Proctalgia Syndromes: Update in Diagnosis and Management

被引：15
作者：
Carrington E.V. [1 ]
Popa S.-L. [2 ]
Chiarioni G. [3 ,4 ]
机构：
[1] Department of Colorectal Surgery, St Vincent’s University Hospital, University College Dublin, Dublin
[2] 2nd Medical Department, “Iuliu Hatieganu”, University of Medicine and Pharmacy, Cluj-Napoca
[3] Division of Gastroenterology and Hepatology & UNC Centre for Functional GI and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC
[4] Division of Gastroenterology of the University of Verona, Azienda Ospedaliera Universitaria Integrata di Verona, Verona
来源：
Current Gastroenterology Reports | 2020年 / 22卷 / 7期
关键词：
Biofeedback; Chronic anal pain; Dyssynergic defecation; Levator ani syndrome; Proctalgia fugax;
D O I：
10.1007/s11894-020-00768-0
中图分类号：
学科分类号：
摘要：
Purpose of Review: Functional anorectal pain syndromes are a neglected yet often disabling clinical entity resulting in significant economic and psychological burden to the patient. The aim of this review is to update the practicing gastroenterologist/coloproctologist on the diagnosis and management of these complicated disorders. Recent Findings: The updated Rome foundation diagnostic criteria (Rome IV) for functional anorectal pain subgroups chronic proctalgia (levator ani syndrome and unspecified functional anorectal pain) and acute proctalgia (proctalgia fugax) on the basis of symptom duration and digital rectal examination findings. Chronic proctalgia is thought to be secondary to paradoxical pelvic floor contraction in many patients and biofeedback to improve the defecation effort has proven effective for over 90% in the short term. Unfortunately, management of proctalgia fugax remains challenging and treatment outcomes modest at best. Summary: A number of therapies to relax the pelvic floor may be employed to improve symptoms in functional anorectal pain syndromes; however, only biofeedback to improve defaecatory dynamics in patients with levator ani syndrome has proven effectiveness in a randomized setting. Further investigation of treatment approaches in proctalgia fugax is required. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
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