PMID: 8944574Oct 1, 1996Paper

Paroxysmal anal hyperkinesis: a characteristic feature of proctalgia fugax

Gut
S S Rao, R A Hatfield

Abstract

Proctalgia fugax is a common problem, yet its pathophysiology is poorly understood. The objective was to characterise colorectal disturbances in a paraplegic patient with a 10 year history of proctalgia fugax that began two years after an attack of transverse myelitis. Standard anorectal manometry and prolonged 33 hour ambulatory colonic manometry at six sites in the colon were performed together with myoelectrical recording of the anus. Provocative tests designed to simulate psychological and physical stress and two types of meals were included. Anorectal manometry showed normal internal sphincter tone and normal rectoanal inhibitory reflex but an inability to squeeze or to bear down or to expel a simulated stool. Rectal sensation (up to 360 ml inflation) was absent. Pudendal nerve latency was prolonged (4.5 ms (normal < 2.2 ms). During colonic manometry, the patient reported 27 episodes of pain, of which 23 (85%) were associated with bursts (1-60 min) of a high amplitude (0.5 to > 3.2 mv), high frequency (5-50/min) anal myoelectrical activity, particularly after stress tests, meals, and at night. The myoelectrical disturbance only occurred with proctalgia. Intermittently, 16 bursts of 3 cycles/ min phasic rectal contractions ...Continue Reading

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Citations

Jun 10, 2011·Diseases of the Colon and Rectum·Gary K AtkinCarolynne J Vaizey
Jun 18, 2010·International Journal of Colorectal Disease·Santhini JeyarajahSanjay Purkayastha
Sep 22, 2009·Current Gastroenterology Reports·Brian E Lacy, Kirsten Weiser
Jun 8, 2001·Gastroenterology Clinics of North America·A Wald
Oct 6, 2001·Journal of Clinical Gastroenterology·A Wald
Nov 3, 2001·European Journal of Gastroenterology & Hepatology·M A Potter, D C Bartolo
Nov 3, 2001·European Journal of Gastroenterology & Hepatology·P KatsinelosT Souparis
Aug 24, 1999·Gut·W E WhiteheadS S Rao
Nov 17, 2010·European Journal of Gastroenterology & Hepatology·Nikolaos P AndromanakosKostakis Alkiviadis
Apr 21, 2012·Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie·M DamphousseG Amarenco
Jul 24, 2007·Best Practice & Research. Clinical Gastroenterology·Jose M Remes-Troche, Satish S C Rao
Feb 19, 2009·Alimentary Pharmacology & Therapeutics·S S C RaoB Zimmerman
Sep 9, 2009·Pain Practice : the Official Journal of World Institute of Pain·Bas GovaertCor G Baeten
Apr 7, 2006·Revista clínica española·A M Sánchez RomeroR Calpena Rico
May 9, 2006·Gastroenterology·Adil E BharuchaSatish Rao
Feb 25, 1999·Gastroenterology·N E DiamantW E Whitehead
Sep 17, 2008·Gastroenterology Clinics of North America·Adil E Bharucha, Emanuel Trabuco
May 5, 2016·Gastroenterology·Satish Sc RaoArnold Wald
Oct 8, 2016·Mayo Clinic Proceedings·Adil E Bharucha, Tae Hee Lee
Jan 30, 1999·Occupational and Environmental Medicine·S SimkinA Malmberg

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