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Rectal spasms (Levator ani syndrome, proctalgia fugax)

Medical ConditionGastrointestinal disorders

Abstract

Proctalgia fugax is a recurrent episodic form of a more prolonged and severe condition called levator ani syndrome. It is associated with often excruciating rectal pain and great difficulty defecating. It involves the internal anal sphincter and may represent neuralgia of the pudendal nerves. It has no known cure.

Symptoms

Recurrent anal sphincter pain, constipation, anxiety

Gastrointestinal Disorders

IBS

Pain Scale: Before Cannabis Use

10

Pain Scale: After Cannabis Use

2

Gender

Male

Age

25-34

Brief history and target symptomatology

The patient is a 26-year-old experienced computer specialist, fully and stressfully employed as a customer assistant in a retail electronics store. His rectal pain may occur at night or during the day, when it causes significant social anxiety.

Previous and current conventional therapies

Warm baths (if the pain lasts long enough to draw a bath), warm enemas, relaxation techniques. (Botulinum toxin, inhaled Albuterol and low dose diazepam at bedtime have been mentioned in the literature as occasionally helpful but the patient has not tried these.)

Clinical response to Cannabis

Inhaled marijuana brings immediate relief of the acute symptoms. Regular marijuana use somewhat decreases the frequency of pain attacks.

Additional Comments

Good review article, with references, in Wikipedia.

Usual method of Cannabis administration

Smoked

Frequency of Usage: Time Per Day

5

Frequency of Usage: Days per Week

7

Follow-up

The patient has been a medical marijuana user for about one year with continued relief but little change in symptoms.

Contributing Physician

Stefan Arnon, M.D.