What is the Pelvic Floor? The pelvic floor is a set of muscles that spread across the bottom of the pelvic cavity like a hammock. The pelvic floor has three openings that run through it, the urethra, the vagina, and the rectum. The functions of the pelvic floor include: To support the pelvic organs, specifically the uterus, the bladder, and the rectum To help provide sphincter control for the bladder and bowel To withstand increases in pressure that occur in the abdomen such as coughing, sneezing, laughing, straining, and lifting To enhance the sexual response • • • • What is Proctalgia Fugax? Proctalgia fugax is a sharp fleeing pain felt in the rectum that lasts from 30 seconds to 30 minutes. In rare cases the pain can last up to several hours. The pain is localized and usually occurs spontaneously during the night. The rectum is the last 6 to 8 inches of the large intestine. It expands to store solid waste, and when full its muscular walls contract, forcing waste through the anorectal canal to the anus; where it is expelled from the body. Symptoms of proctalgia fugax include: • Sharp fleeing pain felt in the rectum Cross-section of the anorectal canal What Causes Proctalgia Fugax? Proctalgia fugax is caused by a spasm in the rectal smooth muscle, or the surrounding pelvic floor muscles. The cause for spasming is unknown. It is not related to hemorrhoids, polyps, fissures, or other rectal conditions. It is not thought to be psychological in origin, however many patients report that emotional stress increases the frequency of attacks. How is Proctalgia Fugax Treated? There is no permanent cure for proctalgia fugax. To decrease the symptoms the following may help: • • • • • • • Warm baths Ice cubes to the area Warm to hot enemas Cold water enema Pushing on the perineum or anus Relaxation techniques Using the asthma inhaler salbutamol to stop prolonged episodes Having sexual intercourse just before or after defecation can lead to an episode of proctaglia fugax. You can usually tell if an episode is brought on in this manner. If this is the case, then avoiding the combination of activities can help decrease the frequency of episodes. Medical treatments that may help with recurrent episodes include: • Electrical stimulation to the rectal region • Massage to the rectal region • Pelvic floor muscle reeducation using biofeedback. Biofeedback uses special computer equipment that measures muscle activity. You can use this feedback while doing exercises to learn to properly contract and relax the pelvic floor muscles. • The medication diazepam Preventative measures of eating a diet high in fiber and drinking plenty of fluids may help decrease the frequency of episodes by keeping stools soft. To find out more about Pelvic Health Physiotherapy, visit www.gatewayphysio.com or call us at 705-474-4440.