Medical disclaimer
Last updated
This website and the book it accompanies are education and lived experience. They are not medical advice, a diagnosis, or a prescription.
Who writes this
Everything here is written by Imran Khan, who has lived with proctalgia fugax since the age of fifteen and who has no medical training whatsoever. Not a physician, not a physiotherapist, not a researcher. Where I rely on published medical literature I cite it at the bottom of the page; where I rely on patient community reports I say so explicitly and present them as anecdote rather than evidence.
Why this matters more than usual here
Proctalgia fugax and levator ani syndrome are diagnoses of exclusion. That is not a technicality. It means they can only properly be arrived at once a qualified clinician has ruled out the other causes of anorectal pain — some of which are serious, and several of which are far more treatable when caught early.
Self-management is safe and effective for these conditions. Applied to the wrong condition, the same self-management is at best a waste of your time and at worst a way of quietly ignoring something that needed treating months ago.
See a clinician if any of these apply
- Rectal bleeding — any amount, any colour.
- Pain that is present between episodes, or that runs well past 30 minutes.
- A lump, swelling, or hard tender area you can feel.
- Fever, chills, or feeling systemically unwell.
- Unexplained weight loss, night sweats, or persistent fatigue.
- A change in bowel habit lasting more than a few weeks.
- New onset after the age of 50, or a family history of colorectal cancer or IBD.
- Pain reliably triggered by defecation.
- Pain following childbirth, pelvic surgery, or an injury.
- You fainted.
- Any symptom in a child, or in pregnancy.
The fuller explanation of each red flag is here.
Emergencies
If you are seriously unwell, this website is not the right place. Contact your local emergency services or attend an emergency department. Severe escalating anal pain with swelling and fever, in particular, can be an abscess — which is a surgical problem that does not wait.
Medication
Nothing here is a recommendation to start, stop, or change any medication. Some articles discuss prescription treatments so that you can raise them in an informed way with a clinician who knows your history. That is the entire intended use. Never stop a prescribed medicine on the strength of something you read here.
No clinician–patient relationship
Reading this site, buying the book, or emailing me does not create a clinician–patient relationship of any kind, because I am not a clinician. I cannot and will not tell you what is causing your pain.
External links
Source links point to reputable third parties — Cleveland Clinic, the Merck Manual, the Rome Foundation, PubMed and others. I do not control their content and their inclusion is a citation, not an endorsement of everything they publish.