July 01, 2021

Should I be worried about a stabbing rectum pain at night that goes away after a few minutes?

Q: My spouse is sometimes up at night in distress. She says she feels a sudden, severe, stabbing pain in her rectum. She's embarrassed to talk about it, especially since it seems to go away fairly quickly. Any idea what may be causing it? Should we be worried?

A: Pain in the lower rectum can have many causes. However, your spouse's symptoms are consistent with a condition called proctalgia fugax (prok-TAL-juh FU-gax).

With proctalgia fugax, intense muscle spasms in and around the anal canal cause severe or even excruciating short-term pain. The spasms occur periodically and can last a few seconds up to 30 minutes. They occur most often at night and are more likely to happen in women than in men. One study found that about 8% of people experience the condition at some point in life, with many reporting feeling too uncomfortable to work when it occurs.

Proctalgia fugax has been tied to high levels of stress and anxiety and also may occur after sexual intercourse, bowel movements, childbirth or surgery. Taking a warm sitz bath — soaking up to the hips in warm water — or using deep-breathing exercises or another relaxation technique may help ease the spasms and relieve pain.

The condition often goes away on its own, but symptoms that persist should be discussed with a health care provider. He or she can evaluate for other potential causes, including hemorrhoids, anal fissures, irritable bowel syndrome, an inflammation of the prostate gland in men (prostatitis) and a closely related condition called levator ani syndrome. In addition, he or she may recommend other treatment options, including applied or injected medications.

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