At least 16-18 percent of the general population experiences a kind of severe, episodic pain in the rectal or anal region at least once in their life-time. Out of them at least 40 percent patients need a treatment for the same due to its recurrence, which can be one of the most annoying ailments. No pun intended, but it is really the pain in the ass! Fortunately, homeopathic remedies can effectively treat proctalgia fugax, as it is medically called, providing complete relief from the excruciating pain.
It most often appears in the middle of the night or if you hold your urge to pass motions due to any reason. Lasting for few seconds to minutes, it manifests as an excruciating pain, when the patient feels spasm-like pain in the anal region, associated with a need to pass motions. The pain attack subsides on its own within some time. Nothing can stop the pain episode once it starts.
There have been many triggering factors reported – including stress, constipation, sexual activity and menstruation. Although in many patients there may not be any triggering factor at all.
It is thought to occur due to the severe stabbing like pain or sudden spasm of the anal sphincter. There are no diagnostic tests and the final diagnosis is usually done on the clinical picture itself. Most of the patients suffering with proctalgia fugax also show evidence of irritable bowel syndrome. Both these disorders are commonly found in people who have an anxious nucleus.
The treatment includes use of warm fomentation or warm enemas, relaxation techniques or a trial of botulinum toxin in advanced cases. Low doses of diazepam at bedtime was tried as preventive. Inhaled salbutamol has also shown to reduce the duration of the attack. A diet rich in fibre content and drinking lots of fluids has been advocated for such patients.
A constitutional approach by selecting the most suitable homeopathic remedy based on the psycho-somatic makeup of the patient works best in resolving the recurrence of the pain. In case of acute episodes, remedies with spasmodic manifestations like colocynth, cuprum met, mag phos or plumbum met can be tried in medium to high potency, but in not so frequent repetitions.
Nitesh, a stock-broker by profession, had consulted me at Swaroop Clinic for a recurrent pattern of getting excruciating pain in the anal region. The frequency used to increase during stressful situations. Any kind of anger or vexation always triggered his symptoms. He used to relieve the pain by pressing hard at the affected region. Based on the symptoms, Colocynth 200 was given to him with a thrice-daily schedule followed by a constitutional therapy. His episodes stopped completely within four months.