Patient Characteristics and Treatment Outcome in Functional Anorectal Pain

Atkin, Gary; Suliman, Amna; Vaizey, C. J.

doi:10.1007/dcr.0b013e318217586f

Cited by 47 publications

(39 citation statements)

References 20 publications

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“…Long-term pain can inevitably cause psychological disturbance. Depression is more severe in patients with FARP as some researchers reported that depression occurs in about 30% of FARP patients [25, 26]. Since depression and anxiety were assessed at the time of pain diagnosis, we were unable to draw a conclusion whether pain precedes psychological disturbance.…”

Section: Discussionmentioning

confidence: 96%

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The clinical characteristics of patients with chronic idiopathic anal pain

Mao

Liao

et al. 2017

Open Medicine

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AbstractThe aim of this study was to investigate the clinical characteristics, treatment outcomes and psychological distress in patients with chronic idiopathic anal pain. The study was conducted on patients referred to Hangzhou Third Hospital for chronic anal pain from January, 2010 to December, 2014. Patient demographics, clinical history, anorectal physiology, and radiological imaging data were recorded for all patients. The treatment outcome was noted for patients treated and followed up for more than 6 month at the present unit. Ninety-six patients with mean age of 45.1 years (range, 17-82) were studied. Seventy-one patients (74.0%) had functional anorectal pain(FARP). The main complaints were dull, sharp, stabbing, or spasm pain. Among all patients, 34.3% reported that their pain radiated into other locations. Fifty-one patients (53.1%) had bowel dysfunction, while 28.1% patients had urinary dysfunction. The common factors associated with pain relief were day time, lying down and warm water baths; the factors that contributed to aggravated pain were night time, defecation or sitting. 92.7% (89/96) of patients reported symptoms of psychological disturbance. FARP patients exhibited increased depression than non-FARP patients(P<0.05). In addition, female patients were more likely to have depression than male patients (P<0.05). The overall pain treatment success rate was 55.2% (53/96). The pain treatment outcome was better in non-FARP patients than in FARP patients(χ2=3.85, P<0.05). Conclusively, chronic idiopathic anal pain is a complex clinical symptom, involving pelvic floor muscles, the nervous system, endocrine system, and the patients’ psychological conditions. Further research is needed to improve diagnosis and treatment for patients with chronic idiopathic anal pain.

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Section: Discussionmentioning

confidence: 96%

“…Still, a large percentage of patients do not respond to any pain treatment. In a study with 80 cases of FARP patients, Gary K [26] found that only 46.3% of patients had reduced pain after treatment, while the majority did not respond to the treatment. Perhaps combination therapies will reach higher treatment efficiencies.…”

Section: Discussionmentioning

confidence: 99%

The clinical characteristics of patients with chronic idiopathic anal pain

Mao

Liao

et al. 2017

Open Medicine

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“…7 In another noncontrolled study of 158 patients with chronic anorectal pain, symptoms improved after biofeedback therapy (17/29 patients [58.6%]), tricyclic antidepressants (10/26 patients [38.5%]), botulinum toxin injection (5/9 patients [55.5%]), and sacral nerve stimulation (2/3 patients [66.6%]). 33 …”

Section: Methodsmentioning

confidence: 99%

Anorectal and Pelvic Pain

Bharucha

Lee

2016

Mayo Clinic Proceedings

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Although pelvic pain is a symptom of several structural anorectal and pelvic disorders (eg, anal fissure, endometriosis, and pelvic inflammatory disease), this comprehensive review will focus on the three most common nonstructural, or functional, disorders associated with pelvic pain: functional anorectal pain (ie, levator ani syndrome, unspecified anorectal pain, and proctalgia fugax), interstitial cystitis/bladder pain syndrome, and chronic prostatitis/chronic pelvic pain syndrome. The first two conditions occur in both sexes, while the latter occurs only in men. They are defined by symptoms, supplemented with levator tenderness (levator ani syndrome) and bladder mucosal inflammation (interstitial cystitis). Although distinct, these conditions share several similarities, including associations with dysfunctional voiding or defecation, comorbid conditions (eg, fibromyalgia, depression), impaired quality of life, and increased health care utilization. Several factors, including pelvic floor muscle tension, peripheral inflammation, peripheral and central sensitization, and psychosocial factors, have been implicated in the pathogenesis. The management is tailored to symptoms, is partly supported by clinical trials, and includes multidisciplinary approaches such as lifestyle modifications and pharmacologic, behavioral, and physical therapy. Opioids should not be avoided, and surgery has a limited role, primarily in refractory interstitial cystitis.

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“…Physical activity may be another option, but studies examining the effect of physical therapy on constipation in PD are lacking. Biofeedback was tested to be effective in patients suffering from anorectal dysfunction [52] and constipation [53] and it might be an interesting therapeutical option in PD patients.…”

Section: Non-pharmacological Treatment Optionsmentioning

confidence: 99%