Proctalgia fugax is described as a condition that 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.
This paper describing proctalgia fugax shares how this pain can
recur over weeks, is localized to the anus or lower rectum, and can last from seconds to several minutes with no pain between episodes. There is no diurnal variation. There are numerous precipitants [preceding factors] including sexual activity, stress, constipation, defecation and menstruation, although the condition can occur without a trigger.
Although the cause of proctalgia fugax is unclear, spasm of the anal sphincter is commonly implicated. The condition may be more likely to occur after sclerotherapy for hemorrhoids and vaginal hysterectomy. There are also associations with other functional pathologies, such as irritable bowel syndrome and anxiety.
My story
I have experienced this awful anal sphincter spasm and pain myself so I want to shine some light on this condition and offer the simplest and most effective solution: oral and sublingual GABA. It works to completely eliminate the pain in 1-2 minutes! And it can also be used to prevent a full-on spasm if you catch it in advance. More about this below.
Let me first share my story so you can relate to the pain. I started to experience this a few years ago. It was right after my aunt died from rectal cancer and my immediate thought was that I was dying of cancer. That’s how bad the pain was. It’s like nothing I’ve ever experienced and I’ve had some pretty bad pain experiences: shingles, a tick bite headache, ice-pick headaches from a neck injury and poking my eye on a tree-branch while hiking.
For me, since it initially used to happen during the night, it felt like I was in bad dream and was lying somewhere injured and in agony. I would half wake-up moaning in pain, not quite grasping how the pain I was feeling could be so bad. Then I would come fully awake and feel the need to bear down (as in needing to have a bowel movement) but this would actually make it worse.
How do others describe the pain?
When I shared this paper on facebook one woman said her rectal pain and spasms last 20-30 minutes and is bad a childbirth.
Someone else shared that her husband “complained of feeling like a knitting needle was being driven through his anus.”
What do I think my triggers are?
I have not had sclerotherapy for hemorrhoids or a vaginal hysterectomy. I do have a history of anxiety and panic attacks (in my late 30s) and do have IBS/SIBO right now and I suspect that both low GABA and IBS/SIBO are my biggest root causes. I no longer have any anxiety but since I respond so well to GABA I assume my GABA levels are not optimal (likely due to the SIBO). I suspect exposure to hidden sources of gluten could also be a factor, and this could also affect my GABA levels.
Medications or heating pads as a solution?
I didn’t ever consider the conventional approaches which include: botox, benzodiazepines, SSRIs, Gabapentin, lidocaine, oral diltiazem, topical glyceryl nitrate, nerve blocks or salbutamol.
A warm bath has been reported to help but I was looking for a 1-2 minute fix (and less if possible). Once you’ve experienced this pain you’ll understand that you not imagine running a bath in the midst of a spasm and waiting to get in it.
Heating pads do also work but can take 20 minutes to take effect and that is simply too long for most people.
The first solution for in-the-moment relief (takes 2 to 12 minutes)
After the first episode I started searching online and because I didn’t know it was called proctalgia fugax I searched for “rectal cramp”, “rectal spasm”, “anal cramp” and came across forums with hundreds of women asking about it and describing their pain.
But no-one really had a solution and many had seen their doctors without much success. The best solution that many people use is 30-60 seconds of finger pressure (with the finger wrapped in toilet paper) in the anal sphincter during a spasm. Sometimes this is needed for up to 2-3 mins and sometimes doing this 2 or 3 times a few minutes apart is needed. Think about how you put pressure on a calf muscle spasm to stop the cramps. This works well but the agony can last for the entire 2 to 12 minutes (depending on how many times it has to be done). Adding a small amount of arnica cream onto the toilet paper seems to helps too.
How common is it?
It took more searching and reading and then I discovered what it was called. Once I found a name for it and started looking into I was surprised to see how common it is:
The prevalence of proctalgia fugax in the general population may be as high as 8%–18%. Many patients present to primary health care physicians and often do not require further consultation because the symptoms are fleeting. This condition is more common among women than among men, and usually affects patients between 30 and 60 years of age.
Although it’s more common among women I worked with a male client who experienced this. During one of his episodes, the pain was SO bad he actually passed out and hit his head on the bathroom floor.
The best solution for almost-immediate relief (takes 1 minute)
I know that GABA works amazing well for physical anxiety and stiff and tense muscles and I decided to try GABA in the midst of a spasm. It worked amazingly well and within 1 minute the terrible pain started to ease. It does need to be taken sublingually and I have found that 250mg to 500mg opened onto my tongue works best for me.
Each person would need to find the ideal amount for their needs but at night this should be a reasonable amount. During the day this could be too much and make you sleepy or too relaxed.
I’ve also used a combination of sublingual GABA and theanine with similar results.
I know GABA isn’t readily available everywhere so I did an experiment with taurine and found I needed more (at least 1000 mg) and it did take longer (2-3 minutes) to get relief, but it did work.
THE immediate solution for preventing the spasm
But I have now gotten to the point where I can nip it in the bud and prevent the spasm altogether – by taking sublingual GABA at the very first hint of an ache or twinge. I’ve been fortunate that when this does happen (about once a month and sometimes every 2 months) it’s around 8-11pm.
The long-term solutions for getting to the root cause/s?
We always want to get to the root cause of an issue and that is the next step. I reached out to the practitioners in my community to ask them how they help their clients and patients with this and what approaches they have used to end the spasm and pain. I will be sharing some of their solutions and how to get to some of the root causes in part 2.
UPDATE: Here is part 2 – How to address rectal spasms with GABA, pelvic floor work, gluten removal and squats
I’d love your feedback!
I’d love your feedback so I can learn what works, so we can all learn from each other and so others get answers quicker than I did.
Have you ever experienced this rectal pain and spasms? And what has worked for you?
I’d love to know if it is more common after sclerotherapy for hemorrhoids and vaginal hysterectomy? Have you had either? Or any surgery in the abdominal area?
Do you also have IBS/SIBO? What about celiac disease or gluten sensitivity?
Do you currently have anxiety or mood issues or have a history of anxiety or mood issues? How many low GABA and low serotonin symptoms do you have – here is the questionnaire (a paper from 1965 mentions that patients with proctalgia fugax have been described as irritable, perfectionistic, meticulous, obsessional, tense, and anxious)
If you’ve tried GABA or these other approaches (or decide to try them) please come back and share. Too many people don’t know about this and it needs to change!
Thank you. I thought the horrible, shooting pain up the lower rectum/spine area was just a weird quirk with me when I am menstruating, especially around the time of a bowel movement. I will try GABA next time after probably 25 years of this.. So sorry to hear some people have it much worse. And if it helps in your research I am ” irritable, perfectionistic, meticulous, obsessional, tense, and anxious” as mentioned in the article and have always been. Never had any surgery, though.
Heather
Thanks for sharing and sorry to hear you experience this too – wow 25 years! Too often us women think it’s just us and I encourage seeking solutions no matter what weird quirks we think we have! 🙂
Hearing the menstruation feedback makes me think of a possible hormonal aspect. GABA and tryptophan (for the obsessive/perfectionistic aspect) helps with hormone balancing too, as does addressing pyroluria (the social anxiety aspect). This article covers some of this https://www.everywomanover29.com/blog/tryptophan-for-pms-premenstrual-dysphoria-mood-swings-tension-irritability/
I’d love to get some feedback from you as to how things go
Thank you so much for sharing!! My poor husband has been suffering from this for a few years now, he is 60 and in otherwise perfect health. I read your post to him and feels comforted to know he is not alone. We are now traveling and do have Gaba Calm and L-theanine with us, but we will stop at Whole Foods and see if we can find the stronger dose of gaba just in case!!! As always, love your posts!!!
Julie
He is not alone! so glad he feels comforted 🙂 Please do keep us posted on how he does with the GABA
What is GABA???
Cheryl
A calming amino acid and neurotransmitter. I have an entire chapter in my book “The Antianxiety Food Solution” on the amino acids
Thank you for your comprehensive explanation of this diagnosis and your forthright sharing of your personal experience. I’m sure you have educated and reduced the anxiety of a population of people who experience this “torture”! GABA causes palpitations for me but I will seriously consider trying it.
Victoria
I wouldn’t use GABA if it causes palpitations or I would at least experiment with super small amounts. I mentioned I’ve used up to 500mg – for many people this is too much and even 100mg may help. Taurine may be an option too. For those who can’t tolerate GABA or taurine part 2 will cover some other options and how to address some of the possible root causes.
May I ask what has helped you? and what your triggers may be?
I found that once I eliminated gluten from my diet, this almost eliminated the problem. If it does occur (usually in the middle of the night), I have to get up and either walk or sit on the toilet until the pain subsides.
I do not have IBS/SIBO. I’ve not had the surgeries that you mentioned. I did have a large umbilical hernia repaired many years ago.
I suppose at times I could be described as “irritable, perfectionistic, meticulous, obsessional, tense, and anxious”.
I’m glad to have a name for the problem as well as a solution! I’m glad to know I’m not alone!
Mary
Thanks for sharing and additional feedback – and you are not alone! It seems abdominal surgeries and gluten can be triggers. Keep us posted on GABA and/or theanine of taurine if you decide to use this approach. I’ll be sharing more next week
My Gastroenterogist recommended going into a deep squat when the spasm starts. I tried and it worked!
I had a vaginal hysterectomy many years ago. And I’m always working to reduce my perfectionism and anxiety.
Maggie
Thanks for sharing some of the possible connections and your solution – wonderful! I’m going to have to try that too. And I’m sure other readers will too!
Thank you for writing about this. I have experienced this 3-4 times in my life. Always in the evening or middle of the night. After the second time I looked it up but found no remedies, so this info is great! I will be prepared for the next time (should it occur). I definitely tend towards anxiety, perfectionism, etc. No history of sclerotherapy or hysterectomy.
When I took GABA in the past for anxiety etc., it really seemed to make me more anxious. I probably still have some in my cupboard, but since I did not have the expected result for anxiety, I wonder if it would not be the best choice for me in this situation either . . . I would like to use something which works quickly, so the sublingual option would have been appealing. I have used l-theanine with good results (for anxiety) and have never tried taurine before.
Thank you to Maggie as well for sharing the deep squat idea!
Emily
Thanks for sharing your connections. I would not recommend GABA for someone who gets more anxious with it. When something does work, like theanine, I’d go with that approach. Let us know when it happens again and what approach helps. More on root causes and other longer-term approaches next week
Hi Trudy, thank you for this info!
I never knew there was a name for this pain. I started experiencing this recently a couple months ago. I didn’t know what to think. The pain wasn’t excritiating but it hurt and was worrisome. I kept it to myself because I was embrrassed to mention it. I am fortunate the pain did not last long and was tolerable. I’m hoping it doesn’t get worse or does not come back. I do have some anxiety, am obsessive about supplements to take not to get cancer, diabetes or illness to cause early death, and I have IBS. I’ve changed my diet somewhat by adopting some principles of the Weston A. Price Foundation thru a Meetup group. They were so informative and educational. I look forward to your next writings.
Denise
Thanks for sharing – often women don’t want to talk about these things but I’m hoping articles like this will make it easier to share. Glad to hear the dietary changes seem to be helping. I would work on the anxiety and obsession 🙂 – there are wonderful nutritional solutions
I have had this issue since I was about 45 (I’m now 60) at least a few times per year. It lasts usually 15 to 30 minutes and is extremely painful. I also didn’t know what it was for several years. It has even occurred while I’ve been out on a long walk, far from a bathroom (horrors!). I worry about a long plane flight that I’ll need to take soon. No predicting it! I do have some perfectionism, though I’m working on it! 🙂 I wondered if the vaginal prolapsing along the rectal wall that I’ve had due to childbirth might be contributing. Thanks for sharing!
Suzanne
Thanks for sharing – 30 mins is a long time! I’d have GABA on hand all the time and remeber the finger massage approach too if you don’t have GABA when you’re out and about.
And yes vaginal prolapsing could be a factor and is one reason why working with a pelvic floor PT helps so much (more on that in part 2)
Perfectionism is often related to low serotonin and tryptophan is a wonderful solution! It helps with worry too
I used to get these right before my period – hormonally related for me. Interestingly, I have been taking Pharmagaba to help me sleep better and to help me relax…noticed that I haven’t had one of these “butt cramps” as I call them, in months.
Eleni
Thanks for sharing here – glad to hear the pharmaGABA seems to be helping the “butt cramps” and improving sleep and relaxation. I laugh about mine as being my “pain in the butt”! Sometimes we have to just laugh about these things 🙂
I have had this pretty much all my life. More common with my period and the spasm lasts for close to 1/2 hour or so. Very deep aching pain. Sitting on the toilet and pushing down like with a bowel movement or sitting on my foot to apply upward pressure before the spasm gets to deep will generally shorten the duration. I do have IBS and am a perfectionist. I have found that stretching and holding the stretch for a few minutes will ease the intensity and duration of the spasm.
Sharon
Thanks for sharing – wow 30 mins is a long time! Good to know about the tip to sit on your foot. What kind of stretch do you do?
For perfectionism I look at serotonin support 🙂
I started having this problem around 25 years ago after a major back injury. I had no idea what it was and never mentioned it to a doctor, but took benzos for it back then. I haven’t had any surgeries, but I’m sure I had IBS for many years. I’ve gotten a lot healthier over the past few years, thanks to hearing you and others on Sean Croxton’s Depression Sessions (and many other holistic health summits since then). But I definitely have one or two (or ten!) of those personality traits! 😉
I still get them occasionally, so I’ll try the GABA for sure because, boy, they hurt! Thanks so much for talking about this.
Marta
Thanks for sharing and do let us know how the GABA goes. I’m curious if taking benzodiazepines helped? and if you took them just during an episode and how quickly it helped?
I was taking benzos on a regular basis for anxiety, but when I’d have an episode of proctalgia fugax, I’d dissolve a tab under my tongue and it would help the pain within a few minutes. I don’t know how I even knew to do that, but it was a great help. Hopefully the GABA will do the same thing, along with a few of the other suggestions I’m seeing here.
Marta
As I would expect benzodiazepines do help but open up another whole can of worms – with tolerance (and needing higher doses), addiction and withdrawal (more here https://www.everywomanover29.com/blog/world-benzodiazepine-awareness-day-say-no-benzodiazepines-anxiety/). So if GABA helps that’s the way to go. Please keep us posted
I was fortunate to get off the benzos after having been on them for many years and I’d never want take them again, but when I get a “butt spasm” I sometimes wish I had just one because they worked so well. But knowing the GABA may help is a much better option. Thanks for all your help, Trudy.
Now we know what it is called! My Hubby has suffered from these for a few years. We are in the process of working through his possible IBS symptoms and SIBO is suspected. His cramps happen late in the eve and ruin the night’s sleep. I am training as a FM health coach so we have been trying many things and some that work are aspirin(sometimes). Surprisingly quick relief in 15 mins from D for H – Gastromend. a product that is healing for entire GI tract. Drinking Aloe juice may be helping. We have found a sensitivity to corn, coconut, and nightshades and eating these brings on an attack. I suspect gluten as well but don’t always get an attack the way corn will. He is certainly in need of some neurotransmitters and is a meticulous perfectionist worry-er. Especially when this pain keeps him up at night! No surgeries or physical issues besides hemorrhoids. But this pain is very separate from the hemorrhoid issue, no correlation besides general location, they flare at different times. Thanks for spreading the word about this painful problem!!
Laura
Thanks for sharing about the connections you have found and some of the solutions. Interesting about Gastromend for in the moment relief. Please keep us posted if he tries GABA and if it helps. And stay tuned for part 2. I’d like to include some of this feedback in part 2 if you don’t mind?
please feel free to use. The Gastromend only takes 15-20 mins to work but not the few mins like GABA. We will def have some GABA on hand for that for next time. He has tried some 5htp in the past to treat issues like sleep but it keeps him awake. But maybe GABA is the one he needs. He seems to have the opposite biology. Uppers make him sleepy and downers make him hyper. Looking forward to part 2 of Blog on this subject.
Laura
Thanks! Please keep us posted with the GABA results. I would start super low. Re the 5-HTP it can be stimulating in someone with high cortisol and too much can be an issue too
Hubby had the pain again last night and asked me for the things to try. I have not purchased GABA yet but had Taurine and Theanine on hand so had him use those two sublingually plus he took the GastroMend. The pain stopped in 10 mins and he slept soundly!
Laura
Thanks for the update – so from 15 minutes with Gastromend to 10 min with Gastromend and sublingual taurine and theanine? That’s a big improvement! May I ask how much of each? I do find you need more of these aminos compared to GABA.
Sorry, should have included amounts! Taurine was 250mg and theanine was 200mg. Next time I might up the Taurine but was wary at first. Also may see if I can have him try the aminos first then the GastroMend if they don’t work in a bit just to have a real test.
Thanks for the update Laura – it’s good to go low and slow but these are both quite low amounts
I apologize in advance for such a long post but this ‘harmless condition’ turned my life upside down for a few years. I’m so glad someone who is popular is talking about this! I have lived with this for 9 years ( since the birth of my daughter). I had maybe 2-4 attacks prior but that was it. I began having them at least once a month and tried and researched everything but to no avail. One day at work (I’m a teacher) I had such a wicked attack I passed out in class . This was the start of one attack after another, several times a month. I had so much anxiety about when another attack would occur that I developed panic disorder and general phobia with my body. I’ve recently been seeing a new naturopathic doctor who addressed SIBO, hormone imbalance as well as a stubborn parasite. My attacks most often occured in corelation to constipation, digestive upset and ovulation pain ( I had low zinc and progesterone). Addressing all three factors has helped. As some have mentioned anxiety or stressful times was a huge trigger (I am still pretty type A) and I finally learned one reason among many that stress triggers it. My naturopathic doctor sent me to see the ‘guru’ in pelvic floor therapy–Caroline Allen in Ottawa. I suffered for years with anxiety and did not realize that I was still constantly holding my tummy in as an old habit to stress even now that I have overcame my anxiety disorder. She taught me how to relax the core which was a challenge at first and required much conscious thought–those muscles had many years of training to stay tight. I was also breathing incorrectly and she showed me that when our breathing is incorrect, our diapghram is tight and then it pulls up and tightens the entire pelvic floor. I can often prevent or significantly decrease the severity of an attack by reminding myself to relax certain key muscles and breathing into the pelvic floor. Sufficient water and 3 150mg magnesium capsules a day has also helped to prevent them. I know some people get attacks as a result of food allergies. Food too high in phytic acid is a huge trigger for me…I avoid nuts like the plague. For some it is corn. I think i practically have an unofficial. Ph.d on proctalgia fugax. It seems no one in the mainstream medical field is concerned about it. It may be physically harmless but I know many people on other forums who live in constant fear of an attack–especially publicly. It is far from psychologically harmless so thanks Trudy!!! A great book on this is ‘ A Headache in the Pelvis.’
Lorraine
Thanks for sharing your journey and solutions for this. Other than on twice mine have all been evening/night but both day episodes was when I was with clients (once in person and the other time on the phone) and it was awful.
You have figured out so many possible root causes with your ND – so glad your approach is helping. Love that you were referred for pelvic floor therapy. I’m going to cover this in part 2 of this article. Thanks too for the book resource. I will also check it out.
This is good but sad…”I think i practically have an unofficial. Ph.d on proctalgia fugax”. It’s so unfortunate that so many women struggle with this without solutions. There are 113 papers in pubmed with the first one published in 1946! Maybe we need to get some case studies published – yours (and those of others commenting here) would be fabulous to include.
It’s no clear if you still have them as frequently or if they are just less severe? And I’m curious if you’ve ever used GABA and seen a connection?
I had an attack three months ago at a restaurant, and then perhaps 2 months prior. I am getting them less frequently. For the most part they are less severe due to me having an awareness to check and see if I’m tightening my pelvic floor when stressed and other times of the day. (Apparently most animals do this when stresssed–they tuck in their tail). I have succumbed to taking a sublingual ativan when it happens in public. I never take meds (natural childbirth) but now I am going to try GABA! I know Ativan is so toxic and hate that I take it but my episodes can last up to 3 hours if I dont catch them. I also always keep magnesium on me as that helps too.
Lorraine
So glad to hear they are less frequent. As I would expect benzodiazepines do help but open up another whole can of worms as you say – with tolerance (and needing higher doses), addiction and withdrawal. So if GABA helps that’s the way to go. Please keep us posted
I’m going to share some of your exercises and tips in part 2 as I’m sure they’ll be valuable to others too
Hi trudy,
Thank you for letting us all know about proctalgia fugax and the use of GABA for the pain. I have been having these spasms off and on for about 2 years, and when I get them, they are so painful. Nothing seems to help me except for a really hot heating pad. It usually takes about 20 minutes or a little longer for the spasms to go away. Most of the time it happens at night while sleeping. The spasms will wake me up, and I have to quick get the heating pad.. A couple of times I had spasms during the day, but the spasms were not as bad as they are at night. A family member passes away in 2015, and I lost my job in 2016. After reading your article, I think it does have something to do with anxiety, and stress, My psoriasis has been really bad this year as well. I have never been checked out for hemorrhoids, but I do have gluten intolerance, and have been gluten free since 2009. I also stay away from dairy, all grains, and eggs. Recently I went off of all nightshades and on a lectin free diet. I haven’t seen any difference yet, and it has been over a month, but then again I haven’t had an spasms lately either. Not sure if that is a coincidence or not. I think I am going to invest in some sublingual GABA to have on hand for the next episodes of spasms.
Elise
Thanks for sharing and helping us to see some of the possible connections. I have my clients keep a food mood log and adding these spasm events + stressful events/times do help us pinpoint possible root causes. More to come in part 2. Having GABA on hand is a great option until we have it all figured out plus if GABA is low you get the calming benefits too. Cravings reduction is a big added benefit too.
I can’t believe there is a name. I have gotten this spasm at random times over the years – always in the daytime and usually when I was doing something I enjoy. To treat, I rub the inner ankle area (above the bone) in an upward motion – both sides. I rub as hard as I can. It takes a few minutes of rubbing but the pain reduces almost immediately. I went to a foot reflexologist and she said that this area relates to the rectum. Thanks, Trudy, for putting a name to it!
Susan
Glad you know the name now! Proctalgia fugax means “anal pain of unknown cause.” (http://www.medicalnewstoday.com/articles/317254.php) Very interesting about the reflexology points. I found this chart http://www.west-meet-east.com/altereflex.htm – is that where you rub? (search for “Rectum and Anus”)
Hmmm – I am really wondering if this is what I have been experiencing for YEARS with increasing severity! Doctors don’t seem to have a clue as to what I’m talking about. The gastro doc. says it’s hemorrhoids, but having them banded (OUCH!) didn’t help at all. I always describe the pain as feeling like a knife is being rammed up my behind. It usually happens after my morning bowel movement and can last for HOURS, then disappears as quickly as it came on, as though nothing ever happened. (the hours part has me wondering if it’s the same thing you are describing). I sense it’s diet related and have discovered that the following foods bring it on the next day: gluten, onions, citrus, especially orange juice, and black tea. Staying away from these foods has made a huge difference, but I still get episodes, which makes me think there’s another trigger I haven’t discovered. During the worst flair-ups I also have bleeding. And it is DEFINITELY also brought on by stress! Taking Naproxen helps, but I am going to try your GABA suggestion. Can you recommend a reliable source/brand in particular?
Cathy
Thanks for sharing. The link to food triggers makes me suspect this condition but I don’t know about the long duration and with bleeding I’d want to have my client check out hemorrhoids (which you’ve done) and rule out colon cancer. My concern with long-term Naproxen is the side-effects of an NSAID like this (https://www.drugs.com/sfx/naproxen-side-effects.html)
Thanks for your comments, Trudy. I don’t take Naproxen very often, but the fact that it does alleviate the pain has made me believe this is inflammation caused by the food triggers. I read the paper on the condition in question, and it looks like there’s a chronic version that is closer to what I experience – longer duration, lower-level pain.
I describe it as giving birth to a large watermelon through your rectum feeling. Not fun.
I usually happens when I lay on my left side and am ready to fall asleep, or later after I have been sleeping on my left side.
San
Thanks for sharing
My family and I have esophageal spasms along with rectal spasms and sometimes chest pain which is a inherited nervous system disorder. My sisters specialist named it non seizure epilepsy. No seizures just muscle spasms. Stress is a huge factor causing this in the brian. My father passed away from Parkinsons and I’m working with a natural path since I am 95% my father. I take 1/4 of a 10mg tablet of Cyclobenzaprine which is the only thing that works instantly for me and skullcap with valerian drops for mild symptoms. This is the only medication I take thank goodness.
Debra
I’m sorry about your father. Keep in mind that “inherited” disorders are often simply the fact that all family members are prone to the same nutritional deficiencies or have the same food sensitivities. In these instances we look at gluten sensitivity in everyone plus start to look for low GABA and other low nutrient status (like low magnesium), SIBO etc.
Since you mention non-seizure epilepsy it may interest you to know that GABA and taurine are factors in seizures and epilepsy.
Great to hear about skullcap and valerian for mild symptoms. As you may know I am always concerned with medication side-effects and cyclobenzaprine (a muscle relaxer) has some mild ones like dry-mouth and dizziness but other more concerning one like insomnia, muscle weakness and even increased anxiety (https://www.drugs.com/sfx/cyclobenzaprine-side-effects.html)
HI Trudy, do you think GABA would help with restless leg syndrome?
Cheryl
GABA has helped many of my clients with RLS. Gabapentin/Neurontin (a drug initially created to mimic GABA) is commonly prescribed for RLS but I’d much rather see GABA used because of the side-effects, tolerance and withdrawal effects of Gabapentin. I also look at caffeine consumption and low levels of magnesium, iron/ferritin and folate.
I have had 2-4 episodes a year for almost 10 years. I am currently 55. I have tried walking or sitting on the toilet which lessens the duration (they still usually last 15-20 minutes). They have always happened at night (why is that?) I have had no surgeries or any health issues (one birth). I have been physically active my entire life.
I will definitely try my Gaba , 5-HTP or L-theanine and the finger massage. Great info to start managing this terrible pain.
I am happy to have a name for this. I have experienced this for years mostly at night, when it wakes me from my sleep. I also thought I was the only one to experience this. I thought maybe I was getting rectal cancer. Over the years I started doing kegal exercises when I was having a spasm. It seemed to helps some. I am irritable, perfectionist, meticulous, obssessional, tense, and anxious. I have not had any surgeries, and am in mid 70’s. I don’t have them as often as I used to.
Here is part 2 as promised: How to address rectal spasms with GABA, pelvic floor work, gluten removal and squats https://www.everywomanover29.com/blog/rectal-spasms-gaba-pelvic-floor-work-gluten-removal-squats/
Thank you to each of you who commented on this blog – I included so much of your valuable feedback in part 2.
Keep the feedback and questions coming
Hi Trudy,
I went through ‘spontaneous episodes’ of rectal spasms, every couple of weeks, about 10 years ago. They woke me up in the night, and other times, occurred spontaneously during the day most often in the morning. Little did I know at the time that I had a large cyst on my left ovary, an endometrioma. The spasm episodes were so unbearable that my gynecologist suspected I had ruptured the cyst, but I was no convinced as it happened over and over again. The cyst is still there but it is not growing. How do I know? I started really paying attention to when the episodes happened. What I began to notice is that the spasms, or ‘cramp’ came on just minutes or hours after consuming CANNED FOOD. As most people know by now, conventional food tins are lined with with BPA, a plastic chemical that mimicks estrogen in a very powerful way. Once I got away from depending on canned tomatoes and beans for my recipes, my symptoms disappeared! Raw tomatoes have always had no effect. If I ever eat food I have not prepared, like chili or pasta, I can get ‘tweaking sensations” in that ovary, but no rectal spasms (having reduced my BPA consumption dramatically).
There are hormone receptors in the intestines, so I wondered if this was the connection? More women then men get the spasms, after all.
I wish I had known about GABA at the time. Thank you for this recommendation. I wondered if anyone has tried magnesium as well, as prevention since magnesium is a muscle relaxant?
Wow this is great info Andrea. Magnesium has helped some for me to reduce severity.
Hi Trudy,
when supplementation with GABA for a long period of time, isn’t it better to use L-theanine than GABA itself?
Valery
In an ideal world you’d get to the root of low GABA and not need to supplement for a long time. But even if you do I have seen no evidence saying GABA should not be used and theanine is fine to use. May I ask why you ask?
I presume it is more natural for the body to make its own GABA from a precursor unless the complaints are rather acute.
Valery
It’s always better to provide the raw materials via diet and nutrients
thank you, i had no idea there was a name for the horrid pain i was feeling just around menstruation and hormonal changes – i am going through menopause.. the pain only lasts whilst i am passing, it feels like there is a protrusion into my rectum and once i have passed the stool, the pain goes. i thought i was developing a tumour down there! This has only started in the last 12 months… will give gaba a go. So grateful you are now in Oz Trudy! you coming to the low carb conference on the gold coast in october, would be awesome to meet you?!!
I have low gaba levels and episodes of proctalgia fugax. This is what works for me. Nature’s Answer has a liquid chamomile that I take as soon as I feel pain from proctalgia fugax. Within seconds, the pain subsides. Chamomile mildly binds to gaba receptors so this could be why it works so well. Only the liquid form of chamomile will work so quickly though.
JL
Thanks for sharing what works for you – this could help someone who can’t tolerate GABA for some reason. It’s interesting too that it’s the liquid that works so well as I find sublingual GABA works much more quickly and effectively than GABA that is swallowed. Do you hold it in your mouth before swallowing it? And how many drops do you find works best for you?
Nature’s Answer Chamomile comes with a dropper that I let fill just about all the way up and I dispense the entire amount directly into my mouth. Tastes great too.
I wonder if this liquid Chamomille isn’t a tincture of the plant?
I’ve been suffering with this since my early 20’s (I’m 39 now). It always happens in the middle of the night. For many years, sitting on the toilet (a must for relief) and eventually passing gas would relieve my pain, and the episode would be fairly quick. It always seemed to be triggered by PMS. I always assumed that my fully engorged uterus was causing pressure on my bowels and tailbone which I think I may have broken as a kid. As I have gotten older, these episodes have been increasing in intensity. Now I’m to the point where it’s as bad as childbirth every time. I’m talking nausea, involuntary abdominal cramping/contractions, full-body clothes-soaking sweating, and basically uncontrolled bowel movements. Also the feeling like I’m going to pass out. Having a bowel movement is the only thing that gives me relief, but’s it’s literal hell getting there. I’m finally looking this up after all this time, and am so happy(sorry guys) to know I’m not alone, and that this stupid thing has a name!
Megan
Glad you have a name and hopefully a solution. We’d love to hear if GABA or any of the other approaches help you.
Megan (and Trudy) I have the symptoms you have, Megan, but I don’t think my episodes are the same as this disorder. Mine started at 5 years old.. they would start as sharp spasm pain in my stomach and pelvic area and I would end up passing out (but it was more like a seizure). I’m now 63 and still have the episodes. In my 30s I learned to control the passing out by hanging by head down (practically to the floor) while on the toilet, prayers and pure determination to stay conscious. It is always extremely difficult to stay conscious. I, too, break out in a sweat where I have to take all my clothes off, I have explosive bowel movements, oftentimes I throw up, and I can’t find my pulse. The episodes can last 30-45 horrific minutes. I too, liken the pain to childbirth. As a matter of fact, while pregnant with my first child, I did not have a single episode (very unusual to go 9 months without one) and I thought I was having one when I went into labor! My labor pains started out every 5 minutes. Years ago I finally found info on the internet of others who had the same symptoms but were dx’d with vasovagal syncope. Years after that, a gastroenterologist gave me a script for hyoscyamine sublingual (an antispasmodic) to take the minute I feel that first pain … it works!! Stops it from progressing. I hate taking a pharmaceutical but Ive been too afraid to try GABA in case it doesn’t work.. but I’m going to try!
Trudy, I would love to print this and share with a doctor, but it is formatting with text over text and I can’t read it. Is it possible to email me or reformat to print? Thans
Hi Trudy,
I am 32 and have suffered with this painful condition since my early teens. It has been a life long struggle to try and pin point and figure out what triggers this and how to alleviate the pain. Like most people, my episodes come on at night, when I am in a deep sleep cycle. They usually last 20-30 minutes at a time, sometimes even up to an hour. I have tried everything to ease the pain but nothing has seemed to work. Name it I’ve done it. It is the worst pain I have ever felt. I have noticed that it does seem to occur usually around my ovulation time and a few days before my period. I have also suffered from anxiety over the years which has gotten substationally better. I found your thread here last night and just wanted to mention that I am 9 Weeks post partum and interestingly enough, when I was pregnant, I only had 1 episode in 10 months time. Since I’ve given birth, it’s back on to a few times a month. I do believe that there is a direct link to our hormones More than anything else. I wish that more people spoke up about this with their doctors and more research went into figuring out and treating this disorder. After reading your post, I immediately ordered a powder form of the GABA from amazon and will be very interested to see if it helps! Anything is worth a try if it causes some relief to this horrid condition. Thank you for your post, I will post again once I try this supplement out 🙂
Lidia
Thanks for sharing and adding to the stories, and highlighting your hormone connection. Interesting about only one while pregnant. Keep in mind that GABA impacts progesterone production so this could be the link.
We’d love to hear how GABA helps you.
This has been such great information! I have been having these episodes for 20 years. I am 58 now. It started shortly after the birth of my second child. They were frightening indeed. I finally self diagnosed myself about 10 years ago. My doctor told me just to have a warm bath that did not help much. My episodes happen in the middle of the night 99 percent of the time. They can last up to an hour. I have almost passed out from the pain too. I had hemorroid surgery and a vaginal hysterectomy, but after these episodes began. I had episiotomy with both my children and have wondered if that had something to do with it. For the last 3 years I have increased my magnesium intake with Magnesium chloride. 2 mls in my lemon and mint water every day. I have noticed a decrease in frequency and duration. I had one just this morning before waking . My lying still and straight it was gone in less than 10 minutes! Magnesium has been a God send for me. I did not realize that this was such a common ailment. Praying for everyone of us that suffers with this. I am thankful there is much more information out there now. It truly is “A Pain in the A**” !
Trudy Trudy Trudy! Thank god I read this! I had a bad episode of ‘ stabby bum pain’ as I call it, last night, and I was very concerned. I woke up, passing out with the pain, which is a bad one for me. I too, had the urge to push, as though I had trapped wind. After crawling around on my bed for a while, in agony, I tried three puffs on my blue asthma inhaler, but it didn’t seem to help. Previously I tried some deep breathing exercises which massively helped, but in the throes of the pain this is easier said than done! There is absolutely no way I could pop to the bathroom and run a bath!!!! I too, suffer with anxiety and absolutely think there’s a direct link. I also know I get this pain on day 10-13 of my cycle. I can feel when I’m ovulating, and from which side, so they definitely go hand in hand, the rascals. I’ve never heard of GABA, but I’m about to read all about it!
Thank you everybody for setting my mind st rest, and thank you Trudy, for this invaluable thread. Did you mention a book? Sorry, I think I joined this thread half way through reading where it started.
Claire
Claire
Glad you found this post and some comfort in it. My blog has tons of info on GABA – here is one of the most recent posts https://www.everywomanover29.com/blog/gaba-physical-tension-stiff-tense-muscles-type-anxiety/ and so does my book “The Antianxiety Food Solution” on Amazon here http://amzn.to/2kptFWm (affiliate link). We’d love to hear if GABA helps your ‘stabby bum pain’ (love your term and can totally relate!) and anxiety.
Hi,
I have over spasming nerve endings in my rectum due to surgeries for crohns and this pain can last for hours! I’m currently on Pregabalin and Oramorph after trying so many over medications over the last 4 years so would like to try this GABA, but where do I get it and as there’s so many GABA products out there what’s the best one please? Thank you in advance for your help
Maria
Here is a blog with some info that may help https://www.everywomanover29.com/blog/much-gaba-use-gaba-product-best/
Thought i was the only one. This started happening after my husband died of rectal cancer. I was thinking of trying Gaba but I have heart palpitations too so maybe I shouldn’t I don’t know. I tried to apply pressure to my rectum when I have that. Where do you find sublingual Gaba?
Geri
I’m sorry for you loss. The best way to know is to do a trial starting low. Also knowing that vitamin C negates any adverse effects helps. You can find GABA products on my supplements blog here https://www.everywomanover29.com/blog/amino-acids-pyroluria-supplements/
Does this work for men too
Geri
Absolutely
So Gaba could work for some muscular spasms in general ?
Pierre
Yes, I have used GABA successfully for back and neck spasms.
I truly truly wish this would have worked for me. I have been dealing with rectum spasms NON STOP for the past 4 days. This is the most painful thing I’ve ever experienced. I’m pretty sure mine stemmed from me being constipated due to some pain medicine and me trying to use a saline enema to go. Ever since I’ve been having to fight back the pain. I have tried everything, muscle relaxers ( HORRIBLE idea, made my issue worse and even harder to fight back the urged to poop) Prep H, GABA (750 mg) that’s the only one my Whole Foods had. I’m throwing in the towel and going to the hospital tomorrow. The only thing that sometimes brought some relief was a hot bath (but that stopped working after I took the muscle relaxers) and a hot compress . On a scale of 1-10 this pain is a 15 lol. Wishing everyone the best of luck
I have suffered for approx 15 years .It use to start during my monthly periods .Sharpe pain in my anus lasting around 20 minutes on and off .
Anxiety made it worse and more frequent .
I can have a few months break and it will wake me during the night .Horrid pain , like a needle going up my back passage .
I find that if I stand up and bend touching my ties holding position can help it to go away quickly .
Glad to hear I’m not alone .
Ps
Meant stand up and touch TOES
hold position , helps to stop pain quite quickly
Pauline
I’m glad you have found a solution for relief in the moment but no one should have to suffer with this for 15 years. I’d focus on root cause resolution – low GABA (since anxiety is an issue), hormone imbalance (since it’s related to periods), IBS/SIBO, food sensitivities etc
Magic
Many people do well with more then 750mg GABA. I just advise them to slowly increase. And don’t forget the finger massage technique and squatting.
Be sure to look at all root causes like SIBO, food sensitivities etc for longer term relief.
Thank you for your advise
I have had a few attacks of this type of pain except it doesn’t feel like it is in the anal area but rather the vaginal opening (can’t believe I just typed that). I had one today at work. It was awful. I felt a dull ache at first and was busy so just kind of ignored it. Then I realized what it was when the pain intensified. I started feeling lightheaded like I was about to pass out. I was able to get to the bathroom and sat with my head between my knees. This helped with the fainting feeling but not the pain. It eventually began to subside so I returned to my desk but was unable to sit normally in the chair. I had to kind of lean back so that my weight was not on my bottom. I think the pain lasted about 25 minutes. I can’t find anything on the internet that matches my symptoms exactly. I would say proctalgia fugax is the closest. My gynecologist recently ran bloodwork which showed I am in menopause. He prescribed Premarin cream which I used for 4 days but it caused nausea and diarrhea so I stopped. Could the spasms be related to menopause? I don’t have a history of anxiety that is out of the ordinary but have periods of feeling anxious for no reason as of late (probably menopause related). I am a perfectionist by nature. I am not sleeping well lately, either. I fall asleep fine but wake up and can’t go back to sleep. Help! I feel like I’m fall apart and I’m too young for that.
Hi
Thankyou for sharing your experience , it helps to hear others suffer and I’m not alone .
I Havant experienced an episode for sometime but confident it will return !
During my anxiety episode , which lasted around 6 months badly , I had lots of these episodes but became less and less as anxiety slowly went away .
I also had bad episodes each month when having monthly periods ( don’t have any periods now )
Any stress or nervous times can bring one on .
Like you , in the past I’ve had one start at work and had to get through the discomfort quietly hoping it will subside soon .
In the past it has woken me st night and felt very painful ,if I walk about , go toilet, and lay in feral position it goes after about 15/ 20 mins .
Pauline
Sorry to hear you’ve had these episodes. Per the blog – clients who have both low GABA physical anxiety and these spasms find that sublingual GABA stops the spams quickly and can also prevent a bad one when used at the hint of a spasm. Of course, they also get anxiety relief too
Angela
Sorry to hear this. Per the blog – clients who have both low GABA physical anxiety and these rectal spasms find that sublingual GABA stops the spams quickly and can also prevent a bad one when used at the hint of a spasm. Of course, they also get anxiety relief too. If I had a client with spasms anywhere, including the vaginal opening I’d do a trial of GABA. GABA/progesterone can both be low in menopause.
I’d also look at dietary oxalates as a possible factor too, plus gut health/SIBO and find a pelvic PT to work with
This is fascinating. I’m going to look into it. I don’t know if what I have is this or just a general pelvic floor spasm because my spasms are around the anus, but also travel to the front and up around my uterus. Oh, the pain is unlike anything I’ve ever experienced. And this started a few years ago after I finished chemo for breast cancer. My hormones have been a mess from artificial sudden menopause and I’m sure the Tamoxifen doesn’t help either. Anyway, I’ll give anything a try to prevent a full on spasm attack. I was just on the brink of one while sitting here at work. The only thing I could think to do was take Ativan. I took 1mg and the tightness is starting to dissipate. But while I’m very thankful for the Ativan- I don’t like to rely on it so much. So, I’m going to give this a try. I have no idea what GABA is. Time to do some reading. Thank you for the info! 🙂
Merey
GABA is a calming amino acid that helps with physical tension including muscle spasms. Keep in mind that a benzodiazepine like Ativan has many side-effects
Hiya, so glad I found this post. For the last four weeks been suffering from such terrible pain in my bum I have had to go to a&e to get help but I still dont know what is wrong. It started with my usual pain from a couple of hermoroids from child birth, which i use over the counter creams and suppositories, which always works. However for some reason i started to feel these agonising sharp pains starting which I cant recall having before, to the extent they can last up to 30mins with me in complete agony. My rectum is now so swollen and i am in so much pain not sure if using the over the counter remedies have worsen things. I have been given anti inflammatories and pain killers, but still feel agony. I cant stand or sit so having to lay down all the time to feel relief. My latest “attack” sent me back to a&e where they did a scan and said I didnt have hermoroids, no cists etc so maybe its a fissure but no signs of it. In the end I asked them to inject something to help relax my rectum. They injected anesthetic, which numbed the area and sent me home with anesthetic cream. I am home still swollen and still in pain. The cream is numbing but still not solving the issue. I am desperate on how to solve this and so afraid to try anything else encase it worsens things.
Hi
I’m on this thread because I also am a sufferer. My last episode was last night about 11 pm. It wakes you out of a sound sleep like labor pains as someone said. I feel like gluten is responsible as Mary said. When I retrace my diet before an attack it always includes more bread and carbs than I usually consume. My Dr. Sent me to a gastroenterologist who thought it was hemorrhoids but didn’t find any. In fact it seemed like he’d never heard of it. I’m also seeing low potassium may be a culprit and that has been a past issue for me.
Anyway thanks for this information Trudy and commenters. Your help is invaluable.
Pam
Sorry to hear – glad you’ve made the gluten connection. We’d love to hear if the sublingual GABA helps when you’re exposed to gluten by mistake
Is there any medical literature of any kund which directly or indirectly supports use of GABA for the these spasms? I’ve searched and come up empty handed. My mother’s in her 70’s and started experiencing it. If there’s something out to support its use would like to share with her Md
Paul
Sorry to hear your mother is experiencing this. Unfortunately there is no direct research supporting oral GABA for these rectal spasms. Just my own personal results and the results of 100s of my clients. Your best option is to share this article and my book “The Antianxiety Food Solution” so he/she has a feel for my work. Unless her MD is a functional doctor or open-minded this approach will likely be dismissed and working with a nutritionist or nurse practitioner (or other allied health professional) may be best.
I am so happy to find this post. My husband has been suffering from this for years now. He is 51. We have tried nearly everything. Lately he is getting a little relief form accupuncture but it only lasts a few days, then it’s back. Its depressing. I research every day more ways to help. He is not able to smoke marijuana or we would try that. We will try GABA tonight! Thank you so much for your information. I pray it helps. Side note, his diet is horrible so I will share the Gluten part too.
Cathy
Please let us know how it goes. And do share the dietary aspect too – no to gluten, and yes to quality animal protein and plenty of organic veggies for starters (for all the raw materials to make GABA)
Hi Trudy, I’m so glad I found this information. I didn’t know there was a name for this condition, Nor did I imagine that there were others out there!
Approximately every two months, It occurs during the night for me, and it involves the rectum and the vulvar area. I have some chronic lower back issues and I notice that when episodes happen my lower back is Cranky.
Quickest relief I have found is to run a HOT HOT bath and get in and lift my rear up a little while sitting to take pressure off my spine while soaking. It is very inconvenient to run a bath in the middle of the night, but experience taught me that waiting for it to subside doesn’t happen. Then I go back to bed with a heating pad on the whole are to keep the spasms at bay.
I will definitely try the GABA next time, thanks for the advice!
Hello Trudy. Thank you so much for putting this information together. I feel very fortunate that I found this post a few weeks ago and I read every comment! I have been suffering with this condition (proctalgia fugax) since about age 21 and I am now 49. My triggers seem to include stress, sometimes sex, or sometimes a little constipation. There are times where it seems to just come out of nowhere but those are probably more related to stress. Anyway, I wanted to let you know that I did try GABA the past two times it occurred and it absolutely helps. I take 5 100mg rapid melt tablets and put them under my tongue. I notice the pain beginning to subside within a few minutes and I would say within about 5 minutes max the pain is gone. That is much better than the 20 to 30 minutes I would deal with it previously. Thanks again. This has been a big help.
Marc
Thanks for sharing and so glad to hear about your great results. I have found that using GABA at the first hint or twinge actually prevents a full-on spasm. Please share what product you’re using for other readers. You may also find it more affordable and more effective to get a GABA-only product as powder rather than using 5 x100mg rapid melt tablets (which I’m sure have other ingredients like flavors etc)
The product I bought on Amazon is called Superior Source GABA Microlingual Instant Dissolve Tablets 100mg 100 count. The ingredients say it also has lactose, acacia gum, and natural cherry flavor. Thanks for mentioning the powder. I will get some of that when I get low on the tablets.
hey everyone! so I see some women also tend to get this around their period? (slightly before it starts and during?) I get these shooting pains up my rectum occasionally with PMS & also during a bowel movement while on my period. Does anyone else find a direct link between this condition flaring up during menstruation?
Casey
This is common for many women and is likely be related to low progesterone. GABA supports progesterone production so this could be one way GABA helps and why it’s low.
I have discovered Magnesium Oil in my baths, 3 tbsp. works great. I am able to eat citrus again and other triggering foods. One food I have found that still brings it on if taken on daily basis is cocoa powder (chocolate). I had to stop drinking white wines because of the acidity, margaritas, orange juice and a lot of other fruit. I am against taking any form of a pill and like to do everything as natural as possible. I attempted to take magnesium orally and it actually triggered my spasm. I read a blog online and found that putting it in your bath helps because it doesn’t pass through the digestive track. I feel like I can live like a somewhat normal person now!
Charlene
Thanks for sharing about the magnesium oil. May I ask which product? Chocolate is a very high source of oxalates and this can be a big issue for some. Magnesium and/or calcium citrate (oral) counters this so this may be the magnesium mechanism.