Have you experienced excruciating pain in the rectum as a result of spasms in your anal sphincter? You may not even know this condition is called proctalgia fugax and you may struggle with the agonizing pelvic floor pain with no quick solution. You may also not get much help from your doctor because the management of proctalgia fugax remains challenging.
The good news is that there is a simple solution that eases the spasms and stops the pain very quickly, typically in less than 2 minutes and sometimes as quickly as 30 seconds. Ashlee discovered how quickly a GABA lozenge worked to give her immediate relief from her scary and excruciatingly painful spasms.
Here is Ashlee’s wonderful feedback on the blog I wrote on this topic a few years ago after this started happening to me:
I want to personally thank you for this article and option of GABA to relieve the excruciating pain I was having.
After research I realized that my pelvic floor was having spasms. Such a new and scary feeling to have been having, and finding your advice and immediate relief of GABA changed everything!
Of course the scariest part initially is the pain and the “what is happening feeling!” But it’s quickly followed up with “when will this happen again, where will I be, and what do I do in that situation?”
I would highly recommend the GABA lozenges which I got at the vitamin store down the street. I carry them in a little baggie with me now just in case an episode happens. I did have an episode happen when I was on site of a job, and thankfully had the GABA lozenge to immediately relieve the pain, literally (within 30 seconds!! INCREDIBLE!)
The option otherwise (and what I did when it first happened) was to soak in a warm bath or with a heating pad, which obviously is not an option if you are at work or not at home.
The other options as suggested online are even scarier… resorting to electric shock up the rectum to ease the spasms! Yikes!
I thanked her for sharing how well the GABA lozenge works for her, saying how happy I am for her! I also let her know that I’d love to share it as a new blog post because it offers so much hope to others (hence this blog).
GABA Calm lozenge and other low GABA symptoms
I assume Ashlee is referring to Source Naturals GABA Calm lozenges which contains 125mg of GABA and is a sublingual lozenge. They do really work this quickly for spasms, pain and anxiety too. GABA always works best when used in a sublingual form like this or when a GABA capsule is opened onto the tongue.
I agree with her – it’s a good plan to keep GABA on hand in case she gets the spasms during the day. I also recommend having GABA next to the bed because it often seems to happen in the middle of the night.
I did ask if using GABA has also helped with easing her other low GABA symptoms. These can include:
- physical anxiety and overwhelm
- intrusive thoughts
- stiff and tense muscles or other muscle spasms/pain
- insomnia (often the type where you lie awake feeling stiff and tense)
- stress eating carbs or sugary treats
- self-medicating with wine or other alcoholic beverages in order to relax and fit in
You can see the entire list of low GABA symptoms here.
(I’ll share an update when I hear back from Ashlee.)
My experience, definition of proctalgia fugax, incidence and overview
I acknowledged her comment about it being very scary the first time it happens. I first blogged about this after it happened to me in 2017 and I figured out GABA worked very quickly for my excruciatingly painful spasms. It was really scary!
You can read about my experience and triggers on this blog: How GABA eases agonizing rectal pain and spasms in under 2 minutes.
The above blog also
- defines this condition called proctalgia fugax which leads to rectal spasms and sharp fleeting pain in the lower rectum or anus. In some people it can be more than fleeting and is often described as excruciating and agonizing
- shares how others describe the pain and how common it is (up to 18% of the population, more common in women and affects individuals between 30 and 60 years of age).
- discusses heating pads as a solution (they also work but can take 20 minutes to take effect and that is simply too long when you are moaning and writhing in pain)
- mentions medications that are commonly prescribed
- describes using 30-60 seconds of finger pressure as one possible solution
- reviews the BEST solution – sublingual GABA. Theanine and taurine can also help
Electrical stimulation of the anorectal muscles or botox – as treatment approaches
When I had first researched this a few years ago, I had not read about “electric shock up the rectum to ease the spasms” that Ashlee mentioned in her comment. I went looking and found this on Webmd:
For severe proctalgia fugax, electrical stimulation of the anorectal muscles may provide relief. This treatment option involves inserting a small, finger-sized probe into the rectum and using a low voltage current to relax spastic muscles through vibration.
This may be similar to the 30-60 seconds on finger pressure I described but I’ll take the GABA supplement thank you!
This article also mentions botox injections which I am aware is often done. But this opens up another whole can of worms with toxicity issues and the risk of increased panic attacks with botox.
I also share additional information here: How to address rectal spasms with GABA, pelvic floor work, gluten removal and squats
Management of proctalgia fugax remains challenging and treatment outcomes modest at best
A paper, Proctalgia Syndromes: Update in Diagnosis and Management, published June 2020 by gastroenterology departments in Ireland, Romania, Italy and the USA recognizes that “functional anorectal pain syndromes” are complicated and “are a neglected yet often disabling clinical entity resulting in significant economic and psychological burden to the patient.”
They acknowledge that “management of proctalgia fugax remains challenging and treatment outcomes modest at best” and conclude that “further investigation of treatment approaches in proctalgia fugax is required.”
I plan to reach out to the authors and share these wonderful results that individuals are reporting with the use of sublingual GABA. I would also love to get some case studies published so this approach becomes common knowledge.
Resources if you are new to using GABA and the amino acids as supplements
If you are new to using the amino acids GABA and the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see the low GABA symptoms here) and a brief overview here, Anxiety and targeted individual amino acid supplements: a summary.
If you suspect low GABA or low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids so you are knowledgeable. And be sure to share it with the team you or your loved one is working with.
The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acid products that I use with my individual clients and those in my group programs.
Have you ever experienced this rectal pain and spasms/proctalgia fugax? Has GABA worked for you? What else has helped?
If GABA helped ease the spasms and pain, how quickly did it work and what product did you use? Did it help with some of the other low GABA symptoms too?
Have you been able to figure out possible triggers or root causes other than low GABA?
If you’re a practitioner, have you seen this with clients or patients and has GABA helped them?
Feel free to ask your questions here too.
Hello Trudy,
Is GABA lozenge 125mg effective for pudendal nerve pain? One of my team members has suffered with what her GYN has told her is pudendal neuropathy. She is open to trying anything that you would recommend for this pain. It has prevented her from being intimate with her husband for years. She would love to regain her quality of life.
Thanks.
Dr. Bethea
12.3.21 926PM EST
Did your coworker try Pelvic Floor PT? It is usually a very effective treatment for problems like that.
Bella
Thanks for sharing and yes I agree. Can you share a little more for folks who may not be familiar with pelvic floor PT. Also how to find a pelvic floor PT and how quickly to expect results.
Have you seen this approach work with proctalgia fugax too?
And do you also initially use GABA with your clients?
Dr. Bethea
I have not come across anyone using GABA for pudendal nerve pain but it’s worth doing a trial especially if she experiences any of the other low GABA symptoms and she also experiences pelvic muscle spasms. Keep in mind 125mg is a typical starting dose for GABA and more may be needed but we always start low and increase as needed.
GABA has been found to be low in urologic chronic pelvic pain syndrome patients. More here https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC5702874/
I write about GABA reducing substance P and Calcitonin gene-related peptide (CGRP) here https://www.everywomanover29.com/blog/acupuncture-gaba-reduce-back-pain/
Two other amino acids help with pain too – tryptophan or 5-HTP (when there are low serotonin sypmptoms) and DPA/d-phenylalanine (when there are low endorphin symptoms). And CBD and PEA/Palmitoylethanolamide may also be worth exploring.
I’d also explore options with pelvic pain specialists (including pelvic pain physical therapists) and acupuncture.
I’m sure you’re aware it’s an “underdiagnosed, inappropriately treated” condition. This article is a good overview on treatment options for other blog readers: Pudendal Nerve Entrapment Syndrome https://www.ncbi.nlm.nih.gov/books/NBK544272/
I am not convinced that Dr. Bethea’s coworker has pudendal neuralgia. Unfortunately, some Drs use that diagnosis without proper testing. Did she have an EMG for the pudendal nerve? The inability to have vaginal sex is called dyspareunia. Dyspareunia is usually caused by an overactive ( tight and tense) pelvic floor. This tightness and tension may be caused by different reasons: decreased estrogen level in vaginal tissue, vaginal dermatological issues, stress-related tension, et., etc. Pelvic Floor PT should be able to figure out what the pain driver is and develop the best plan of care for this person. here are some links where you can find a PF PT in your area: http://hermanwallace.com/
https://pelvicguru.com/
http://www.womenshealthapta.org/
https://docs.google.com/spreadsheets/d/1hjh0yBqHf9qoLRSwg8j3cOBcKMXbPtRcLBkCgzAZEDc/edit#gid=0
http://www.pelvicpain.org/
It is hard to describe in a few words how pelvic floor PTs work, but I could provide some links to read about our work: https://www.pelvicpainrehab.com/female-pelvic-pain/401/what-is-a-good-pelvic-pain-pt-session-like/
https://pelvicpainrehab.com/pelvic-health/5711/part-2-of-2-what-is-a-good-pelvic-pt-session-like/?__s=prz5szvknkp5rgvp2s7k
https://www.mypfm.com/post/what-to-expect-with-pelvic-physical-therapy
https://www.expectingpelvichealth.com/blog-posts/the-difference-between-a-gynecology-exam-and-pelvic-floor-physical-therapy-exam
A friend has lower back lymph nodes. very painful! Wondering if GABA worth trying?
Patrick
I would not think so. I’d seek expert help to rule out lymphoma. And then get help on lymph drainage if it’s not lymphoma.
Although I can no longer recall the brand, the GABA lozenges I bought were stuck together by humidity after only a few days. Trying to scrape one out in the middle of the night to get back to sleep is a waker-upper!
But the suggestion of opening a GABA capsules onto the tongue is one I’d forgotten. Thanks, Trudy!
CJ
Yes I’ve seen that happen with the GABA Calm product but typically when it’s been opened for a long time in a humid climate.
Glad you like the reminder about opening the GABA capsule. Do let us know how you have benefited from GABA (or do still benefit)
Hi Trudy,
I just watched your last Anxiety Summit and would really like to get in touch with you so I can start taking the amino acids you suggested. I tried to contact you but have not been successful. I need some guidance as I am having major gut issues related to anxiety and the zoloft medication I have been taking for years. Does your book The Antianxiety Food Solution has instructions of the type of amino acids to take and how much is recommended to start?
I was hoping to have a consultation with you but I believe you are unable to offer it at this time.
Carole
When you are new to the amino acids (and other anxiety nutrition solutions like gluten/sugar/caffeine removal, blood sugar control, gut health, pyroluria etc) my book “The Antianxiety Food Solution” is a great place to start. More here https://www.everywomanover29.com/blog/the-antianxiety-food-solution-by-trudy-scott/ It’s a comprehensive approach – amino acids AND diet.
With anxiety I always start with addressing low serotonin with tryptophan or 5-HTP and low GABA with GABA. The best way to determine if someone may have low GABA/serotonin is to look at the low GABA/serotonin symptoms, rate them on a scale of 1-10 with 10 being worst, do a trial of the respective amino acid and rate the symptoms again right afterwards (in the next 2 to 30 minutes). Here are the symptoms https://www.everywomanover29.com/blog/amino-acids-mood-questionnaire-from-the-antianxiety-food-solution/
My book does have an entire chapter on the amino acids and many folks do really well implementing on their own. My online GABA Quickstart group program is helpful when you have questions and need guidance (and moral support/encouragement). More here https://www.anxietynutritioninstitute.com/gabaquickstart/
Apologies that you were not successful in contacting us
Your info is always so helpful, Trudy! Thank you!
I started having rectal spasms as a teenager with severe PCOS and estrogen dominance from about age 13. Of course, the only solution doctors offered me was birth control pills, which made everything worse, and all of that, including insomnia, contributed to low GABA, I’m sure. But at the time, I had no idea what PCOS or estrogen dominance was, or that there were natural solutions.
I haven’t had them in years but it’s so interesting to put the puzzle pieces together and understand what was happening to me for so many years. If only I had had good information like yours 30 years ago maybe my life would be worth something now!!
Ava
Glad to hear this has helped you put the puzzle pieces together. Unfortunately the BCP is so commonly offered as a solution and it does cause another whole set of issues. I write about some of the issues here – The pill and other hormonal contraception: depression, anxiety and FAM https://www.everywomanover29.com/blog/contraception-depression-anxiety-fam/
This is a great resource for anyone who has been on BCP – “Beyond the Pill A 30-Day Program to Balance Your Hormones, Reclaim Your Body, and Reverse the Dangerous Side Effects of the Birth Control Pill” by Dr. Jolene Brighten https://www.everywomanover29.com/blog/beyond-the-pill-by-dr-jolene-brighten-my-book-review/
Thank you Trudy !!
Been taking the GABA calm mind, severe insomnia and bladder urgency feeling need to go, but can hold it
has me getting up at night; often i take another Gaba chewable;
Pelvic PT been hard since muscles very tide for Theraphist to work on me; doing kegels, that just not doing much; not sure to go back to P.T.?
The Gaba Calm is in capsule form, did not try that one; if that would be better for insomnia and busy brain hard to shut down;
wondering about the Gaba chewable lozenge
there is fillers and artificial sugar in.. that should be avoided?
Thanks much ~
Blessings
Romy
It’s not clear what has worked or what your question is by sublingual GABA is typically more effective. If someone doesn’t want the GABA Calm lozenge I have them try GABA powder or open a capsule capsule
Thank you Trudy, i meant the Source Natural GABA calm mind, has 125mg GABA
the Calm is one has 750mg? Would be good to take higher amount when keep waking up from sleep ?
Thank you ~
I have been dealing with rectal pain for 18 years. Started after giving birth to my daughter. I didnt have it during my second pregnancy at all. It starts 10 days after the last day of my period and last about 10-12 days. It includes ovulation period and more. Mostly wakes me up at night times. Sometimes 3-4 times a night. lasts about 15-50 minutes. it is a carving pain. Nothing helps to relax. Pain killer (ibuprofen) doesnt work most of the times. I get up and sit on the hard part of the couch. Somedays I cant sit nor I can walk. (Like a short labor pain). During that 10 days, if i am stressed pain is more intense. cold aggrevates the pain. I used to take birth control pills when i was younger and it stopped the pain. Since bc pills are not good for health (unless the doctor prescribed it for medical resons) I quit taking them 15 years ago and have been having this carving pain every month for ten days for 15 years. Doctors say that everything looks good and I am very healthy. They dont understand the pain that i go through every month.
I am excited to start using GABA and i will post my result soon. Thank you for all your information. I have been reading online for the last 18 years to find anything about this pain and finally found your posts. Gave me hope again. Thank you.
Derya
Glad this gives you hope – please do share how GABA works for you (and sorry you’ve experienced these for so long)
Hey Trudy,
So I’m not sure if I have pelvic floor issues but I’d like your help understanding what I’ve been experiencing.
I’ve had stool blockage for almost a year now brought on suddenly. Many doctors have diagnosed hemorrhoids or constipation – I myself suspected cancer and got a colonoscopy where the doc said hemorrhoids were extremely small and another doctor says it’s not constipation because I go everyday no problem. Many doctors say I appear to be having some rectal spasming around the rim of my floor, but none seem to have a solution for this except Miralax or Binafiber.
Any idea what I might be dealing with?
I am a 31 year old male.
Clarence
With rectal spasms I have clients get a 2nd opinion and diagnosis of proctalgia fugax or at least give GABA a trial to see if it helps.
Hi Trudy – Thanks to you I have found relief from anal spasms using the Source Naturals GABA lozenge. I’m forever grateful for the day when I was listening to a podcast that you were on and mentioned it. In looking at the low gaba symptom list I only present with the spasms. I have not tried anything else and do not know what the trigger is. I do have Hashimotos and eat gluten free. I’m wondering if regular supplementation with GABA would prevent the spasms?
Lori
Wonderful to hear this helps! Many folks supplement regularly to build up GABA levels and then may only need GABA from time to time as soon as they notice a hint of a spasm coming on. I will share that many of my clients don’t feel they have any low GABA symptoms and then actually notice improvements in stress tolerance and better sleep when getting their levels up.
Please keep us posted
I happened to come across this article since I’ve been experiencing those symptoms for several months now after my morning BMs and my excruciating (understatement!) rectal pain continues through the day
I had originally wanted to know since I actually take MANY supplements and wanted to begin taking the GABA Calm as well despite my pain beginning in the morning after my BM, when should I take it? –but then after trying it on my own it actually does not seem to be working for me at all, despite taking more that one not sure why??
And was also wanting to know if there are any issues that may come from the Tyrosine it contains since there is a warning on the label about it?
Elliot
Our individual needs for GABA vary and a higher dose may be needed. I have clients increase to find the ideal dose and stop if they get adverse effects
There are some contraindications with tyrosine – I write about these in the amino acids chapter of my book “The Antianxiety Food Solution”
Thank you Trudy!
With regards to a higher dose would that be two or more lozenges at the same time or one more than once a day? I’ve already tried the latter with two and have gotten no result.
Also not to get TMI but despite me having normal BMs due to what I feel is a related nerve issue from my lower back my inner rectal tissue has gotten quite weak and with that my normal BMs are causing internal hemorrhoids every time which I must push back in when I’m done and after doing so is when my excruciating pain gets much worse despite the hemorrhoids being successfully back up. And the only thing that eases the pain is me merely touching the outside of my rectum and having to hold my finger there for a bit.
Again so sorry for the TMI
Elliot
I’m afraid I can’t offer specifics for someone via the blog but both options you mention could work.
The constipation/pushing and hemorrhoids does need to be addressed too and I often find my clients do well with the addition of magnesium – it improves bowel movements and helps with muscle spasms too.
Thank you Trudy and yes I actually do take a high dose of magnesium (citrate) every night reason being because despite my BMs actually being full and loose after each pass I feel extremely incomplete which leaves me sitting on the toilet for nearly an hour waiting for the next pass and which of course doing so doesn’t help matters. However the pain and pressure I’m experiencing is excruciating but progressively gets a little better as the day continues however it never fully goes away
I’ve been trying taking the GABA one tablet two to three times a day and still have had no resolution so not sure if I should take even more than that??
Elliot
I have clients slowly increase the GABA until they find resolution or they get to a point where they can decide it’s not related to low GABA