Proktalgiya – the pain syndrome in the field of back pass and a rectum caused by a muscular spasm. It is characterized by attacks of sharp pain, with irradiation in a stomach, a crotch, a tailbone. Pain can independently pass after defecation, a heat sedentary bath. The disease can proceed is long, exhausting, with development of a kantserofobiya. At the phenomena of a proktalgiya of the patient needs consultation of the coloproctologist, carrying out manual and tool inspection of a rectum. Depending on the reasons of a proktalgiya the physical therapy, blockade, medicamentous therapy can be appointed. Identification and treatment of other diseases of intestines and urinogenital system, psychoprevention is important.
Proktalgiya – the pain syndrome in the field of back pass and a rectum caused by a muscular spasm. It is characterized by attacks of sharp pain, with irradiation in a stomach, a crotch, a tailbone. Pain can independently pass after defecation, a heat sedentary bath. The disease can proceed is long, exhausting, with development of a kantserofobiya. Identification and treatment of other diseases of intestines and urinogenital system, psychoprevention is important.
Many diseases of a rectum are shown by a pain syndrome. Pains can be various character, have connection with defecation (to arise during it or after) and various intensity. If it is not possible to find the organic reasons of pain in a rectum, the doctor diagnoses existence of a syndrome of a proktalgiya (pain in a rectum of an undetected etiology). Proktalgiya can be called by psycho-emotional experiences, spasms of a rectum of neurologic character.
Proktalgiya is more characteristic of men of average age category. It is shown usually by attacks of suddenly arising pain in a rectum of various intensity and duration (of several minutes before half an hour). Painful attacks can arise several times in a night and promote development of sleep disorders. Rectum pain demands the obligatory address to the expert for careful inspection and detection of possible proktologichesky pathology.
Proktalgiya can have as flying character (pains suddenly develop and also unexpectedly pass), and to last till several hours, without giving in to effect of anesthetics. Pain can have the pricking or spastic character. Pathogenetic as the proktalgiya reason most often serves the neurogenetic spasm of muscles-levatorov of a rectum, or coccygeal muscle. The stress, psychological experience, a heavy physical overstrain can serve as the reason.
The secondary proktalgiya is a consequence of proktologichesky diseases (a crack of the anal channel, sharp hemorrhoids, a paraproktit, tumors of the anal channel, the complicated kaudalny teratoma, perianalny localization of defeat at a disease Krone). Besides, the proktalgiya can be manifestation of an idiopathic anokopchikovy pain syndrome. Sometimes at endometriosis pain irradiates to the area of a rectum.
The transient or passing proktalgiya represents suddenly arising and the pricking rectum pains which are passing in a few minutes sharp subjectively felt as a painful convulsive spasm. Pain can irradiate in a tailbone, back pass, a crotch, coxofemoral joints.
Pain is not connected with defecation. Painful attacks can sometimes be noted with a big frequency and considerably worsen quality of life of the patient. Quite often the proktalgiya is followed by the discomfortable feelings in a crotch suggesting patients an idea of possible pathologies of the urinogenital sphere.
Proktalgiya proceeds is long, wavy, with the calm periods which are replaced by aggravations in the form of increase of attacks of pain. Over time the frequency of aggravations usually increases. The factors provoking aggravations up to the end are not revealed and most likely, have psycho-nevrogenny character.
Diagnostics of a proktalgiya
At inspection of patients with a proktalgiya quite often in the anamnesis the postponed diseases of bodies of an urination, the sexual sphere, and also proktologichesky pathologies are noted. However, primary proktalgiya usually precedes these pathologies (patients note that rectum pains happened earlier) and quite often is the reason of the address of patients to the gynecologist or the urologist. "a proktalgiya syndrome" the doctor needs to make full inspection regarding detection of diseases which can clinically be shown by rectum pain for diagnosis.
Fizikalny inspection of such patients is supplemented with survey of field of back pass and a manual research of the anal channel. Manual research usually without serious consequences. Sometimes it is possible to note a spasm of levator. Sfinkteromanometriya at a proktalgiya usually does not reveal pathological changes of a tone. Make a rektoromanoskopiya for detailed inspection of walls of a rectum. If necessary to examine the top departments of an obodochny gut carry out a kolonoskopiya or an irrigoskopiya. Laboratory blood test helps to reveal signs of inflammatory process. For an exception of pathologies of urinogenital system appoint consultation of the gynecologist and urologist, carry out ultrasonography of a bladder and bodies of a basin.
In case of lack of organic and functional violations and at the available complaints to pain, diagnose primary proktalgiya. Differential diagnostics of a proktalgiya is made with a syndrome of a pear-shaped muscle and a koktsigodiniya. Usually patients with these pathologies were already treated in various ways therefore the analysis of the procedures taking place and their results is necessary.
Basic principles of treatment of a proktalgiya
At a proktalgiya the following medical procedures are applied to simplification of painful attacks:
- physiotherapeutic techniques (UVCh, infrared radiation by the semiconductor laser intrarektalno, diathermy, mud cure, electrostimulation, etc.);
- novokainovy blockade (perisakralny, epiduralno-sacral and retrorectal);
- massage of a coccygeal muscle and levator of back pass at their expressed spasm;
- microenemas with novocaine, sea-buckthorn oil and kollargoly;
- demulcents (sedative, somnolent, easy tranquilizers).
Usually the course of treatment is begun with sanitation of a rectum with antibacterial medicines as a measure of treatment of the possible hidden proktosigmoidit. As primary proktalgiya has a certain dependence on a psychoemotional condition of the patient, the main objective of therapy of this disease is creation of psychologically comfortable situation, a protection from stresses, retension. Quite often apply psychotherapeutic techniques of a relaxation. Sometimes consultation of the psychologist is required.
Besides performance of medical appointments, it is recommended to patient to adhere to the diet contributing to digestion normalization. Secondary pathology passes after treatment of the main pathology which caused morbidity.
Often the proktalgiya passes independently, but in certain cases persistent frequent emergence of painful attacks promotes noticeable deterioration of life of patients and decrease in their working capacity.