Proctalgia fugax
A sudden, cramping pain deep in the rectum that lasts seconds to minutes and then goes away completely. It has no known cause, and it is harmless.
How common
Does this happen to you?
How it works
The name means fleeting pain of the rectum. The rectum is the last part of the bowel, just above the anus. An attack starts suddenly, usually with no trigger2. Most people describe a cramp, a spasm, or a stab2. The pain stays in one place and does not spread2. Then it stops completely. There is no pain between attacks1.
Attacks last from a few seconds to several minutes, and rarely up to 30 minutes1. In one clinic study, the average attack lasted 15 minutes, with a range of 5 seconds to 90 minutes2. The same study counted about 13 attacks a year, roughly one a month2. About a third came in the day and about a third at night2. Attacks can wake people from sleep1.
The cause is not known. Attacks are too short and too rare to study easily1. A common idea is a cramp in the anal sphincter, the ring of muscle around the anus3. Another idea is a cramp in the levator ani, the muscle that forms the floor of the pelvis6. A third is irritation of the pudendal nerve, which serves the area6. Stress or anxiety comes before some attacks1.
How common it is
Estimates range from 4% to 18% of adults4. Another review gives 8% to 18%1. A 2026 survey of 28,771 adults in 15 countries used the newest criteria, Rome V, and found 7.3%5. In one clinic study, 83% of people with the pain had never told a doctor2.
The sources disagree about sex. One reports more women than men3. In one clinic study, 69% were women2. A major review found no difference1. The pain rarely starts before puberty1. The average age in the clinic study was 512.
Is it a problem?
No. It is harmless1. But a doctor gives this name only after other causes of pain in the rectum are ruled out14. Those causes include haemorrhoids (swollen veins), a fissure (a small tear), an abscess, inflammation of the bowel, and cancer134. So new pain in the rectum is worth one visit, even when it matches this pattern.
See a doctor if the pain:
- comes with bowel movements,
- lasts longer than 30 minutes,
- stays between attacks.
Those are not the pattern of this pain1.
Bleeding from the bottom, a lump, or a lasting change in bowel habits also needs a doctor, whatever the pain is like.
Sources and further material
- NCBI Functional Anorectal Disorders Free full text. The Rome IV diagnostic criteria. Sets the 30-minute limit and calls the condition harmless.
- PubMed Proctalgia fugax: demographic and clinical characteristics. What every doctor should know from a prospective study of 54 patients Abstract. 54 of 1,809 patients at a proctology clinic in Paris had the pain.
- NCBI Proctalgia fugax Free full text. A one-page summary for doctors in the Canadian Medical Association Journal.
- PubMed Proctalgia fugax, an evidence-based management pathway Abstract. A systematic review. Gives the 4% to 18% range.
- PubMed Rome V global epidemiology and validation survey: prevalence of disorders of gut-brain interaction and comparison with the Rome IV global epidemiology study Abstract. An internet survey of 28,771 adults in 15 countries, using the Rome V criteria.
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