year – but man-oh-man – Pain in the Butt!!) feeling much like I was in labour again (four kids, no more thanks!) but unable to do much but pace around, stretch and want to hurl pillows at my sleeping husband. Turns out, I did go to bed tonight with heavy thoughts in my mind, so perhaps it’s true that stress seems to bring this on. Thank goodness for the internet, and all you brave souls searching desperately in the wee hours for relief from this!! There … it’s gone now. :-}

  33. I am a Male, 40 yrs, & have been experiencing this problem Proctaglia -F for almost 15 years without knowing what it is called & never even went to doctor though I was concerned that this could lead to some dangerous situation later.
    Today I am relieved to know that there is a name for this & many are having it.
    In my case this episode happens only when I force the bowels a bit for complete expulsion, & particularly when I use toilet within 2-3 hrs of previous visit & again if it is a little forceful. This happens in my observation if we are not taking lot of fluids.
    The usual relief is through an aspirin or a paracetamol/diclofenac.
    Recently I experienced when I was in the middle of a Ping pong game after about 90 minutes of visit to toilet, in the evening.

    For me it is usually in the night as everybody here, but again because I usually go to toilet before sleep. I wonder if PF can happen even without a visit to toilet, because not many are correlating these two, apart from sexual activity (which is not my case).

    I found kneeling with a curled back provides some relief & sometimes bypass the episode. May be this allows the muscle to contract without tension.

  34. I’m a 28. My spasms are very random (without a pattern/schedule) and always happen during the day. Mostly when I’m standing up. I could be walking and out of the blue as if someone sticks a sharp object far up my ass. Usually I would jump up and even gasp if it’s really bad. I have learned not to “jump up” anymore. But it is very painful and sudden. And just as suddenly it’s gone. It usually lasts for just a second. I will rarely get 2, maybe 3 in a row. About 3-5 second apart. That’s it. Never had one that lasted as long as most of you have described.
    I am gay and I do have receiving anal intercourse with my partner of 8 years. So I don’t think this could be an STD. However, we do not use condoms (because both of us have never had other partners). I wonder if a contributing factor could be trauma/tears to my rectum. Usually that is attributed to anal intercourse. I don’t think I have had any such spasms before becoming sexually active.
    So what about treatment options. I understand the whole taking your mind off it thing, and sitting on a towel and everything for it to go away. But what about actual treatment? Plus in my situation there is no time to react. There is just pain, as if someone sneaks up on you, and then it’s instantly gone. Has anyone talked to their doctor since? If so, could you share what their treatment plan was?
    Thanks in advance!

  35. At first suggestion of attack, I set a heating pad on “high” and sit or lie on it for a few minutes. Pain is gone.

  36. Am so glad I found this sight. Just came back from a colonoscope to see what has been causing this excrutiating pain since June 2120. My family doctor would only tell me to buy and use first, anusol, then had me try prep H. This was not even coming close to help with the severe cronic stabbing pain I’ve been enduring 24/7. Finally my 3rd trip to emerge to having a wonderful doctor finally see first hand the pain I was in, gave me a prescription for NITROL.Yup the nitrol on my ass has been my only saving grace to get me through every day since June. Now with the colonoscope done today and a diagnosis of proctalagia fungax, I will try this new prescription and hope it works wonders as the side effects of using nitrol has been unbearable head-aches!

  37. Like the above posts I too have suffered for years. I have tried many remedies and the only one I find to be somewhat helpful is to sit in a shallow and excruciatingly hot bath. I am not sure if it is the shock or distraction of the heat or if it actually helps to retract the rectum but it does help.

  38. I have been experiencing this since I was 10 years – ever since my IBS (irritable bowel syndrome) and anxiety symptoms began. I am now 21 and am a psychology student. Honestly, the best thing that works for me is meditation (mindfulness meditation) and I encourage everyone with this problem to try it! Seriously – it’s amazing how much of a difference altering our perspective on pain can make. Learning to deal with the anxiety, stress, and fear around the pain has made such a difference in my life. I used to be afraid to death of this pain, which would only make it worse and bring on my episodes. But now (after practicing meditation for about a year or so), whenever the pain does occur, I simply think, “Oh, there’s that intense sensation again… Hmm!” and go on about my business. So through meditating, I’ve learned to change my mind-set completely. I also use this to help with my anxiety and depression.

    Now I know many of you may be thinking, “Really? How they hell can you react in such a way to something soooo soo painful?” Well, I thought this too at first after I did some reading up on meditation and pain. But I began to realize that this exact label of “soo soo painful” that we attach to the symptom is what prevents the pain from subsiding. So I decided to drop this label, and just TRY looking at it as simply an “intense sensation.” So I meditated. By doing this, I took away some of the power that the pain held over me. The power that once elicited fear in me, which alwaysss made the pain worse, was gone. I realized, I hold the power over this sensation – it is separate from me. It’s just a sensation. Ever since I’ve been practicing this technique, I rarely have many intense episodes. And even when I notice the sensation coming on, I just view it as no big deal, and off it goes!

    So really, I encourage ALL of you to try meditating! You should begin to try it when you don’t have the pain so that you can get some practice in before trying it when the pain arises. I realize everyone’s experience with it is different and this may not work for everyone – but hey, it’s worth a shot right? 🙂

  39. Everytime I have gone on the Master Cleanse , which consists of lemon water, maple syrup and cayenne pepper, I have experienced the symptons of Proctalgia Fugax. One time, I actually fainted because the pain was so intense. I don’t know if it is one of the ingredients in particular, or the combination that does not work for me, but I only experience this excruciating pain when I have been on this cleanse.

  40. I cannot begin to describe how relieved I am right now to have found this website! I’m 41 and I’ve been having these for the last two years, 2-3 times a month. I’ve been too embarrassed to go to the doctors or even tell my husband. It wakes me up at night from a deep sleep or when I feel panicked about work. The pain is excruciating, feels like someone is squeezing the life out of the rectal area to the point of fainting. Hot baths is the only thing that gives me relief but it’s not always convenient when I’m at work. I will try the baby aspirin though. Thanks for the advice.

  41. Hi! I too have Proctalgiafugax it is a total pain in the butt! Butt having seen a leading colorectal surgeon for another mater she firstly diagnosed the pain for me (I had been suffering for over 10 years and no one knew what it was) and two prescribed a ventolin inhaler – yep the blue one that a lot of people use for asthma! It works like a dream for me in seconds! It has changed my life! I sleep with out fear of the pain from hell and keep one inhaler under my pillow and another with me at all times … it works in seconds and I now do not take pain killers for it – well they were mostly pointless anyway as by the time they worked the pain was leaving anyways.

    Hope it works for you too!

    Found ref to it on wiki:

    http://en.wikipedia.org/wiki/Proctalgia_fugax

    In patients who suffer frequent, severe, prolonged attacks, inhaled salbutamol has been shown in some studies to reduce their duration

  42. Very happy to see a name put to the condition. I have suffered from this since I was 15 years old – still vividly remember the first frightening event. I am now 53 and it still occurs on a very irregular schedule.
    What I do know:
    – If I drink rum I will frequently have an event within 48 hours
    – My events sometimes subside in a 1/2 hour but are usually much longer – longest one was about 10 hours and took place the evening of my daughters 11th Birthday party which I was soley supervising – 8 kids to tend to – tough night
    – Pushing hard during a BM is a guarenteed trigger
    – Stress is definately a factor – I have had events in the middle of 3 major life moments
    – Have had it several times during sex – definately associated with effort and orgasm
    – the pain varies a bit in intensity and location the BM pain is in a slightly different spot than the orgasm pain. Neither is pleasant, but at it’s worst … I would do almost anything to get it to subside
    – The only thing that ever helped during an extended event was oxycotin. I have tried several other pain killing drugs for relief including atasol 30s and demerol – no joy. I got the oxy from a guy I knew from work who is a druggie and though it worked I was never comfortable using it due to it’s reputation. It was 15% with aceteminophin and did not kill the pain but just left me feeling ok with it. Used it 4 times and once even that didn’t do the trick.
    – Get it anywhere from once a day to once a year – recently been getting it a couple of times a week, but I have been having a drink more often lately
    – it seems to be affected by BM regularity – if I miss a bm – look out.
    – I believe it is genetic – one brother has exactly the same symtoms, my sister and mother get it as well.

    I have spent alot of hours suffering with thus over the years and the fact that it is not well documented meant that the doctors that I have consulted with never put a name on it. One was even dismissive about it sarcastically asking me “well what do you think it is?” That occured after the first event.

    Anyway – hope that info is useful to someone.
    Although it is sad to know that others are suffering from this disorder, it does help to know others share my unique understanding of the “visiter” as my brother and I call it.

  43. Hi everyone,

    I have had PF for the last 10 years, I’m now 44 and each episode usually last 30min to an hour or more! Extreme bouts sometimes includes fainting too. For relief I have tried asthma inhalers without any relief but usually use heat packs or packs filled with flax seeds that you heat up in the microwave then sit on it until the pain subsides or goes away. I have also used marijuana and ingested brownies made with marijuana for relief as well. Attacks usual occur after having a bowel movement or a couple hours after an orgasm. Massaging of anal area has varied results too.

  44. Thank God I found this site. I first had this at age 30, and not again until recently– I’m 51 now. It’s happened about 5 times. The first time it happened, I lost consciousness because the pain was so intense. It started in bed in the middle of the night, a sudden, intense pain in a very specific spot. The pain seemed to be getting worse and worse pretty fast, and I felt I should head to the bathroom which was downstairs. I passed out at the top of the stairs and woke up later, at the bottom of the stairs. My husband called an ambulance and the ER docs were unhelpful. My regular doc hadn’t heard of it either. I always described it as an “anal anneurism”, and thought that the loss of consciousness had a more direct and dangerous connection to the rectal pain. Because of these posts, I know that it’s not dangerous, that I won’t lose consciousness each time and that it will pass. When I feel it coming on I draw a very hot bath and it’s usually gone in 5 minutes. Thank you to everyone who shared their experience here!

  45. Wow.. I am also glad to have found this website and the information here. Luckily before spending alot of time, energy, doctors or tests on it. In the last few months I have been having this pain after a BM that is so intense that I can’t stand up straight and no position gives me relief. It has a very sudden onset and is so intense I am almost crying from the pain. The first one lasted 2 days, the second 1 day with the help of muscle relaxers and laxitives. This last one lasted about 15 mins and I was completely confused when it went totally away with nothing but the heat from my hand. I figured after 3 bouts of it, I really should look into this. I also have been diagnosed with fibromyalgia so I am used of having fantom pains and usually just try my best to ignore the pain. This is one pain that I have not been able to ignore.

    Some of the simularities I have experienced with the posters here are: I just ate a hot dog today. Due to the hot dog I had 2 BM’s within a few hours. It has always happened only after a BM which feels like half of it got stuck. I get the stabbing/cramping pain that has been described here. I found that muscle relaxers helped during the longer episodes.

    One thing that I think may have something to do with it: I have recently had an IUD put in for birth control.. It feels like it maybe it moves into a bad spot during a BM and starts the pain.

    So once again.. I find out I suffer from a “syndrome” that really isn’t well documented or studied or known, that really has no cure, that isn’t life threatening but is life altering when it occurs. As many mixed emotions as this produces.. at least I didn’t have to wait 15 yrs to be diagnosed with it after being mercilessly poked and prodded by tests that reveal nothing. I am very grateful for that!! I will definitely not eat any more heavily processed meats!!!

    Thanks to everyone for sharing their symptoms and ideas!!

  46. For those not experienced this, the pain is excruciating!!!! It is horrible and sometimes scary. I will try the baby Aspirin trick. Also I noticed that if I lie on my right side down curled in a ball, and totally relax my bum muscles instead of tightening them which is what my body wants to do, it tends to make it more “tolerable” but only slightly so. I also find controlling my breathing and not breathing too fast helps. The worst is when it happens in public and not at night when you are in the privacy of your bed and can grimace as much as you want though mostly it happens at night.

  47. I’ve had this problem since I was in my teens (I’m now in my 30’s). At times it has occurred weekly and at other times it has left me alone for a year at a time. Most of the time it only lasts 10-20 minutes but at times has lasted up to an hour and has been excruciating. What I am most certain about is that it is stress-induced. My dad also suffered from this problem so it appears to be genetically linked.

    I’m one of those who had to search for a doctor who cared enough to help me find some sort of solution, and he seemingly did! He prescribed an Albuterol inhaler. He told me it seems strange but assured me that the muscle relaxant pumped into the lungs is quickly absorbed into the blood-stream. Whether or not this was meant to be a placebo, it seems that it often helps and I’ve been using this method for about five years. Perhaps this will work for others.

  48. I’ve suffered this agonising condition [on top of severe ibs pain] for years. Over the last year it has become much worse. The pain makes we want to scream at times- it’s pure torture. I haven’t yet tried Salbutamol [a friend has given me a spare inhaler], but I’ll give it a go next time the pain lasts for more than a few seconds. It’s good to know that others share my pain- if you understand what I mean!!

  49. Thanks for a place like this to share stories. I liken the pain to birthing a baby , but through the rectum. It first occured in me about 10 years ago and I have had periodic episodes ever since. I have no IBS, no do I have any other health issues that would lead to this condition. I do find that If I sit for long periods of time, I get pain in the cocyx, followed by the rectal spasm. Walking helps me. I do have a high stress job and I am a relatively high stress person, so I have had to learn to relax through the spasm. I take Tylenol, too. Sometimes it helps, sometimes not.

  50. I have found that taking Psyllium Husk daily, mixed into a glass of water or a shake, significantly reduces the occurrences. It works wonders! When I’m faithful to the Husk, life is good!

    I highly recommend you give it a try. You can buy it where you find bulk foods, in stores like Sunflower or Sprouts – and it’s pretty cheap.

  51. I’m so glad I came across this website. For so long I’ve been wondering why I sometimes feel like my anus has been turned into a kabob or held up at knife point. The pain is random and intense, but in a bad way. I have never found a cause for the pain personally. I’ve been suffering from this since I was very young and kept it to myself. This is so liberating to discover that others have the same condition and experiences as I. Kind of like coming out of the closet or confessing to a murder…. ah I’m soooo relieved!

  52. This should help a lot of people… I’m a male and have been suffering with this for over a year now. It got so bad that my pelvic floor was tightened to the point where I had to use enemas to defecate, and could not go without them. I also have a nonrelaxing puborectalis. I go to a physical therapist once a week for one year. She massages my pelvic area and rectum (digitally with her finger).

    This is what has really helped (in two very drastic phases).

    1. Compounded Suppositories with Baclofen, Lidocain, Valium.
    2. Botox injections into the puberectalis and pelvic floor(coupled with an anti-imflammatory steriod). I searched far and wide for a Dr in the states who would actually do it. Here’s his name.. Dr. Winston in San Antonio, Texas. He’s a colorectal Dr.

    You will have drastic improvements with these two things. I did need both.

    Also sitting on a heating pad helps. Hot baths help, but not as much as the heating pad. Nifedipine ointment can give mild relief as well. But if you have really bad, get the suppositories first, if they don’t 100% do the trick (they will help though), then get the botox injections.

  53. I forgot to say.. eat one apple every single day. They provide anti-inflammatory qualities and a source of fiber. The apples should be organic because you’ll be eating them daily and should avoid the high concentration of pesticides that are heavily used on apples… seriously, get organic (they taste better too). I also stay away from Lactose and Gluten… but that’s just me. You might not have to.

  54. I also forgot to say that the pain was so bad for extended periods that I couldn’t get away from it and contemplated suicide. If it had not been for my children, I probably would have. I felt like I was being raped by a bull and heavy narcotics weren’t an option as they cause constipation.. which I already severely had.

  55. Thank you God, as I have been praying every nite for an answer. I have found so many angels on this website. I have been to 5 different doctors with no clue as to what I have. In two days I will have a colonoscopy after having a previous anal manometry. Doctor still hasn’t told me the report on that one yet. I have also been scared to thinking I might have cancer (Farrah). But I always have to remember how this all started. The first time I had IT was after I took Miralax for constipation. I can’t remember for how long I had it, but it was for months. My husband had had a pancreatis attack at the time, and I guess now, I thought a miracle had happened for me in that the horrible pain I was in, suddenly just went away. I suppose my mind was just on him since I did not know if he was going to die right then and there in the hospital. That was 3 years ago. The next time I got IT was late Feb. 2011. I have only had relief for 1 day in 5 months. Yes, Bob, I can very relate to you. I also contemplated leaving this world as I am so exhausted and depressed from the pain. Only 4 hours or less into the day I will not have pain, if I am lucky. I cry almost every day. This pain started when I stupidly thought I would hurry things along, using a fleet glycerin suppository. That suppository immediately brought on a horrific spasm, which I am now wondering why they would put such a thing on the store shelf. I try to describe to my sister and daughters the horrible pain. The closest thing I can find is if you have had given birth naturally and had an episyotomy (incision made by the doctor before delivery, for you guys) and the incison never, never, never, heals up. Very painful. The episyotomy is worse than the birthing as the pain last for at least 2 weeks with no relief. I had over 30 stitches. Yes, the pain goes from one end to the other. After trying to describe my pain to my gastro dr., after examing my rear, he said he could see no reason why I should be having that much pain.All he said was, “I’m sorry for all your pain”. And also”, you shouldn’t have put that suppository in you”.No —-! I thought to myself. And then he commenced to giving the nurse orders for the two tests I mentioned. Thanks to you all so much, as you made me laugh and have hope. I will try all the remedies you all offered. I have already tried most of the creams you mentioned and the heating pad and ice pads and asscilces and hot baths, etc. One thing I did that really seemed to help was rubbing Blue Emu cream all over my rectum and my butt, hips,groin area and any where I might feel pain after a hot bath or shower before going to bed. You see, I have chronic pain from having back surgery 20 years ago, and also using my TENS unit and taking Klonopin for my muscle spasms. And also tylenol sparingly as I don’t want to eat my liver up over this. I will definately tell my gastro dr. about this PF syndrome. I now have a name to give the MONSTER. Thanks, for letting me know this is real and I am not crazy. How many are of us are out there and am embarressed to tell?

  56. I have the shooting knife-like pain that comes on in the night or the odd time sitting on a hard surface. Comes on very occasionally.
    I’ve found taking the homeopathic remedy ‘Aconite’ 30 eases the pain very quickly. I really try not to go out without it.
    Recently didn’t have it with me and walked thru the pain which eased and didn’t get worse.

  57. I am a 52 yr old white male that has been experiencing this for 20 years plus. After consulting with 3 or 4 different doctors with negative results. Finally my fiance googled the symptoms and found what it was and how many other people it has affected. My episodes last about ten to twenty minutes, thirty max. I read where some people recomended anti inflamatory, muscle relaxers, and pain meds. My pain would be gone before any of these would take effect. Then in my younger wilder days I remember trying (N2O) Nitrous Oxcide from a seltzer bottle. This works immediatly, and makes you totally relaxed which I believe will help relax the spasm. I haven’t tried this yet because my fiance just discoved what this was. We are on our way to the head shop to see if we can still buy the Nitrous Oxcide (whippits), and we may have to wait two months before I have another episode to try it. So if anyone reading this is game, you may be able to try it before I have another episode. I do believe this will work. Anything is worth a try when you experience this excruciating pain.

  58. I had my first attack when I was 10 or 11. Try explaining that to your friends….so like many others, I never did. I keep this little secret to myself for almost 40 years. I will be 50 next month and continue to have these pains. I had another attack last night. Because I had found a similar site a couple of weeks ago, when I was woke up once again and could not bear the pain, I had some idea of how to get relief. Looking for the quickest and easiest form of relief I use a hot washcloth as a compress. As hot as I can stand it! It seems to give me enough relief so that I can get back to sleep but in the morning my butt still aches. (Just a dull ache, but an ache non the less. Feels like I am recovering from a swift kick in the butt.) I finally got up the nerve with the last attack to tell my husband. It was so embarrassing and of course he strongly suggested I go see the doctor, which I haven’t yet. It seems like the attacks are coming more frequently the last few months, but if there is no cure ….and obviously I have been living with this a very long time, I think I will just try a few more of the recommended remedies suggested here and hold off on seeing the big DR. Like so many others have experienced, I am tired of the unknowing doctor blaming everything on IBS… Good luck to all my fellow suffers. Sleep tight, ( or should I say relaxed) and God bless us all!

  59. Here’s what works for me, sometimes: I press down hard on my thighs with my straightened arms for as long as the pain continues, or until my arms fail. Somehow, the stretching of the lower back (and possibly the spine) can relieve the pain. I haven’t ever seen this in the literature or comments, so it might be just me. Anything that seems to work, though, is worth trying.

  60. Try THIS during your next proctalgia fugax/rectal pain event:

    Straddle or sit on [like on a saddle] the narrow part of a bathtub edge to put pressure on the nerves and muscles around your anus, but well between your hip bones. It works. This was recommended to me by an on call nurse at Group Health in Seattle, whom I never got to thank. So thanks! It stops the pain in a minute or two.

    AND, when traveling, I take the very thick cardboard inner tube (it’s 1.75″ dia. & you can’t crush it) from Costco’s [Kirkland] brand of plastic wrap with me as a surrogate to the bathtub edge. If I have an event, especially on an airplane, I have discretely taken the tube out of my camera bag and just sat on it for a couple of minutes to take the pain away. Sounds weird but it works. Plus, TSA has never asked me what it’s for.

    Med schools need to train doctors on proctalgia fugax, as with most people, I have described this condition with exacting and excruciating detail with little or no response from our general practitioners.

    The only doctor to nail a diagnosis of it on my 1st visit w/ him was actually last week, and he is an older neurosurgeon.

    Good health and luck to all,
    Marcel

  61. I am an 60 year old male. My first encounter with this condition was while driving, at the age of 17. Very sharp stabbing pains moving me around in the seat, lasted about 60 sec. Very scarey, almost had to pull over. Very rarely get them like that anymore and never have had very many like that again. Now like most I wake up in the middle of the night with the intense dull aching pain that will not subside if I continue lying down. I also sleep on my side with a leg pulled up and the other straight. Does not matter which side with me. I get these randomly maybe 15 -20 times in a year. The episode will last from 10 to 40 minutes. Once the pain starts I can not will it away, I must get up, I can not just lay there and take it. I find the sooner you get up the sooner you can get it to go away. Also with me reaching orgasm too quickly during sex may trigger an episode, or it may not. I also have not found a doctor that knew what this was, even my Gastroenterologist, nor did any of my family have this that I know about. For me relief can be achieved by tricking the body to send blood elsewhere by doing some exercises (squats usually) and walking around or sitting on the toilet and rocking back and forth or sometimes curling up in a ball, knees to chest and hold it, If I return to bed before it completely subsides it will start over again. I will try the heat method next time. So glad to have found this site and thanks to Dr. Bharwani and all who have commented. Looks as though we can look forward to having this for life. Will be just wonderfull to be 90 and have to get up with this, ha!

  62. This is something I have I have been suffering from for almost 20yrs now! I also went to the Dr. only to get a funny look and no answers. That response from the Dr. made me leary to go through medical testing. I just knew they would run all kinds of test on me just to come away with “we really don’t know what’s wrong”. I kept telling my husband if it was serious it would have already killed me! I ended up self diagnosing and figured they were just bowl cramps. But painful!!!! I have passed out from them. Mostly I get them while sleeping but have experienced them during the day. I have had to leave work twice over the years. I have learned to control the pain through trial and error. Hope some of my suggestions help others as this condition can be very scary at times.
    1. when an episode starts to hit me in the middle of the night I can usually feel it coming on. I try to relax my body as much as possible. I guess you can call it meditation but I just really try to relax and take some deep breaths. A lot of times this will make it go away. If not then I will usually have to get up and pace for 20 min.
    2. I think diet has alot to do with it. To much red meat, cheese ect. will cause episodes
    3. Drink plenty of water (which I don’t do and will have more epispodes)

    I’m going to try the baby asprin and Inhaler to see how that works. Thank you so much for the suggestions! I printed this article out so my family and Dr. will know what’s going on when I do have an episode.

  63. I started noticing my symptoms about 8-10 years ago and it always only happens during my menstrual period and the pain appears right before my bowel movements. The pain is so severe but as soon as I have my bowel movement, the pain disappears. The worst episode was right after I had my appendectomy in 2009, we went to Key West a few days after my surgery, I had my period while we were in Key West and the pain started while in the car on the way home from our vacation. The pain this time lasted for a few days. It is the most excruciating pain I have ever experienced and for a few days, I couldn’t even sit at all and all I can do freeze & scream in horror as the pain arrives. I saw 3 doctors including my surgeon who did my appendectomy but no one could tell me what was wrong. The pain slowly resolved itself after a few days. I haven’t had another episode until yesterday. This time around, the pain woke me up from a sound sleep, the pain started at end of my period and it lasted all day yesterday and this morning. I will be making an appointment to see my PCP so that I can be referred to whoever needs to see me to rule out other problems (I am definitely convinced that Proctalgia Fugax is what I got). Oddly enough, they seem to be a common problem to professionals, managers & perfectionists?. I was all that at one time when my symptoms first appeared. I’ve been a housewife with no children since 2005.

    I just wanted to share this information with you because I am 100% sure that this is my problem although I think I should see a professional to rule out other possible problems. My pain lasted all day yesterday. The pain subsided from 15 minute intervals to 30 minute intervals with the help of 2 Aleves, 1 glass of Fiber, 10mg Alprazolam & I slep on a heating pad (I did not take these meds all at same time. They were spread out throughout the day). Last night, I woke up twice in the middle of the night with the pain and I took 2 tabs of Tylenol at 5am. Had my 1 cup of coffee this morning and took my morning supplements. I had an attack prior to my first bowel movement of the day. I took 2 Aleves and so far……it looks like the episodes had stopped. I only feel a mild residual pain right now. I will describe my pain as……someone just shoved a samurai sword up my ass and is wiggling it around, a bowling ball is trying to get out of my ass, someone lit a dynamite and shoved it up my ass and it is exploding inside me. Bottom line “it’s huge a pain in the ass”!

    Definition

    The term “proctalgia fugax”, a Greek–Latin hybrid term was coined by Thaysen in 1935 [16], and the condition was more firmly defined then as

    1. Attacks that begin suddenly at irregular intervals during the day or night.
    2. Pain spontaneously disappears without leaving any ill effects except a quickly passing lassitude.
    3. The localization of the pain in the rectal region is always at the same place.
    4. The degree of pain is so severe that some patients feel faint during the attack (no shit! :-).
    5. The duration is short, continuing for only a very few minutes in most patients.
    6. The pains are very uncomfortable, often described as gnawing, aching or cramp-like.

    The pain has been reported to be precipitated by sexual intercourse, masturbation, stress, defaecation and menstruation although it can be largely without a trigger. Conversely, other authors report that it is independent of evacuation. There is also a great variation in the length of the pain from a few seconds to 2 h. The average duration has only been reported twice as 15 min and occurs less than five times per year in 51% of patients.
    Presently, it is very clearly defined by the Rome III Criteria as recurrent episodes of recurrent episodes of pain localised to the anus or lower rectum which last from seconds to minutes with no anorectal pain between episodes. Proctalgia fugax is differentiated from chronic proctal- gia, also a functional anorectal pain disorder based on duration, frequency and characteristic quality of pain. It is necessary to exclude other causes of anorectal pain such as haemorrhoids, cryptitis, ischaemia, intramuscular abscess or fissure, rectocele, malignancy and inflammation and to differentiate from other urogenital and pelvic pain disorders when making the diagnosis, and this can be done successfully with the criteria defined.

  64. I am so glad I found this site! I’ve had this for over 30 years now!

    And a big thanks re: baby aspirin! I had the start of an attack a few weeks ago and took two….just melted them on my tongue. In a matter of minutes it felt like someone flicked a switch. The pain was gone.

    Thanks again!

  65. Funny I found this site while suffering through an attack as we speak. This is about my 6th in 6 years so not too often, I am 34. I thought it may have been dehydration.

    I fainted once for 5 seconds luckily as I was falling into a bed. Another time got dizzy and very close to fainting. What a weird penetrating pain, ouch.

    Anyway, the nitrous oxide should work, I am going to put 4 bottles of whip cream in my refridge for when this happens again. That stuff relaxes your whole body and fast. I will post back if/when I try it.

  66. I seem to have the same problem. I am 32 yrs old female and the first time I got this was 6 months ago. I was in a hut in the mountains. I thought I am going to die there. After that I had 2 more attacks. Each of them happen for me when I am on my period. Also happens after sitting down of a not so soft chair and standing up. First it begins with a knife cutting pain in my lower abdominal area combined with my bum, as if I need to go to have a BM. I go and sit on the toilet and it gets worse – nothing comes out and the knife cutting gets so intense that I think I am going to faint any second. Last time I was close -everything became white – but maybe I was too scared and was breathing wrong. After 2 visits at the emergency, blood tests and x ray nothing was found. My attacks usually last for about 2 hours and then the stabbing pain transforms into a dull ache and radiates all over my tummy and stomach (still very uncomfortable especially during movements, lying down, standing up, etc).
    This dull ache lasts then for about a week.
    I have no idea what triggers it – the only similarities of these 3 attacks were:
    day 1 or 2 on my period
    standing up from a hard chair
    thinking heavy thoughts/ being worried/ stressed
    The 2 months where nothing happened I was taking magnesium for about a week – as my period cramps are usually really bad. I know for a fact that magnesium has helped me get rid of very bad calf spasms over night. So today I am on my period again (after the last two months I had attacks) and I have been taking magnesium. So I really hopes it will work.
    Other things I have tried during these attacks- while I had no clue what was actually happening with me:
    Buscopan (cramp relief drug) – small relief –
    Baking soda – small relief – thought it will help pass gas or BM
    Clonazepam (anxiety drug & muscle relaxant) – small relief – took it because I was freaked out
    Novaminsulfon (= metamizole – powerful analgestic drug) – good relief of the stabbing –
    Walking – once it helped – the second time: not at all
    Drinking water – once – it seemed to have helped now that I think about it

    I have also hemorrhoids and been wondering if this affects the severity of it? since many of you seem to have shorter attacks and then it’s all gone.. while I suffer from the “aftermath” for about a week…

    Hope the Magnesium idea helps for me now and for you all – it certainly won’t have negative effects. Only one thing, make sure you take it daily!! (300-400 mg dose) and 1x day and after a meal, otherwise it could cause some pretty bad (not long lasting) runs! 😉
    So great to read all your stories – I will try the bum pressing, the aspirin and the meditating and maybe the hot bath – but I pray I won’t have to!!!

  67. Wow I am so happy to read all this I have tried most of the tips before I have sat on the toilet at 2 am crying with so much pain hoping my girl won’t hear me! Nice to have a name!!!

  68. Mine started about nine years ago when a certain hard-seated stool came into the house. Sitting on it–especially in front of the computer–relieved some lower back pain, only to be replaced be this excruciating cramp deep in my rectum just behind the tailbone. They never last more than ten minutes, but once when I insisted on getting up to go to the bathroom (even though I knew from past experience that no bowel movement would happen), I fainted twice, once in the bedroom and then in the bathroom– as others have stated, this is probably the most dangerous aspect of the issue: sinks, bathtubs, etc. are hard on the bones! Anyway, through various sites I figured out that sitting on that stool and perhaps the racing saddle of my bike triggered the attacks. I will also note that stress does seem to be a factor: the last two times these attacks occurred, I had given up alcohol for the day–we live in a winemaking region, and those few glass of red wine at the end of the day were my stress releasers.

  69. Fellow sufferer here. I have had bouts since about the age of 17 (I’m now 55) sometimes twice a year, sometimes twice a month. Most often at night but once in a while during the day at work. I am afraid of it happening at work as fainting from the pain can be an issue for me. In January 2006 I fell down the stairs at home and broke my ankle while trying to get from bedroom to bathroom (for a hot bath) during an episode. Husband has anti-spasmodics for a condition of his and if I take 1/2 a pill immediately upon feeling pain it seems to lessen the severity and duration. Hot bath with pressure (sit hard) seems to help or make it at least more tolerable.

    Today I had a rare midday episode at work and could not talk myself out of it becoming major. I ended up sitting in a toilet stall, not to do anything other than keep myself from fainting. The pain was excruciating. And then it goes, leaving just a tiny rumbling in its wake. Most episodes of mine last for around 20 minutes, years ago it was only 10. Today’s attack was a half hour.

  70. I am so glad to find this website and see all these replies. My daughter whom is 16 has been having these episodes about 2years. The first doctor prescribed her some Miralax and Stool softeners. She doesnt have any issues with bowel movements or constipation. The “ATTACKS” come along in the middle of the night while she is sleeping. She had an episode last night which lasted about 20 minutes. She also sleeps with one leg up and one leg down. The second Doctor prescribed some antibiotics for a bacteria infection maybe. She asked my daughter was she sexually active and my daughter told her no. She just could’nt believe that so she asked me after my daughter left out of thr room. I told her no. My daughter and I talk about alomst everything. I think she was believing from the symptoms my daughter had that she had an STD. So my daughter had to get a pelvic exam and a pap smear before her and she was almost traumatized by that. When I think about it, I had an episode a couple of times. Last year I was sleep laying in the bed and I got that sharp pain. It was so exruciating Icouldnt lift myself out of the bed. It was so bad, I felt like I was going to faint. My son was about to take me to the ER. I had him take me to the bathroom and I sat on the toilet for about 20 minutes feeling like I was having labor pains. I finally had a bowel movement and it felt a little better. But I was so weak after that. I cant wait until my daughter gets home from work to read these responses. She is going to feel so relieved someone knows what she is talking about and can relate.

  71. To Tisha’ This is Shirley, my first bout of rectum was when my doctor also recommeded taking Miralax. When I told my doctor of the pain and like something hanging out my rectum, she said , oh, you took too much, needless to say, I thru out the Miralax. Never took it again, but episode came back 2 yrs. later. Don’t know what really set it off. I just went to a dr. spealizing in pudenal nerve entrapement and they gave me a ct guided steriod injection with lidocaine. It felt like Christmas for 4 hrs until the lidocaine wore off….. I’m still waiting for the steroids to kick in , this is day 2. Try to keep regular, magnesium really helps with that. Hopefully her pain will go away on its on as mind did 2yrs ago after about 3 months. Pray it don’t come back, it was extremely worse the second time. Take care.

  72. Proctalgia Fugax……I have the best pain releiver/cure for this debilitating pain!!!!! Really it works… Yea ha. Use a vibrating massage machine! One like a hand held type. Yes sit on it or use it over the anal area and crank it up. My husband gets this pain and so do I. A friend gave me this machine as a gift to massage our backs.LOL One night when the pain suddenly appeared as it always does I used it on my butt and 5 minutes later the pain disapeared! Beleive me I have tried everything and this is the quickest.
    I used to roll my butt over a tennis ball or a rolled up towel but this works so much better!!!
    Best of luck, try it!

  73. I had one of these phantom pains the night before last. It was a little more a dull pain than usually when I get them. They start always when I am asleep. Usually I get up and take a bath as hot as I can stand it. If the pain persists, I got back and do the bath again. Night before last though I had taken some over the counter sleep medication and it took enough of the edge off of the pain to manage to just wait it out. Of course I wasn’t sleeping through it, it would be like sleeping through a labor pain. It isn’t that it is located where labor was in me when I had children, but it is just as persistent a hard pain and there is not ignoring it.

    It feels like I had the hardest bowel movement in the world but instead of it being dry the next morning, I have a normal bowel movement. I am mostly vegetarian but have eaten some meat lately which I am determined now not to do soon again if at all. It is hard to maintain my regimen as I am the only one in my family who is vegan. It feels like the bowel movement turned sideways. Perhaps it did. But the duration of my pain always seems to be about an hour. I may not get another one of these pains for months or even a year.

    I have a desk job and I frequently sit at my desk in the evening too. I think movement is therapy, and is something I must do to avoid this monster pain coming back. This time it came in conjunction with days of insomnia and migraine headache from the lack of sleep. I have taken so much Execedrin Migraine medicine that this might have had a trigger effect on this pain. I also have at this time a boil or carbuncle on the right check of my buttocks but not near enough to have formed from leftover feces after wiping clean. It is subsiding now.

  74. Thank you so much for the reassurance, I’ve had this pain on and off for years. The attacks have almost always come at night, they have been lasting longer recently. Will check it out with my doctor sometime soon. Thank you for all your comments, makes it a bit easier to deal with it knowing you’re not the only one!!

  75. Thank you for the article. I’ve had the pain many times. I find that eating too many oranges or nectarines brings it on for me. I also sometimes get it after sex when I feel as if my rectum remains open. Often my erection also remains in place for some time. I lie down on a cold floor and just wait for it to pass.

  76. You people are so lucky, you only have these spasms once in a while.I have had Levator Spasms for the last 19 years. I have these spasms 24/7/365 days a year. One night I was laying in bed and I had one of these spasms and it has never went away. I was doing a search on the internet one evening when I came across a forum called Tipna.According to the information on this site,Levator Spasms(and Proctalgia Fugax) are caused when the Pudendal Nerve gets inflammed or entrapped. The Pundendal Nerve runs vertically down each side of the buttocks near the butt crack.Botox injections into these nerves provides some relief,but only for a short time.I have tried everything but surgery.People who have had this surgery claim they are 50%-75% better.I really don’t like the the idea of being cut on, but I don’t like the idea of living the rest of my life feeling like I have a golf ball in my butt!

  77. I have had this problem for at least 15 years. My son was seeing a gastroenterologist for crohn’s disease type symptoms, and in discussing my son’s symptoms, after I described my own, he instantly said, “You have proctagia fugax.” The symptoms are exactly what others describe: an excruciatingly sharp, stabbing pain in the rectum. I always have described it to my husband as “that pain I get”. My episodes almost always happen in the night, waking me up from sleep; but I have had it happen at other times of the day as well. It is absolutely incapacitating; all you can do is try to survive until it goes away, which usually takes about an hour. As someone else above mentioned, it subsides as mysteriously as it comes, and I may not have it again for six months.
    I have found that the biggest contributing factor for me is not drinking enough water. If I drink a minimum of two large glasses of water every day, plus take fiber in the morning (I use Benefiber), it seems to prevent episodes. More water is even better (like 4-6 glasses). If I go a couple days not drinking water, just drinking tea, coffee, juice, etc. (especially when we are traveling and it’s hard to get enough water), I can pretty much predict I’ll have an attack.
    When I do get an attack, I immediately get out of bed and take four, 200 mg Ibuprofen, and within 15-30 minutes the pain goes away. However, 15-30 minutes is a long time when you’re in this much pain, so prevention is important.
    I also agree with the comments about feeling like if you could have a bowel movement, it would alleviate the pain; but it never does. However, just knowing what my condition is, helps so much; plus reading comments of others describing exactly what I go through; thank you all for posting!

  78. P.S. – I also believe that it’s genetic, because I have two sisters plus an aunt who describe the exact same symptoms. I think it’s way more common than thought, because as you said, most people who have it never tell anyone. I never told anyone for years about it, except for my husband.

  79. I’m a 39 year-old male who’s experienced this at least monthly for the last twenty years. It’s exactly as the others have described. I wake in the middle of the night with shooting pain coming from my rectum. It lasts about 20 to 30 minutes. It’s excruciating, totally debilitating, and wall-pounding agony. At first I thought it was constipation so I feverishly tried defecating….felt like I was trying to shit a bowling ball. It took me about 5 years, but I slowly realized that this just made it worse. I can’t identify a pattern or cause, but will take into consideration the other commenter’s ideas. The only thing I’ve found that helps is to distract myself by reading. My only condolence is that I now know the technical name (although I can’t pronounce it) and that I’m not alone…..and that (for me) it never happens during intercourse! That would put a serious damper on the festivities.

  80. Thank You Doctor for spreading the word on this.

    I am here to discuss other methods that help me and may help others..
    For me I discovered that I was Gluten intolerant. When eating gluten the little silia fingers in the intestines that are there to grab nutrients from food get matted down. The body then sends antibodies to attack the Gluten grain and treats it like poison breaking it down in the gut too early.
    This causes severe gas and bloating and a lack of Absorbtion of vitamins and minerals.
    For me I was becoming deficient in Magnesium.
    One of the 300 things that magnesium does is relax muscles.
    The right balance of Magnesium versus Calcium is the Ying and Yang of the Body.
    Since I was being depleted of Magnesium my level of Calcium which tightens cells was taking over. Magnesium also helps with bowel movements.
    So needles to say here is the cause order of events:
    1. Ate Gluten
    2. Became Magnesium Deficient
    3. Became Chronicly constipated
    4. Developed a Anal fissure from the constipation
    5. Having a Anal Fissure causes the anal region to spasm because the
    body is trying to protect itself from the fecal matter cutting itself.
    6. Spasms then become chronic after BM
    7. Developed External hems from straining
    8. Thought of Suicide several times.

    Here was the Solution for me.
    1. I had a LIS proceedure
    2. Went on a Gluten Free Diet
    3. Started Taking Magnesium Supplements
    4. Pain and discomfort 90% better
    5. Still have spasms occasionally after sex
    6. life is better

    Recap Magnesium deficiency may be a epidemic
    and so may be Gluten Intolerance or Celiac Disease.
    Please look into it and help more of your patients.
    It only took 3 days after not eating Gluten to change my life.

  81. Try this. No joke. After having this a few times, and being a physician, I knew (or thought I did) what the problem was. PF is much like a cramped leg muscle, which stops hurting after you stretch it out. I had my wife glove up, use lube, and and insert her finger into my anus, pressing down in all quadrants. I experienced almost immediate relief when she placed pressure on the 6 O’Clock(anterior) region(as viewed from behind). 20-30 seconds of this relieved my pain. Many people would be uncomfortable with this idea, but if you hurt like I did, they would not care if it gave relief. This is not written for any reason other than passing along another strategy for a condition that may otherwise not respond to anything. I have never had to use this on a patient, but you will find in medical literature that the treatment is, in fact, forced dilation of the anal sphincters.

  82. My wife got the huge pain in the butt right after we had sex. I found online that it is possible for proctalgia fugax to be triggered by an orgasm.

    I also read that caffeine might help, so next time it happens I’ll make her a strong espresso.

    Dr. B, thanks for your article!

  83. I have had periodic attacks of Proctalgia Fugax for about 15 years. The longest has been about an hour and the most severe resulted in passing out. I feel that for me I have found a direct connection to the amount of white flour ingested. If I am only eating whole grain and high fiber foods I often go many months (the longest has been a year) without an episode, however, an attack is often followed by a dinner or two of white flour pizza or pasta, or if my general diet has swayed more towards lower fiber foods and highly refined grains.

    I have found that I can greatly manage the pain until the cramp fully subsides by alternating series of sit-ups (hands in front not behind the head) and gentle rocking on a carpet or mat. I take two Advil the moment I awake with the cramp and begin the sit-ups. Usually relief is in about 30 minutes. Thanks to everyone for sharing. I had all of the tests to rule out the various more serious possibilities and was fairly worried until I found this condition through internet searches. I am writing this at 2:00 in the morning after a fairly severe episode – but a fantastic pasta dinner. I won’t share the recipe.

  84. Thanks for the info. I was just speaking to my father earlier today about how I have those same pains in my rectum and I how I was going to go see my doctor about it asap so that she could recommend me for a rectal exam. As I was sitting here googling to find any possible explaination for the “stabbing pains in my butt” I’ve been experiencing for the past 8 years, I began to have an episode. Oh God, it’s horrible. As I read more and more of the previous comments, it began to diminish. The sudden pain usually lasts no longer than 2-5 seconds and I normally have them about twice a month. I’ll generally have the sharp pains for a period of 5-30 minutes and they subside. I’m going to speak to my doctor next week, so I’m soooo happy I’ve found a name for the condition. Thank you.

  85. Phew! I’ve been having similar ‘episodes’ for about a year now and in fact, the past three days have been almost unbearable due to the sharp pains! Just when I decided to finally go ask my doc about it, I found all this info. Sitting, standing and walking, everything seems so difficult. I need to ride a bike to work and that half hour ride makes the entire day extremely uncomfortable. Even right now I can feel intermittent spasms that seem like they’ll make me pass out. I just pop a painkiller to try and feel like I’m doing something about it (not always effective). But I’m beginning to understand the ‘pressing down’ option and it makes sense. Thanks a bunch for this. Feel loads better!

  86. I had one of these excruciating episodes last night that lasted about 20 minutes. I’ve tried hot baths, sitting on the toilet etc & have found no relief!This only happens to me while I’m sleeping. So happy to find this website & understand this awful condition!Not sure how to say this tactfully but here goes……i was in such pain I felt that I needed to push the knife stabbing pain to release the pressure. I had my husband put his finger in my rectum. He could feel that it was actually in a spasm. Great news….after about a minute of the pressure he appliedI hopped in the hot tub & it completely went away! Over the past two years I haven’t found anything that significantly helps. Hope this can help thers!

  87. Male, 37. I have suffered from these symptoms for 19 years now, over half my life. I have more or less ruled out food by keeping a very strict log of everything ingested and eventually ended up with no discernible pattern. Like a few previous mentions, my bouts seems to occur during times of heavy stress and when I allow myself to become dehydrated. My bouts typically last exactly an hour, most often waking me from sleep or occurring after an orgasm. I have learned to recognize some warning signs before a bout and I can usually lie a different way or hop out of bed and pace, allowing me to skip a bout. Attempting a bowel movement usually brings on more pain, but there have been a few times that I managed it and the bout duration ended early. What I do to avoid a bout… always try to sleep on my back and if I do sleep on my side, I don’t bring my knees up in front of me at all. I have actually successfully reproduced a bout on purpose by pulling my knees up close to my chest and sleeping on my side. I can do this almost anytime I want, which is never, but it can be done purposefully. Also, if sex with my partner doesn’t happen, I masturbate. I have found that the stronger the orgasm, the more likely it is that I’ll have an attack. And to keep strong orgasms infrequent, a daily orgasm tends to do the trick and it’s good for my prostate anyway. The good news is that as I get older, both the bout frequency and pain levels are greatly decreasing.

  88. I’ve had these excruciating pains since I was about 7 or 8, all my life (I’m 62). I have them at night, and during the day (when something stressing happens or something very irritating).

    I found a fool proof method to almost instantly get rid of the pain (well it works for me when I can manage it). The trick is to get your self to the toilet and pass faecies, even a little bit will fix the pain. Sometimes just passing wind will do the trick. I’ve found that even the process of ‘straining’ whilst seated on the toilet will relieve the pain as you do that.

    If you can’t manage that sitting on something like a tennis ball can relieve the pain. Someone (writing above) suggested sitting on the edge of a bath.

    It’s a terrible pain and in me comes and goes in waves for 20 minutes to half an hour if it were to go its full course. But I haven’t had to let it run it’s full course for a good 20 years.

    I found out the name today. Only my oldest friend and my brother has admitted to experiencing this. Why the silence?

  89. i have what is called proctalgia fugax and if you ever had a bee sting imagine having hundreds sting you in your rectum a one time constantly.and feel like they are crawling around thats what it is like it will make your nerves on end it is the horrilest pain you could imagine .i have been on muscle relaxers pain killers nerve pills and all they do is make you drowsie .if anyone knew anything else .i go through this aleast eight hours aday i have used everything there is .to no avale.

  90. Very helpful article. I guess I am the minority male sufferer of this condition. I had hemorrhoids for over 2 decades, I always thought this pain was caused by my hemorrhoids. I had the hemorrhoids removed couple years ago and the pain still wakes me up in the middle of the night a few times a year. My doctor told me about this term proctalgia fugax and your webpage put my mind at ease. Thanks.

  91. K ive had this for ten years im 35 and a dude in perfect health. I have found a way to push the pain back where it came from as is randomly shows up and and quickly raises its volume. I suck my anus in as the pain comes. The best way to do this is to pace this action with the speed of the on coming pain.(if that makes sense). For me by sucking in my asshole as the pain tries to stab me it muffles it. Then i begin a short back and forth anus flexing tug o war lol. (I’m serious). I get a small hint of the pain that could set in, but i never allow it to really stab me good.(only people who have this problem will understand this). I just won a war with it while i typed this and its over i think now. I havent had this happen in about 3 months btw and sometimes it will go away long enough for me to forget about it(6months or longer). Learn to flex your anus the right way and u can naturally fight this thing off. lol I’m serious but this sounds a bit strange

  92. Maan-oh-man!..thank god for this..I was so scared that I had something serious. This pain is/ was so unexplainable. It’s the worst pain I have EVER felt in my life. Just like everyone says, like a knife pushing something in and out at the same time. I get this wave of fear,anxiety and start sweating, begging god to help me! Ive been going thru this for about 15 years on and off. But the frequency and painfullness has got worse.. I use to think I had a high pain threshold.. But as the pain has gotten worse and the duration is longer I may just pass out from the pain because the episode I just had was unbearable. I WANTED to pass out just to exscape the pain, which led me to the internet determined to find out what this is! THANK YOU SO MUCH….

  93. Male, now 53, probably could be characterized as a somewhat driven somewhat up tight professional. I have had the pains associated with Proctalgia Fugax likely for 20 or so years. I found the breathing regimen recommended for childbirth helpful in reducing the intensity of the muscle cramp, and perhaps shorten the ordeal. I used to get it more when there was more stress in my life. But i can still get it shortly after orgasm, spontaneously in the middle of the night and randomly (sitting, standing, walking). If needed I will excuse myself to the bathroom, settle down and breathe. Last night’s episode lasted for 20 minutes, with the pain increasing and decreasing several times. A few mini-movements seemed to help everything relax.

    It is assuring to know I have plenty of company, that I don’t have the knife in the butt pain many have described, and there are some approaches providing more immediate relief, namely coffee, baby aspirin taken sublingually and hair dryer… except we have not got a hair dryer and I hesitate to use a heat gun.

    I have had the colonoscopy and gastroendoscopy (lower end was pink and healthy, upper end showed ibuprofen caused early stage lesions and irritated esophagus) so no causes for the PITA.

    I wonder if this relationship to orgasm has any connection to the severe headache I sometimes get after a really good orgasm. Yes, I have had my head examined (including and MRI) and the good neurologist concluded there was nothing there. >:-| That is supposedly related to the Vegas (or maybe Vargus?) nerve and is associated with low blood pressure. Hydration seems to help so I try real hard to drink plenty of water (not very exciting).

  94. Hi guys..

    I have just had an attack yesterday and was looking on the web on what are the causes. So glad that I am not alone. I have tried doing a couple of things but nothing seemed to work. Thanks for the different methods that I could experiment with. I tried something yesterday that worked for me. I drank 2 glasses of cold water, and had two asprins just in case the cold water didnt work. The pain was gone in less than 5 mins. I think different methods work for different people. Maybe you could try this after trying everything out. I only tried it once so I guess I have to try it a couple more times to see whether it was really the cold drink that helped.

  95. After discussing my symptoms with my gynecologist for the last 3-4 years (how long I’ve been suffering with this condition) and going through all of this ideas of what it could be like, “Have your husband wear a condom because his sperm is causing your uterus to contract” (it wasn’t that as it happened after orgasm with masturbation and sometimes on nights that we didn’t even have intercourse), I finally started researching it on my own to come to discover that I am without a doubt suffering from Proctalgia Fugax. The symptoms are dead on to mine-there is no rhyme or reason when they occur (although they often occur when I’m feeling anxious or stressed and after orgasm). The pain is so severe that at first you’re not sure if it’s coming from your rectum or vagina (although I have since located the pain to my back end). The pain can last from a few minutes to upwards of 20 minutes. The pain is so severe that on one occasion I did pass out. At first, I was so worried that I had cancer or something, but I’m pretty certain that it’s nothing to worry about. Last year I practiced Yoga and Meditation regularly and although I did have my worst episode last year (in which I passed out), I had far less than in prior years. I found that getting into Yoga poses while having the episode helps. One of the positions that helps me is either on my back with my legs straight up and rock side to side or on all 4’s and rock my body. It almost feels like you’re having a baby! And although it can happen in men, it is far more common in women (a fact that I stumbled upon during my research). People, you must talk to your doctors about this. I am fortunate enough to have a gyno that isn’t afraid to admit that he may not know everything and asked me to call him with the spelling so he could read up on it. But if we don’t talk to our doctors about this, it’s going to keep going unnoticed. According to my research, this has been around for over 2000 years, so why have we not heard from it until we started looking into it?

  96. I’m a male 28 years old. I remember when I was 21, my first son had just been born and I got these horrific pains in the rectum like knives. Seriously unpleasant feeling. When I got the stabbing pain I instantly felt the urge to go for a number two but nothing would happen. This lasted about two weeks and went away.

    I’m now 28 and last week my third son was born and hey presto, I have the pain in the rectum again, same horrible pain and lasts just seconds and goes away. When they happen I feel the need to go just as before. I think stress may be a cause and I think the Gluten theory may have something to it.

    I have never had the pain during the night, always during the day. I have been having about 4 attacks daily and then two days without any pain which is odd. I take 400mg Ibruprofen and drink some water and the pains stop after a while.

    I’m taking citalopram for anxiety and that seems to help, I doubled my dose today due to the pain, it was intense. I suppose people out there worry it’s something worse like the big C or some other life threatening condition. This is understandable as it is very scarey.

    I’m less worried now I found this page and having experienced the pain some 6 years ago I’m hoping it will go away soon. I’ll give it another week and if I still have the pains I’ll go see a competent doctor about it. I’m just worried they will brush me off as I suffer with Health Anxiety 🙁

    Anyway, thanks to all for sharing their stories on this topic. I hope you all feel well soon.

  97. I scoured the internet until I discovered this myself with the symptoms being dead-on. It comes on out of the blue( even when driving). My husband asks me what’s wrong and I say I have an excruciating pain in my ass. He probably thinks to himself because I have other bowel problems that I’ve gone over the edge. But since he is legally blind and I do the driving, I am all he has-so there! Have had this for years and I am wondering if it has anything to do with the vagus nerve.
    I had an extremely bad upper respiratory infection three years ago and started having tingling and bowel problems. No answers-just tell me to up the anxiety medicine. I have learned though that if YOU feel something is wrong, then just because the medical profession can’t figure it out, doesn’t mean it isn’t so. Glad to have found this site because it is so relateable.

  98. I’m so glad I found this article. I’m a 48-year-old male. I’ve had these exact symptoms, occurring usually at night or while asleep, for the past dozen years. I’m a bit ashamed to say that I’ve never mentioned it to the doctor, probably because it happens only 4 or 5 times a year, and each incident lasts only 15 minutes or so. It’s nice to know it has a name, and that it isn’t really serious, just annoying.

  99. I’ve described the pain this way: someone trying to remove my tailbone without benefit of anesthesia, either by using rusty tin snips or a really slow belt sander. The pain lasts anywhere from 10-30 min and I’ve passed out at least twice. I’ve tried the aspirin suggestion and it may have shortened the duration by 10 min or so. I think I’ll try sitting on my dog’s hard rubber ball next time…

  100. Had the scorching pain in the rectal area for about 5 years. Sometimes once a week – sometimes not for 3 months. Only thing that helped was warm baths until I had a bowl movement which relieved it. Episodes lasted from 20 – 60 minutes. I’ve had them during the day, but most frequently at night. Seems like after drinking too much wine and/or having sex I would frequently get them. During the last one I had the pain was so severe that I sweated through my shirt and almost passed out. This made me go to a internist rather than my family doctor to find out what it was. He knew instantly what it was but did a colonoscopy to be sure. He was right. He did give me some meds to take when an episode starts – it doesn’t stop it, but, makes it pass faster. So glad to have finally found a name for what I have – and that it’s not something worse. This board has been extremely helpful. Don’t be afraid to go to a specialist about your pain – chances are, they know what it is and can help you!!!!

  101. This website has been such a blessing to me. Ever since I fell down the stairs a few years ago I have awaken from out of a deep sleep on occasion with the same symptoms that are listed here. The episodes lasted anywhere from 10-15 minutes and would go as quick as they started. It feels exactly like a spasm. It is horrible. I also would get the feeling that a bowel movement was imminent but would only pass some small hard feces upon much straining. I always thought that maybe this is what caused the spasms but that would not relieve them. What I have found to be very helpful is to massage the entire anal area with gentle firm massage. I could usually feel the tightness of the muscle during the spasm. Most always it would immediately give relief after 5 minutes of massage. Hope this helps others! And there is much assurance that I am not alone with this problem!

  102. ps I forgot to mention that when I fell down the stairs I hurt my coccyx bone really bad and it took about a year to heal. Ever since that injury I had these spasms of which occur about 8 times a year and only after I fall asleep.

  103. Hi,
    I am 46 years old and have suffered through Proctalgia Fugax since my teens. I too discussed this with my GP and had specialists involved to be told I had “PF”. This occurs not in the middle of the night but when I need to empty my bowels and only 3-4 times a year now (used to be much more frequent). I cannot move from the toilet when it happens. I now leave a step ladder in the bathroom to lean on and have an Asmol inhaler in the drawer next to the toilet (which for me does not seem to work but what the heck I’ll keep using it just in case) and have a wet flannel for wiping sweat from my face. I have tried taking Panadol and Asprin but it does not seem to help either. Trying to control my breathing seems to help a little but I usually end up with my hands in tight fists which I cannot open, numb legs and slurred speech as well. Last night I had to help my 17 year old son go through his first episode. I felt so helpless but empowered at the same time as I knew what he was going through and helped him as much as possible. After reading these posts I feel sorry for all of us and empathise with all as well. Thanks for a few other ideas I will certainly try some of them out.

  104. Hey
    I have suffered from this condition since I was 12 and i’m now in my 40’s, I used to get attacks at least once every few weeks especially after orgasm and after going to the toilet also i experiences random attacks in the middle of the night, I started taking zopiclone ( sleeping tablets ) about 3 years ago and haven’t had one since, i’m not advising people to start taking these however they do get rid of the pain as they are a muscle relaxant. Another thing i used to use before i started taking there is buscopan, you can buy them over the counter and they work by stopping the spasms.

    Hope this helps

    Vic

  105. So glad to find this site! I too get awaken in the middle of the night with pain. Usually I have found there is a small stool just inside my rectum which needs to come out (with help) once it does pain goes away shortly there after. Just had this two nights ago. Now last night after eating I started with pain, I believe from eating an onion. (Dr’s prev felt I had gas reactions to some foods I eat) but it’s not always consistent. Some times they bother me it seems, some times not. (but I think this is two sep issues as I am still bloated, hurting with alot of gas still yet today). I have not tracked how often I get awaken at night with the shooting pains, but I guess I should track that better too. Now I know what I can tell my Dr what I think this is as I did not know how to explain it correctly before.

  106. I am so glad I found this, i have been suffering with this for months now. I was too scared and/or embarrassed to even tell my husband, but the pain has become so intense I wake up crying. It feels like a knife is stabbing me. I have been so afraid that I had colon cancer or something similar that i haven’t even told my doctor. It is becoming so frequent now that it is really affected my life. The pain is unbearable most of the time, and it always seems to come on at night while i am sleeping. I am glad to see that I am not alone. It has come to the point I am going to have to see the doctor, i just can’t stand the pain anymore.

  107. As a sufferer for years, to come across your website is both a blessing and a curse. A blessing in that I know I am not alone, but also a curse, as I have been unable to enjoy sex in any form without pain for years now. My doc calls it IBS and they prescribe fibre supplements but these make it MUCH worse. I long for the day when the medical profession will take the sexual pleasure of women as seriously as they do for men. I am only 42, could still bear children, but how can that be possible when ANY act of pleasure triggers the “knife up the arse” pain. Any sexual stimulation can trigger it – its like playing Russian Routlette – how long can I get away with it this time? I just want to make love to my husband without him having to worry if he’s hurting me. I want to be able to make love to myself and not worry that I will be crippled on the bathroom floor with the “knives up the arse”. Basically I want to be normal. Have a crap – no pain. Have a pee – no pain (oh and hold it in if I choose to). Get slightly sexually excited – no pain. Have an orgasm – PAIN FREE!!!!!! 🙂 🙂 🙂 If only 🙁 Feel’s like its never gonna happen. But thank you so much for reading my sorry rantings, gonna go cuddle my husband now xxx

  108. Thank you so much for this. I have had this for maybe 2 years now. I was just awaken by this. Is why I am on here. This was the first in a few months it happened. I am one of the unlucky ones that just get it. I began getting it during an extremely stressed time in my life. I have not been any where close to that stress level in maybe 6 months. I am glad you have an idea of what it is. I sometimes wake my husband because it hurts so bad. When I try to explain it to him he looks at me like I am crazy. I tried to also explain it to my dr. Yeah, she looked at me weirder than my husband.

  109. Interesting that there are so many other people out there who have this condition! I started experiencing it about 10 years ago but was reassured by the first doctor I saw that this is more common than one would think, and likely nothing to worry about. He did recommend a specialist who verified that nothing was wrong. As with most other people it seems, mine happens at night. When it happens, I press in around the rectum to find the most sensitive spot and I continue to apply pressure until I notice the pain subsiding. Sometimes it lasts 15 minutes or more. Sounds kind of gross, but it really does work! 🙂

  110. I’m 65, and I’ve had this condition, in all its permutations since my early teens.
    In recent years I’ve discovered that deep breathing from the stomach is very effective for relieving and dispersing the pain. I too was comforted in knowing that I was not alone with this problem. The onset of my Proctalgia Fugax, is I’m certain, triggered by anxiety or uneasiness.

  111. I’m 47, female and have had about 6 episodes of proctalgia fugax in recent times. The first one made me think I had cancer or something. I felt it after having a general anethesia for wisdome tooth removal (when I was 20).
    Then nothing until about 4 years ago. I awoke in the middle of the night to pain that made me think I was going to die. The pain was excruciating. I paced, tried to defecate, tried to massage it, nothing worked. It subsided after about 30 mins.
    It felt like a very sharp ache that was like a ball sitting just above my anus, putting immense pressure on me in a pulling down sensation. It REALLY HURT A LOT!

    I’ve tried a few things but this is my solution.
    Clonidine (usually used as a blood pressure medication) can help. I take it for BP problems.
    I take a valium as soon as the pain awakes me and it helps tremendously.
    I breathe through the pain and reassure myself it will pass (learned from meditation).

    My doctor(s) did not know what I was talking about. I’ve had to diagnose and treat it myself.
    Good luck fellow PF sufferers. It really is a pain in the butt!

  112. Spasms pressure sharp dull achey. It all describe very real pain in th butt. Nobody believes you. After colonoscopy MRI epidural injections pelvic surgery to remove masses. Still having that pain in the butt. It was triggered from my hysterectomy in 2006. I complained the whole time he pull my pelvic organs thur my bum. Now I know it not just my spine which by the way hurts too. When they gave me my first injection the local temporally stop the pain. Wow was I the butt of that joke. Excuse my Kindle it just went wacky. But y’all fell me. Its a. Real disorder. Love y’all.
    I write the to my fellow sufferers never give in to doctor’s ingnorance you not in PAIN. It is what it is. I’m trying it all I hag a m

  113. I first experienced this phenomenon about 10 years ago. It is VERY painful and lasted about an hour. It seems to happen once every 3 months or so and it doesn’t have to be during the night. The pain comes on very suddenly and is very sharp, for me it feels like a downward pull and the feeling like I need to push…. but I found sitting and pushing made it 10 times worse, like I almost saw stars. So now I know not to bear down. Standing is not good either, any type of gravity downward seems to make it intensely worse for me. What works best for me is this. I lie completely flat on the bed and put two pillows one on top of the other under my knees. I then put my arms up over my head and stretch my torso as much as I can and take slow deep breaths into my abodomen to relax. It usually takes about 7-10 minutes for it to completely go away.

    The pain is very intense and I find during the day before it happens, I feel a pushing down of some kind from my lower intestines. It happened last night and that’s why I am here. I finally googled and came here. It’s exactly what everyone is talking about. Never went to the doctor about it, as I always felt it was some kind of spasm.

    OUCH!!!!

  114. Omg I have been having these SAME symptoms…the pain comes sporadically and hurts like hell! I thought I was alone, everyone else looked at me like I was a hypochondriac. Glad to know that I am not alone.

  115. I found out today that I have fugax. I knew it had to do with some type of spasm but I can not believe how many people actually describe this same horrible pain.Always in the middle of the night and sometimes lasts for an hour. I like the idea of the baby aspirin and I am picking up a bottle tomorrow. I have used GAS X max strength and my husband will get a baggie of ice cubes.This is the only way I get relief. Sitting on the toilet makes things totally worse! I concentrate on my breathing and stare at the clock and pray myself to sleep.

  116. For me it only happens at night and
    only when I’m dieting, it has to be related to dehydration and diet also cutting out to many carbs

  117. I know PG well since I was 14 or less. Now im 60 and dont have it much these days. Usually after an awkward bowel movement.

    I found that for quick relief I would stand with feet 1 foot apart, lift the elbows up to breast height with hands on the chest. Keeping back straight twist you torso back and forth twisting the whole abdomen, slowly increasing degrees of rotation till your reaching as much as you can.

    After as little as 30 seconds to 1 minute I would have relief. Im not a doctor and I have a good back.
    It works for me and I have done nothing else. A spasm of PF does not bother me any more as I can rid myself of it in a minute.

  118. As we speak, I am slowly getting over tonights pain. It feels like it’s getting worse, it’s always after having sex 2-3times in the same day. I am heathly and have no idea what causes this which is frustating, my girlfriend tries to help but I tend to get angry as I rather be left on my own when the pain comes on which isn’t good for our relationship.

    Well tonight was the worst, it normally would only last 15-20mins but this time it last 2 hours ;-(, I am now thankfully it’s almost gone now, as I feel so tired and have up get up in 4 hours for work so better try and make most of it, the only thing that I want to find out is why we get these pains, this only came on 3-4 years ago.

  119. This happens to me usually at night 6-10 times a year for about the last 5 years I’m 30 now and find it happening more often. It usually happens to me if I haven’t been eating well fast food, quick meals, etc. One thing that I find is drinking toooooo much coffee I love coffee. If I drink to much in a day I can almost guarantee I will have an attack through the night. Limiting my coffee intake has really helped!!!
    As far as relief the only thing that works for me is to go back to bed and lay perfectly still on my back and do my best to relax breath slowly and deeply. Hope this helps

  120. I am so very glad I decided to google this because I was extremely scared thinking I had something more severe…! I don’t like the fact that other people go through this but it’s good to know I’m not the only one…! My episodes have woken me out of my sleep and taken me to the restroom and as soon as I try to make my way back to bed…, I’ve fallen…, bruised myself pretty bad and start to sweat and hyperventilate…!

  121. proctalgia fugax – even more effective than the bathtub edge remedy is to sit on a firm rubber ball on a hard surface and shift your weight around as necessary – this does not remove the pain but changes it from unbearable to very manageable – it seems to reduce the spasms – suffered for many years until I found this treatment.

  122. I’m 20 and I’ve had this condition for about 4 years. My first episode was really scary, the pain was so intense I thought I was going to die, my heart felt like it was about to give out. I fainted during my second episode. It usually happens after a bowel movement or an orgasm and I had no idea what it was before I found this article, I never talked to anyone about it as it was rather hard to describe. Luckily, my attacks never last more than 2 minutes, so I’ve never really tried anything to relieve the pain, I can’t imagine how bad it must be for people who suffer long episodes. Good luck to all.

  123. Hello everyone!
    I as well have been suffering from proctalgia fugax, but my attacks usually happen when I’m menstruating. Not only does this “sharp knife” feeling occur in my rear end but also feels connected to the outer and inner vaginal area. Also after having sexual intercourse I don’t experience that “sharp knife” feeling ,instead it feels like something has been stuck up there and forgotten, the”corncob” feeling.

    Thank you Doctor Noorali Bharwani

  124. After hundreds of hours of pain, I’ve perfected the fastest cure (for me at least), which is getting to bed as fast as possible, and get on my stomach, legs about ½ a foot apart, with my feet and anchels over the edge of the bed, so I can relax the entire body.
    Also, avoid the pillow as head support, and have your arms by your sides, and try to relax your entire body. The pain then goes away after about an hour, tops.
    I don’t know how times my partner has freaked out (more than me) that every 3 or 4 times we’ve had sex, it ends with me lying in bed afterwards moaning in pain.
    Thanks for a great article, and apart from no known cure, I’m glad to hear it’s at least a well known disorder.

  125. I had exactly the same thing for almost 3 years now… a sharp pain that feels like something just went up my butt, lasts for abt 10-20 seconds then goes away… i thought it happens when you have a prostate infection as well… glad it isnt as bad as i thought

  126. I am 21 and have had this for years. It normally happened when i was standing or driving with sharp stabbing pains for a few minutes (never up to 20). Multiple times. I would just freeze waiting for it to go away because movement would cause unsettling pain.
    It got really bad starting January 2011. I was having at least 12 episodes a week sometimes 5 a day. I knew what Proftalgia Fugax was then but I had to seek out a professional specialist. I ended up seeing a rectal surgeon and starting a year later I underwent bio-feedback therapy in weekly sessions at Baylor where it actually helped not only decrease the amount of episodes but also the severity of the pain. I still have a few by the month but it’s not as bad as it use to be. Also take fiber, it helps
    After reading a comment higher up this page I identified with a gay guy who has the exact specifications with these attacks. I just came out of the closet a few months ago and I can’t help but wonder if there’s a connection despite that the therapist said there typically wasn’t (she didn’t know i was secretly gay though).

  127. i have been suffering this fugax problem for sometime .During the pain episodes , i try the yoga pose vajrasana or supta vajrasana ,it gives me great relief. it reduces the pain an duration of the pain intensity . hope this helps to some extent to all other sufferers.

  128. I’ve suffered from this curse for nearly 47 yrs. I was 23 when I experienced my first agonizing butt
    pain that came out of nowhere in my sleep. No one I talked to seemed to know what I was talking
    about. At least they were spared the misery. Even my doctor gave me the “deer in the headlights”
    looks when I asked him about it. I’ve had colonoscopys over the years unrelated to this “butt pain”
    so if this was a serious condition it would have been detected by the medical procedure. But to no
    avail. I can never predict when it will strike. I’ve had them at work, at the dinner table, paying a
    visit at a friend’s house, asleep (of course, as so many people have had), at the sink washing dishes.
    When I feel one coming on I try to get as comfortable as I can (sit or lay down) grab a pillow or stuffed
    animal and hold it close to me and clinch my teeth and bear down until it’s over. This evil entity has
    control over you. All you can do is endure(tollerate) the pain as best you can ’till it’s over. I’m an old
    hand at it. As long as I’m above ground I am cursed to deal with this.

  129. I came back here to thank whomever it was that suggested stretching the lower back. However, I can’t seem to find that post but I swear I read it on this page. I had tried the exercise described once before, but it didn’t seem to do anything for me, so I disregarded it as an effective way to get rid of the pain. But today I had a worse-than-average bout of P. Fugax and I decided to give it a go again. Standing up with my feet about a foot apart, I twisted my upper torso from side-to-side while preventing my waist from turning. I think the key though is to twist enough that it starts to hurt a little, trying to push past the physical limitations of your body. I did this slowly at first and then increased the pace somewhat. I went from hugging my arms in close to letting them swing freely as if they were noodles. After about a minute I started to feel the pain subside. Two minutes later and the pain was completely gone! Excepting a few occasions, my bouts always last for a full hour. I’m actually for once anticipating my next bout to see whether or not this exercise is truly effective, but that could be a month or more away. I hope it helps someone else. I wish I could thank the person who suggested this, whoever you are. It was an older lady if I recall correctly and she said something about not worrying about it anymore because she knows how to get rid of the pain immediately. Please try this and report your results.

    1. I can’t stand when I get an episode. It makes me have cold sweats, dizziness and nausea because the pain is so bad. My blood pressure has dropped to 50 over 25. Can’t raise my head let alone stand and swing my arms around.

  130. I think that I have a similar issue to what is described here. Basically I have the same pain issue that everyone has described but I think I found another way to treat it. One night in extreme pain, I decided to see if something was stuck in my rectum. Sure enough there was a small piece of feces stuck in my rectum. Once I pulled this out, the pain immediately went away. Now, every time this happens I go through this unfortunate routine of pulling out a small piece of feces at 3 am in order to get instant relief and go back to bed. I think that if I could have a BM this material would be flushed out but during these episodes, I never need to have a BM. Perhaps the material is left from a previous BM.

    I also think that certain foods get caught and irritate the rectum more than others. I love red pepper flakes,but I’ve noticed that if I add something with red pepper flakes, I will definitely be pulling them out of an irritated rectum at 3 am.

  131. Ron, I have noticed the same thing. There is always a small hard piece of stool that wont come out on its own. Once I get removed I feel much better. I havent noticed red peppet flakes being a prob, bur some foods I have problems with.

    1. Ron and Diane…I think you are on to something. I had a similar episode last night. (This usually happens to me about once a month) I woke up last night about 3AM and the pain was there. I went to the bathroom and sat for about 10 to 15 minutes and all I could muster was a small turd about the size of an almond. I went back bed and but could not sleep because the pain was still there. I went back to the restroom and tried again. I managed another almond. I laid back down and there was no pain at all. I was relived, but confused that such a small amount of material could be giving me so much pain.

  132. Times like this make me wish i was a boy 🙁 im a 19 year old full time college student and im currently experiencinv this! so far it has last for hours and is worst when i stand up. sitting down actually relieve the pain but once i stand up, it shoots back up. so unbearable, heck i cant even concentrate on my essay 🙁

  133. One or two puffs of a marijuana cigarette stops the spasms very quickly. It relaxes the anal spasms. “Someone” I know has been doing this for months when ever the pain starts and it really works. Only puff a little, just enough to stop the pain, not enough to get really stoned, just a little.

  134. I am so happy I found this information, now I know why I have pain in my rectum. It hurt so bad. I find that after sex I get this sharp pain in my rectum it hurt bad. It is good see that I am not alone with this pain in butt problem. My mother had the same pain too guess she passed it on to me. My mother used to get on her knees to ease the pain. I want to thank everybody for posting.

  135. I have been suffering from Proctalgia Fugax for almost a decade. Since being diagnosed with this condition, I’ve monitored what triggers the episodes of sharp anal spasms. I’ve found that caffeine (coffee, soft drinks), stressful periods and processed foods (fast foods, processed sausages like hot dogs, salami, peperoni etc and overly sugary foods) set it off. 90% of the time the pain comes a few minutes after ejaculation or in the middle of the night and lasts anywhere from 5 minutes to an hour. I have had the odd occasion where the pain has come during the day while at work, but this has been rare.

    Now, over the years I’ve found that the pain can be treated with a variety of the above mentioned strategies. Too often I’ve just rolled up in a ball and ‘waited out the pain’ in total disbelief that I now have to live my life in this way; for example – enjoying a great meal and the having to suffer for it for the next two nights or being rewarded for great sex with what feels like a knife in my arse.

    Over the last month I have found what could be a permanent solution. Over the past few months, the episodes have increased to a point where I could expect to have a proctalgia fugax episode two or three nights per week. I read on one of the forums that MAGNESIUM SUPPLEMENTS could relax the body and the muscle tissue n the body, including the anus….so I thought I’d give it a go. Since taking the Magnesium tablets around 2 hours before bedtime every day, I have not had one single painful experience. I’m still very careful with what I eat, and I try to monitor my stress and how many coffees I have per day, but I feel there is a MAJOR difference with the Magnesium. These supplements have not only erased the chance of all pain, but now I am getting to sleep faster and I’m sleeping longer – feeling more refreshed each morning. I can enjoy having an orgasm without having fear of what might happen next in the back of my mind. And I’ve even tried fast food and processed food while taking the Magnesium and have found that there is no pain after eating this also.

    All in all, in my experience over the last few weeks I personally believe that Magnesium supplementation is the cure for me, and could be the cure for everyone suffering from proctalgia fugax

  136. I am 21 years old. I had this attack twice one one recently and one when I was 18. I would get up in the middle of my sleep feeling like I really need to defecate. Nothing or very little would come out. I would go to the wash room and feel very dizzy. On both occasions I started having cold sweats and fainted. After lying down on the ground for a while the pain would go away and I feel better. On both occasions it was due to stress since I had exams the next day both times. I believe stress is a triggering factor and my advice is to try to relax and if you feel like you will faint. Lie down or out your head on your lap.

  137. I’ve suffered from this for years. I’m 45 and male. I find that stress seems to be related (which also can bring on a cold sore). I know mine is not diet related as I eat very healthy having at least a banana, a apple and a orange every day. I’m a runner so I watch my diet. I rarely eat fast food…perhaps two times a year and even then it’s from the “healthy” menu. For me it can occur equally at night or during the day. Sometimes the pain is enough to make me feel light-headed and then I break out in cold sweat and I faint or nearly faint. If I’m at work, I usually go to the washroom and find an empty stall and just sit down on the toilet and wait it out. After the incident, I sometimes wait for my clothes to dry as they’re soaked with sweat :(.

    1. Gummybear. Your post was particularly relevant for a number of reasons. Firstly I also have been so faint with the pain that on one occasion I actually passed out and hit a hard marble floor! Still kept it quiet from my wife. I was also a runner but mostly during the 80’s. During these days I never experienced any p.f. but don’t think it was diet. I wonder if it is stress related as the running did wonders for my metabolism and fitness which helped me sleep deeper and generally feel up-beat.
      I have made some very strange connections with my condition: hot curries, periods of starvation, excessive creamy meals. All I believe now are wrong. I’ve just had a blood test and am going to have my prostate checked to be absolutley sure it’s not something else. The sheer longevity of this condition, I expect, rules this out.
      Anyway, great post and it is SO good to know that others suffer this embarrassing condition which I have told nobody.

  138. These episodes do not happen at night for me, they always happen when I am active and often when I am working at the worst possible moment. I am a nurse and during surgery or an intense procedure or immediately following these I will be brought to my knees with pain so severe that it causes dizziness and diaphoresis and an inability to concentrate on anything but the pain. Lately it is getting more frequent and dibilitating but only lasts about 10 to 30 minutes. My coworkers think I am crazy when I fold under the pain. I heard about potasium for this and may try it as I am also experiencing increased leg cramping. I sure would like to find a solution, having to bear up during work even though I am in excruciating pain is getting less tolerable as the spasms increase in both pain level and frequency.

  139. I’ve had these episodes for years: sharp, excruciating pain lasting 30-60 min, cold sweats, fainting spells, usually at night, etc. The only effective solutions for me have been a little bit of caffeine and/or soaking my bum in warm/hot water. The soak stops the attack almost instantly while the caffeine (I stick with Coke) takes 4-5 minutes. Your mileage may vary. Good luck all!

  140. I have suffered from fugax for 20 years. I have found some relief with this method. I often feel the pain coming on while I’m sleeping. I wake up, realizing the inevitable pain is starting. I position my body by lying on my back, with my legs together. I breath easily and relax. Then I gently flex the butt muscle, sort of puckering my cheeks together, and hold that position for a few minutes until the pain subsides. It greatly reduces the duration and intensity for me!

  141. I’ve had this pain a few times a year for maybe 10 years, and have been treating it as a muscle spasm anywhere else, I found it improved if I was able to defecate, and realised it was stretching out the pelvic floor muscles that were in spasm, like you would if you got cramp. I’ve found that inserting a finger into the anus has a similar effect (with latex gloves and lube!). A bit wierd, but if it helps with the pain I’d try most things.

  142. Thank God for google! I also suffer with this. I mentioned it to a friend once and got laughed at. So i thought i was imagining things or over exaggerating. I am glad to know this horrible pain has a name and is not serious. My episodes happen at work with no warning. I sweat and start shaking like crazy. It lasts for only a few minutes and hurts sooo bad. I too think this is stress related, at least for me. Thanks for sharing everyone!

  143. This is SUCH a relief to know. It’s not something I talk about. It happened back in 1976 after passing a stool I felt a small ache/pain deep in my anus which grew and grew. I rose from the loo and realised, as the blood drained from my head, I was going to faint. It took an hour for the pain to pass. Being male I was to embarrassed to see a doctor. It disappeared for many years before returning in the mid-80’s. I found then the best way (not recommended) was filling a sink with very hot water and dipping my hands into it. The pain of the hot water distracted the pain from the anus. Now I resort to paracetemol and sitting on a firm surface, like the lid on the w.c. It takes about an hour for the tablets to work, which probably indicates that they aren’t helping.
    I always believed it was related to my bowel movements but it has happened after sex and now will strike at any time. Lately the pain arrived after sex but in a mild form and lasted for
    several days.

  144. 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.

  145. 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 . .

  146. 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.

  147. 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.

  148. 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!

  149. 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 🙂

  150. 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

    helps.

  151. 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!

  152. 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.

  153. 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.

  154. 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 🙂

  155. 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…

  156. 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

  157. 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!

  158. 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.

  159. 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.

  160. 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.

  161. 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.

  162. 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.

  163. 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.

  164. 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…

  165. 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).

  166. 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.

  167. 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!)

  168. 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.

    1. I know exactly how you feel! After 40 years of this, I have found that what works the best for me is to walk around and drink lots of water. It really does the trick, often very quickly.

  169. 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.

  170. 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.

    3. I find the best is to walk around and drink lots of water. It stimulates peristalsis and the muscles come “unstuck.” And yes, you will invariably pass wind at that point, usually a sign the episode is ending. By doing this, my episodes have been very short duration the past few years, whereas in the past they would go on and on, sometimes all night. Now it’s just a few minutes.

  171. 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.

  172. 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

  173. 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.

  174. 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.

  175. 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. 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.

    4. That’s super!

      I have also found after years of dealing with this that just getting up out of bed, walking around and drinking lots of water works every time. No more drugs for me.

  176. 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.

  177. 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.

  178. 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.

  179. 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.

  180. 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?

  181. 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?

  182. 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.

      1. 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

    2. 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.

    3. Lying down is worse for it – I think that’s why it happens in sleep. Get up, walk around vigorously and drink lots of water. That works every time for me.

  183. 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.

  184. 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.

    1. Try walking around and drinking lots of water. Always works for me. I used to take drugs for it but no longer need them. Do not lie down! Makes it so much worse.

  185. 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

  186. 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.

  187. I found what is very helpful
    1) don’t go to bathroom
    2) drink 3 to 4 glasses of room temp water. Force yourself, that make such a big difference .
    3) walk, walk

    1. Totally agree – walking plus drinking! The worst position to be in is lying down. Most often it comes on during sleep, and I think it’s from being in the prone position. No idea why, though.

  188. I found after having been free from these painful episodes for a couple of years, that it recurred suddenly one day after sharing a diet soda with my daughter. I found a connection mentioned on another site of the relationship of recital spasm with some artificial sweeteners. I had stopped drinking diet sodas a couple of years or so ago, so now I suspect this could be a trigger for some people.

  189. I first noticed this when I’d drink the milk from fruit loops only never ugly charms ilk, or frosted shredded wheat milk, rice crisped with Regular sugar milk and it happened like everyone else is saying at 3 am or so of the day that I ate the fruit loops…so I was convinced it was something in the dye of one of the colors…it didn’t happen with trip or pebbles just loops.generic or name brand it didn’t matter….so I stopped eating them obviously….theb I got older and began to masterbate with a vibrator it would happen after orgasim…it was a clitorial orgasim never any pentration with dildo. Pain was right away and less severe than the fruit loops attack…but lasted for less time….now it’s been some odd years and it’s happening when I have organic with partner either from penetration, non pentarated heavy four play or oral …it gives everyone a warning pain throb and I got like 3 minutes max before it sets on and the pain in more severe than the fruit loop attacks and the vibratory attacks.it helps when I : talk about it before it happens, squat like I’m doing number 2 in the forest…sit on toilet and lightly squeeze, being hydrated makes it less painful and it doesn’t last as long eithèr…..what hasn’t worked is any touch in that area by self or other as in massage or whatever…I’ve only had Anal sex a few times in life and no attack after weird…I am a true Anal retention person who stresses a lot and according to freud also have oral issues I smoke, bite nails, blow bubbles unconciousl if chewing gum, bite or such on inside lip when I’m trying to deesculate a situation…or add fuel to fire. I couldn’t possibly say that it’s more than PF cut doctors have just looked at me like I was insane and asked if someone was touching me while I slept…but I feel there has to be something associated with sweetner,dairy,chemicals and hydration…but it can also have something to do with your lymph nodes, glands and other gynecological to fiber balance stools…I often only stool once every 3 days or sometimes for a week…I also have periods where my tummy cramps and then stops and no stool is required so I am convinced it’s in the intestine area so could it be related to celiac disease? Chrome disease? Prostate?and I wish someone would finally have the answer to be able to tell our doctors what test to run and what can be given to prevent it from happening…all the stuff is fine for after it happens but preventive would solve a lot of problems for me. I don’t wanna have sex cut I know I’m gonna pay for it, I don’t wanna be stuck when it happens so I sleep at home more so than most people with my lifestyle.and honestly speaking it happened a lot more when I was healthier and my system was clean of any illicit,street,prescribed driugs. My food intake was healthier when it became obnoxious and would happen with out no fruitloops, or sexual provoking. Please someone find a doctor to help us it’s awful.

  190. I have had this most of my life. Did not know what it was for years. I finally had an episode that lasted a whole night and was so severe that I was vomiting from it. Got checked out, including a barium enema x-ray (what a waste of time…) and while the doctor did not have a proper diagnosis, I was given Colofac (mebeverine hydrocholoride, an intestinal muscle relaxant) which seemed to help very much.

    Since that time, I learned about proctalgia fugax, and I discovered that I don’t really need the drugs. If I just get up and walk around, and drink lots of water, the cramping eventually goes away on its own. I think it may be that drinking the water to take the pill is what was doing the trick, not the pill itself. Swallowing seems to stimulate peristalsis and get the muscles moving again, along with the walking. The worst thing for me is to be lying down – if the cramp is subsiding and I lie down again, it often comes right back.

    The worst part is knowing that sexual activity may result in terrible pain! Not exactly an incentive for pleasure, especially before bedtime as that is the worst combination – I wonder why it happens so often in sleep? Maybe it’s just the prone position and nothing to do with sleeping itself.

  191. I have had this issue most of my adult life, starting in my late 20s (that’s over 30 years). Once it started when I was on my way to class and instead of taking a Tylenol or otherwise trying to relieve it, I went to class and sat there in pain for hours. At least I can gauge the pain though, because in my later years it’s become far more painful and nothing I can endure once it starts. I don’t take pain meds except if very necessary so 325mg of Tylenol usually takes it away. In the past I wouldn’t need a pill because except for that day in class I don’t recall it ever lasting long enough to warrant taking a Tylenol. Sitting on the toilet and bearing down somewhat relieves the pain, as does anal massage (with TP in hand of course). I usually know when an attack is coming by a twinge of nerves down there so I can grab a pain pill first to lessen the experience. Unfortunately the attack often comes in the middle of the night, waking me from sleep in the worst possible way.

    I’m going to try what nzchicago suggests above and try drinking more water. That is one remedy that’s worth a shot.

  192. I have had several surgeries for endometriosis and a colonoscopy since I my early 20’s. I have seen so many GP’s, specialist, chiropractors, physios, naturopaths, etc, etc.. Today at 39 I visited a dietitian for help with my ongoing abdominal pain, I did not mention my random rectum pain. Upon researching my FODMAP diet I found a IBS article that listed pain in the rectum as a common IBS symptoms. I am crying as I write this; as for over 15 years I thought that I was alone and that people think I’m making it up. I have been googling my symptoms since google existed and have been begging doctors to help me. I am ANGRY to learn that there are LOTS of people like me; so why someone, including myself, has not mentioned Proctalgia Fugax before. I have no idea if any of my remedies have worked at all; when I wake in the middle of the night my partner runs to get my drugs, ice and heat, but we often wonder if it just stopped on its own when it was ready.

  193. My doctor many years ago, prescribed a nitrolingual spray for this symptom. I thought she was nuts. I was waking 3-5 times a year with pain likened to that similar to sitting on a golf ball. Sure enough, after trying walking it off, taking Tylenol etc, I rubbed a little of this magic spray on the area affected, a spot in the butt crack near the top, and presto! Within minutes the pain disappeared and stayed gone. Has something to do with relaxing the smooth muscles I understand This affliction I refer to as a tiny Charlie horse high in the crack of my butt. This magic elixir works like a charm, first time, every time. I hope this helps someone else. It’s been a godsend for me. (I understand it’s also good orally for heart attacks or angina from same.)

  194. I have noticed the stabbing pain just below tailbone/above hole since i turned 50. Happens every 6-12mos. Stabs for a while,then just ebbs off… try to poop with tiny result,if any. Feels like i’m trying to pass a jagged golfball,but nothing there! Lasts about 20-30 min. Not constipated.am Healthy. This time i have a smart phone &distracted/relaxed myself by reading articles such as yours. Suddenly it was gone. Thank you for info, p.f. is EXACTLY what is going on down there!!! The other articles were confusing and just wrong to me,,thank you for explaining it plain enough for average joe to understand. It was like the light went “BING” . I just had an episode half an hour ago so ghost pains are still shadowing me,a shady reminder… good luck out there (& in there!)

  195. I’m 49 and male. I had this mysterious pain for the first time in June of 2016 and then again in December. The first episode was worse, lasted longer – I got quite nauseated felt very close to vomiting. The second time was bad but briefer. Both times I got myself to the bathroom and sat on the toilet but didn’t defecate. It seemed to help when I leaned far forward, almost hanging, maybe because it brought blood to my head. I’ve been searching and reading online trying to figure out what’s going on — this page comes closest to describing what I experienced. Some things I’ll say that might be helpful, relevant: I have an enlarged prostate (common for men my age). Also there were several parallels between the two times in which both episodes occurred: both times I was dealing with stress (eg new job), doing a lot of sitting (eg long car rides), and going longer than usual without any sexual release.

    1. Hi I to have this problem and what help me is a fast acting ativan in the form of a small green pill and then take about five min to go away work every time your dr has to prescribe. The way it works is that it relaxes your muscles and your pain goes away.

  196. I’m 45 years old, healthy, have extremely regular daily defecations.
    Today I had my 3rd episode during an afternoon nap, last year I had the first two, during deep sleep at 5 o’clock in the morning.
    The pain was sharp, as most commentators indicated, the only difference is I did eventually defecate during all 3 episodes, it wasn’t easy but it was planty.
    Is it still cosidered to be the same condition?

  197. The first time I woke up with this pain, I thought I was having some kind of weird seizure. I’ve been referring to them as butt seizures ever since. But now, after reading this article, I now understand whet they are. It always happens to me in my sleep, about once a month or so. It’s painful and wakes me from my sleep. The first time I experienced it, I tried to poop, then started to sweat profusely and passed out. I think the sweating and passing out part was more of a panic attack than anything. Now when I get them, I just stretch for about 10 minutes, try to focus on breathing, relax and they seem to ease up. I also have Crohn’s, but it’s in remission. Ive had a lot of autoimmune symptoms that are not intestinal related as well.

  198. First time I experienced it, I thought my PJ bottoms had cut off circulation to the region we’re talking about and the pain was just blood returning. But over months, I’ve had the “experience’ and it’s not that. Last night, it woke me from sleep and the pain was not only anal (tailbone and deep inside) but vaginal. I could barely move. I was lying on my side with my leg brought up (as someone posted above). There wasn’t much I could do but kind of massage the area and wait for the excruciating pain to subside. So odd.

  199. I have found that applying an ice cube to the area helps. I know it sounds odd, but I tried it in mere desperation during a horrible episode and it worked! Also do not sit down! Make sure you continue to walk or pace around. I have a gluten intolerance and I believe this could be the cause of my issue. I am very careful about avoiding foods with gluten, but sometimes I will accidentally get an amount of it and the episode may follow shortly after. Just FYI.

  200. I have had these for years. They wake me at night with unbelievable pain (I wouldn’t wish on an enemy). I have had them happen during the day as well.
    Only relief I get is as soon as they start I either suck in my bottom as hard as I can and hold as long as possible I do that a few times in a row and then do the opposite and push and push hard. Sometimes I feel like I need to go to the bathroom which ends with no result but feel safer when pushing hard.
    I’ve been suffering with these as much as two a day to one ever other month. I’ve become pretty good at stopping them or at least shorting the duration by using the pushing and sucking in method. I also found putting pressure with my hand.
    I do believe stress is a huge trigger I have not noticed diet yet however I will keep that in mind!
    For all who suffer from these I hundred percent get what you’re doing through ~ this pain is almost cruel and can put anyone to their knees. You are definitely not alone and you are not nuts/crazy no matter what Dr’s/friends/spouses say there’s no way on hell anyone would make this up..
    From one pain in the ass to another!
    xoxo

  201. How comforting(?) it is to be able to finally know that there is a legitimacy and name to this condition. For years I have been subject to the same bouts of being awoken from a sound sleep with sharp stabbing pains with no prior warning, or anticipatory reasoning. I do have a small hemorrhoid, and figured that this had something to do with it, but talking with my P.C.P., he suggested it was more likely a fissure. I figured I was the only one that suffered from this as, my Dr. didn’t seem to think it was that much of a problem. It wasn’t until I went for my colonoscopy, and had an in-depth chat with her about the symptomatology of my night time episodes…that she was quick to diagnosis. I have since done my own research into it, and firmly agree with her conclusion. What amazes me is the similarity with everyone here about the sharp sudden horrible stabbing pains, accompanied by the feeling of nausea, and syncopal feeling. The only relief I get after having tried home remedies (from a massager to hot and cold compresses) is an aloe based ointment that I digitally insert into the rectal cavity, and then just time. I wish there was an instant relief medication that was available, but was wondering if anyone knows of, or has tried a lidocaine crème/ointment. I know that lidocaine has a numbing effect, and am curious if this might alleviate some of the pain.

    1. Ok I to go through the the same symptoms sometimes I almost pass out even cold sweat from the pain. Here what medication I found work instantly for me ,get your doctor to prescribe Ativan,it come in two form a small white pill with a slot to cut in half or better yet a small green pill almost looks like a nitro pill and you could dissolve it under your tongue all its does is that it relaxes your muscles and the pain goes away within 5m. I operate machinery and I can take one and still work,but since it seem to attack at night even better it help you sleep and relax. My dr prescribe these to me for anxiety and that’s when I discovered that it works well for these terrible pain in the butt, wish you luck.

    2. Yes, I tried lidocain ointment and it does work. You simple rub some on the anus and the pain does go away within a minute or so.

      I found I did not need any medication at all. Whenever the pain comes on I do a few sit ups and pass a little gas. The pain goes away instantly every time.

  202. Idk really what i have exactly i have had hemorrhoids for anout 15 yrs and they will get where they would bother me or come out more but now the pain is worse i havent been sittin for a long period of time i have a lot of anxiety and have lots of stress i also felt the worse different unbarable pain not long after sexual intercourse so if anyone has any suggestions that would be great thx

  203. This happens to me once about every 3 months… I get woken up from the pain.

    To stop the pain last time, I tried “shaking it out” and it worked, surprisingly. It helped loosen things up. Basically all you do is, while standing up, bounce up and down by bending at the knees.

    Hope this works for other folks too.

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