The pain may feel as if it would be relieved by the passage of gas or a bowel movement and usually subsides spontaneously within a few minutes. In severe cases, the pain can persist for many hours with recurrences. The patient may have undergone various rectal operations for these symptoms, with no benefit. Physical examination is often normal, although tenderness or tightness of the levator muscle, usually on the left, may be found. Occasional cases are caused by low back or prostate disorders.
Treatment consists of explanations to the patient of the benign nature of the condition.
An acute episode may be relieved by the passage of gas or a bowel movement, by a sitz bath, or by a mild analgesic. When the symptoms are more intense, skeletal muscle relaxants or anal sphincter massage under local or regional anesthesia can be tried. Physical therapy with electrogalvanic stimulation applied to the lower rectum is usually effective. All rights reserved.