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Biofeedback, Relaxation Training, and Cognitive Behavior Modification
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
Ann L. Davidoff, William E. Whitehead
Diagnostic criteria for proctalgia fugax are as follows (40): recurrent episodes, lasting from seconds to minutes, of midline pain localized to the lower rectum for at least 3 months; no anorectal pain between episodes; and no evidence of another anorectal disease. Generally, the pain is reported as being intense—often sharp or stabbing—and nonradiating, although it may be merely uncomfortable.
General Practice
Published in Keith Hopcroft, Instant Wisdom for GPs, 2017
This is thought to be caused by spasm of the pelvic floor muscles but, being a less clear-cut symptom with a wider differential than proctalgia fugax, is harder to diagnose in primary care. The typical symptoms are an ache or pressure high in the rectum, usually in a woman, which is constant or regular, in the absence of an obvious cause, but the diagnosis is likely to be made in secondary care after referral to exclude other possibilities.
Chronic abdominal, groin, and perineal pain of visceral origin
Published in Peter R Wilson, Paul J Watson, Jennifer A Haythornthwaite, Troels S Jensen, Clinical Pain Management, 2008
Episodic spasms (seconds to minutes) of pain localized to the rectum/anus, occurring at irregular intervals and without identifiable cause, are termed proctalgia fugax.131 Highly prevalent, occurring in 14–19 percent of healthy subjects, the episodes are brief (seconds to minutes) and infrequent (normally < 6/year). They may be precipitated by bowel movements, sexual activity, stress, and temperature changes and so may lead to avoidance behavior on the part of the patient. No etiology or method of treating/preventing proctalgia fugax has been universally accepted. Spasm of the sigmoid colon, levator ani, and/or pelvic floor musculature have been postulated as sources of the pain. If episodes are prolonged (> 20 minutes) then the disorder is termed chronic proctalgia rather than proctalgia fugax and the likelihood of involvement of the levator ani musculature is increased, particularly if there is tenderness with posterior traction on the puborectalis during physical exam.131 Local anorectal pathology such as fissures or abscesses need to be ruled out as alternate sources of pain and spasm. Due to the brief nature of most episodes, most reactive pharmacological treatments have usually proved inadequate although inhaled salbutamol, clonidine, nitroglycerin, antispasmotics, and calcium channel blockers have all been reported as effective. Heat or pressure applied to the perineum, food/drink consumption, dilation of the anal sphincter, assumption of a knee–chest position, and assumption of other postures have been anecdotally reported as beneficial.
Factors influencing magnetic resonance imaging finding of endopelvic fascial edema after ultrasound-guided high-intensity focused ultrasound ablation of uterine fibroids
Published in International Journal of Hyperthermia, 2022
Yuhang Liu, Yang Liu, Fajin Lv, Yuqing Zhong, Zhibo Xiao, Furong Lv
According to the SIR criteria, the classification of observed postoperative adverse events is shown in Table 4. There were 296 (44.3%), 109 (16.3%), and 3 (0.4%) cases of Class A, B, and C events, respectively, in the two groups; no class D, E, or F events occurred in this study. Among the Class A adverse events, the main adverse event was vaginal discharge (180 [26.9%] cases; 27.0% (150/556) and 26.8% (30/112) of patients in the edema and non-edema groups, respectively). The incidences of lower abdominal pain, sacrococcygeal pain, and lower limb numbness/pain were 7.9%, 4.7%, and 1.3% in the edema group and 7.1%, 2.7%, and 0.9% in the non-edema group, respectively. Further, nine (1.6%) patients in the edema group and 3 (2.7%) in the non-edema group showed odynuria. One patient experienced proctalgia. Among the class B events, 9.1% of patients had postoperative lower abdominal pain (8.8% [49/556] and 10.7% [12/112] of patients in the edema and non-edema groups, respectively). The incidence of sacrococcygeal pain and lower limb numbness/pain was 2.9% and 1.8% and 2.7% and 0% in the edema and non-edema groups, respectively. In class C, 3 patients with fascial edema had urinary retention. No significant difference was observed in adverse events between the two groups (p > 0.05).
Long-Term Functional Outcome after Internal Delorme's Procedure for Obstructed Defecation Syndrome, and the Role of Postoperative Rehabilitation
Published in Journal of Investigative Surgery, 2018
C. A. Leo, P. Campennì, J. D. Hodgkinson, P. Rossitti, F. Digito, G. De Carli, L. D'Ambrosi, P. Carducci, L. Seriau, G. Terrosu
When compared with other surgical options, IDP is favorable for ODS. STARR procedure has a wide range of reported outcomes, likely because of differences in surgeon's experience, different devices used, and variability in technique. In a recent international registry study on STARR, involving 22 European colorectal centers, a total of 100 patients were reported. Complications were reported in 11% of patients, including bleeding and staple line-related complications. The study reporting a low rate of symptom recurrence however describes only 12-month follow-up [25]. Stuto et al. [26] report similar results, with 2171 patients undergoing STARR, with a complication rate of 5% and a significant symptomatic improvement was recorded at 12-month follow-up. In spite of these results, the role of STARR is still controversial and reports of proctalgia, persistent pain, and perianal discomfort are still high even when functionally good results are seen [27, 28]. It has also has been demonstrated that poor function outcomes are inevitable when a complication occurs, which requires surgical re-intervention [29].
Angiogenesis inhibitors and symptomatic anal ulcers in metastatic colorectal cancer patients**
Published in Acta Oncologica, 2018
Francesca Bergamo, Sara Lonardi, Beatrice Salmaso, Carmelo Lacognata, Francesca Battaglin, Francesco Cavallin, Luca Saadeh, Sabina Murgioni, Antonino Caruso, Camillo Aliberti, Vittorina Zagonel, Carlo Castoro, Marco Scarpa
The most frequent adverse effects of angiogenesis inhibitors are hypertension, proteinuria and effects on wound repair, which are defined ‘very common’ because they occur in 10% or more patients receiving these drugs [11,12]. Other effects, such as gastrointestinal perforation, venous and arterial thromboembolic events, bleeding diathesis and proctalgia are ‘common’ effects that occur with a frequency greater than 1% [12]. However, the cause of proctalgia or the pathogenic mechanism that determines the appearance of painful symptoms has not yet been identified.