If you’ve ever experienced sharp pains in your bottom out of nowhere, you may have shied away from seeing your doctor or speaking to anyone about it out of embarrassment. But you may still have wondered what causes these intense pains, and whether you should be concerned about them.
To find out more about these cramps and pains, HELLO! caught up with NHS GP Dr Masarat Jilani, who shared the lowdown on proctalgia fugax, often dubbed ‘lightning bum’.
What is proctalgia fugax?
Often, these intense pains are due to a little-known condition called proctalgia fugax, and not usually a sign of anything more serious. “Proctalgia fugax is defined as sudden, brief episodes of severe pain (cramping or sharp) in the rectal/ anal area. These episodes can last between seconds to minutes. Often, no structural abnormality can be found in a basic physical examination,” Dr Jilani explains.
What triggers proctalgia fugax?
Just as there is often no underlying condition associated with ‘lightning bum’, there are also no confirmed causes for why it occurs, as the women’s health expert explains. “Despite the impact this condition can have on an individual, the causes and triggers remain unclear. There are theories that it could be related to sphincter muscle spasm in that area or neuralgia of the pudendal nerve. In some cases, sphincter thickening has been noticed, though,” Dr Jilani says.
You may have also heard of this pain referred to as ‘lightning crotch’, a common pregnancy complaint that involves similar muscle spasms and discomfort in the pelvis. However, it can occur at any time, not just in pregnancy, with women more likely to experience it than men.
“Proctalgia fugax affects women approximately twice as often as men. On average, it affects women around the age of 50. The reason for increased prevalence in women remains unclear, but is likely related to multiple factors, including hormones affecting nerve sensitivity and the fact that women can have increased risk of pelvic floor dysfunction,” the GP shares.
Unfortunately, while it can have an uncomfortable impact on someone’s quality of life, there is little that can be done to help it, and often, there is no underlying disease found. “There are correlations, though, with other functional gastrointestinal disorders and pelvic pain syndromes such as IBS and levator ani syndrome,” Dr Jilani adds.
Can it be treated?
Due to the unpredictable nature of ‘lightning bum’ attacks, there is little you can do to stop them. But, Dr Jilani says there may be medical options available from a doctor if it impacts your quality of life.
“Treatment options can be limited because these attacks are often so short and sudden, but options that have been offered to patients include soothing the area with a warm bath and applying a topical smooth muscle relaxant treatment like GTN and diltiazem, which are also used in anal fissure treatment,” the GP says.
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