Sharp Rectal Pains

[kennyd]

I'm a male, 35 years old, overweight but in relatively good physical condition.  Recently I have been getting pains in my anus/rectum, sometimes sharp.  At first it seemed to happen mostly after exercising, particularly when I moved in certain ways (like twisting to get out of a car after getting home from my workout).  I run on a treadmill and it is not painful during the exercise.  If I play hockey, with different motions it starts happening after I have been playing for 15 minutes or so.  It is not constant, it is intermittent.  Sometimes the pain is quite sharp, such that I instinctively take the weight off one of my legs, other times it is just uncomfortable.  It seems to be getting more frequent and happening more between exercise sessions, even if I don't exercise rigorously for several days.

I have absolutely no discomfort during bowel movements, and no blood at all.

The only other thing I can think of to tell you is that a few times per year I sometimes wake up in the middle of the night with rather bad rectal pain...feels like it would go away with a bowel movement but it doesnt.  Then it goes away.  I am told this has might be "proctalgia fugax" and is harmless, so I have never worried about it.  It hasn't happened in a long time, and the pain is more of an ache rather than the sharp pangs I am getting now.

If this does not subside I will go see my doctor, but I am wondering if this sounds like anything in particular.  Could I have actually strained a muscle in there somehow?

[Kevin Pho, MD]

Proctalgia fugax can be considered if other diseases have been ruled out (i.e. anal fissure, hemorrhoids, inflammatory bowel disease etc.).  There are no specific lab studies or x-rays that confirms this diagnosis.

I would consider an evaluation, including digital rectal exam and/or flexible sigmoidoscopy, to rule out the causes listed above.

There is no consensus data to guide treatment for proctalgia fugax.  Options can include topical nitroglycerin, inhaled albuterol, injection of botulinum toxin, or oral clonidine.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b

[kennyd]

After reading some other posts, perhaps the following information will also be helpful:

- My stools are generally soft, constipation is not a problem, and I am regular.  Again, no pain, discomfort, or blood during bowel movements.

- I believe my diet to have a good amount of fiber...any grains that I eat are almost always whole grains.  I eat veggies but not much fruit.

- I drink red wine almost every evening, 2-3 glasses.

- Urination frequency is normal

[mat441]

A related discussion, sharp pains in stomach and anus was started.