Dr. Alethea Fleming, ND

The most common scenario is waking up in the middle of the night with a strong pain deep in the rectum

Have you ever been minding your own business, getting ready for bed in the evening (or worse, been woken up in the middle of the night) and been completely sidetracked by a sudden, sharp pain in the butt? It doesn’t happen often so you may be inclined to ignore it, especially since it only lasts a short while, but it’s probably worrisome to you when it’s freshly on your mind and I’d be willing to bet you haven’t made an appointment to discuss it.

There are a number of conditions that patients typically don’t plop down in the chair and start conversing about. “So, doc, let me tell you about this weird pain I get in my rear” is not something I’ve heard right after a comment about the weather. One of the many important things that physicians do is to establish trust so patients can feel comfortable bringing up potentially awkward concerns, many of which seems to be centered on the areas typically covered by underwear.

What is it?

Proctalgia fugax is an ailment that is quite startling and uncomfortable and yet usually harmless. “Proctalgia” meaning pain in the rectum and “fugax” meaning fleeting. The most common scenario is waking up in the middle of the night with a strong pain deep in the rectum. It’s not connected to digestive issues, but rather is a spasm of the rectal sphincter and lasts anywhere from seconds to 20 minutes. There are other disorders that can look like this, but those tend to last longer and appear more often, so they are harder to ignore. If it’s uncommon and brief, it’s almost always proctalgia fugax (which is fun to say – try it!).

What should I do about it?

Treatment of proctalgia fugax can be quite simple. Given the short length of episodes acute treatment is most often simply to wait it out. Other options include a hot bath (ideally with Epsom salts) or stretching of the sphincter manually to disrupt the spasm (yes this means a finger in your bum). If this happens more than once it’s advisable to consider supplementing with magnesium which is a smooth muscle relaxant that many of us run a little low on in our diets. Nuts, spinach, whole grains and beans are all excellent sources if you need some meal inspiration. A simple supplement will also help, but be careful to avoid magnesium oxide which can have a laxative effect. Try a low dose of magnesium (200 mg is common) with your evening meal as it helps relax all muscles and can often help people sleep a little better to boot.

Fleming,-Alethea_resizedDr. Alethea Fleming, ND is a passionate advocate for naturopathic geriatric medicine. A 2007 Bastyr University graduate, she also earned a certificate in Gerontology from the University of Washington. Dr. Fleming is the owner and leadphysician of the Vital Aging Clinic in Anacortes, Washington where she provides primary care to all adults as well as adjunctive geriatric care. Dr. Fleming is active in multiple community organizations as well as a member of WANP, AANP and OncANP. In her off hours, Dr. Fleming can be found hiking the beautiful trails of Fidalgo Island, spending time with her wonderful husband and son, or with her nose firmly in a good book.

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