Medical Treatment

• Because proctalgia fugax attacks last for such a brief period of time, no treatment acts fast enough to stop an attack. Salbutamol or albuterol, an inhaler used in asthma, may help in cases with more frequent or prolonged attacks. Other treatment options include clonidine tablets (Catapres) 105mg twice a day and nitroglycerine ointment applied locally.

• To help control the pain of levator ani syndrome, your doctor may prescribe an anti-inflammatory medication or a muscle relaxer.

• The best time to treat a thrombosed hemorrhoid is in the first 48 hours. If the patient goes to their doctor during this time period, a simple office procedure can bring instant relief. After the hemorrhoid is injected with an anesthetic, a small incision is made and the blood clot is removed. If the patient is seen after the first 48 hours, treatment for the hemorrhoid is the same as the home treatment recommendations.

• To help heal an anal fissure, your doctor may give the patient prescription creams such as diltiazem (Cardizem, Tiazac, Cartia XT, Dilacor XR, Diltia XT) or glycerine nitrate that will relax the anal muscle. Injection of botulinum toxin into the anal sphincter can also improve healing in patients with chronic anal fissure. If the fissure fails to heal, a procedure called sphincterotomy may be needed. A small nick is made in the anal sphincter to decrease the muscle tone. This procedure can be performed in the doctor's office or at an outpatient surgery center.