Two conditions - proctalgia fugax and chronic proctalgia - are frequently suggested as the cause of anal or rectal pain. Of the latter, an NIH publication has the following to say, inter alia:
no organic disease explanation will be found in approximately 85% of patients presenting to gastroenterologists with chronic anorectal or pelvic pain.
No single treatment has been reported to be consistently effective in chronic proctalgia, and management can be a frustrating endeavor for both patients and physicians.
the minority of proctalgia patients affected by unspecified functional anorectal pain are still left without a satisfactory treatment option. In this regard, depression and anxiety are both frequently reported in non-responsive proctalgia patients.
The subject of pelvic, anal and rectal pain is apparently shrouded in relative mystery, and one wonders why, in the 21st century, this should still be so. Is it because of the absence of an 'organic disease explanation'? And why are gastroenterologists consulted about these conditions? Should not colorectal surgeons have the last word, although such specialists often appear uncertain when asked to determine the source of the pain?
