What Is Levator Syndrome
Levator syndrome is repeated episodes of sudden pain felt in the rectum due to the spasm of the levator ani muscle of the pelvic area.
A sudden fleeting pain in the rectum is termed as Proctalgia fugax and an unexpected pain near the coccyx or the tail bone is called coccydynia. Both of these are considered as belonging to Levator syndrome. The pain due to the spasm of the muscle does not last long, usually getting resolved within 15 -20 minutes. However, it can occur suddenly and may be so intense as to awaken a sleeping person. Sometimes it may be felt as a dull ache in the rectal region but not related to a bowel movement. It may feel as if passing gas or having a bowel discharge would relieve the pain but in spite of such measures, it may last for several hours and appear intermittently. Various treatments undergone by the patient, including surgical interventions, may not have brought any relief.
Diagnosis
The main aim of diagnosis is to rule out other disorders of the rectum and the anus which may have similar symptoms. Doctors usually look for the presence of anorectal abscess and fissures as well as thrombosed external hemorrhoids during a physical examination. Since lower back troubles or prostrate problems may also cause pain in the rectal area, tests to rule out such disorders may be done. But usually, nothing much directly related to levator syndrome may be observed besides a tightness or tenderness of the muscle.
Treatment
Educating the patient about this harmless condition helps relieve stress. Depending on the severity of the symptoms, general measures that may bring temporary relief such as emptying the bowels, passing gas or sitting in a warm bath may be tried. Mild pain killers like aspirin may be taken. For severe cases, electrogalvanic stimulation of the offending muscle can stop the spasm. In this procedure, an electric current of high voltage is applied to the muscle through electrodes inserted into the anorectal cavity.
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Yasser Elnahas
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