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Proctalgia fugax , a variant of levator ani syndrome , is a severe, episodic pain in the regions of the rectum and anus. It most often occurs in the middle of the night  and lasts from seconds to minutes;  pain and aching lasting twenty minutes or longer would likely be diagnosed instead as levator ani syndrome. In a study published in involving patients, the attacks occurred in the daytime 33 percent as well as at night 33 percent and the average number of attacks was Onset can be in childhood; however, in multiple studies the average age of onset was
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New Protocol to Treat Anal Fissures | Columbia University Department of Surgery
Anal fissure is a common problem and is associated with severe pain and rectal bleeding. It is a longitudinal or elliptical ischemic ulcer in the anoderm, extending below the dentate line to the anal verge. A retrospective pilot study 6 and another prospective trial 7 to analyze the manometric and clinical results on this technique have already been published and this study is being presented with a longer follow-up of 24 months. Between February and August , patients of chronic anal fissure who were nonresponders to medical therapy [analgesics, stool softeners and nitroglycerine ointment] were treated with this procedure. Eleven patients were lost to follow-up and were excluded. The remaining patients were enrolled in the study men, women; mean age 29 years, range years.
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Anal fissure is one of the most common lesions to consider in the differential diagnosis of anal pain. This is an ulcer in the squamous epithelium of the anus located just distal to the mucocutaneous junction and usually in the posterior midline. It typically causes episodic pain that occurs during defecation and for one to two hours afterwards. Atypical fissures may be multiple or off the midline, or be large and irregular. These may be caused by inflammatory bowel disease, local or systemic malignancy, venereal infection, trauma, tuberculosis, or chemotherapy.
Proctalgia is pain due to a spasm of the pelvic floor muscles, the muscles of the anal sphincter, or the muscles of the rectum. This causes severe stabbing pain like a knife sticking into the rectum. This type of pain may originate without warning.