Proctalgia Fugax Diagnosis and Management

Clinical Characteristics

• The absence of fever rules out anorectal abscess, which would present with throbbing pain, fever, and tenderness on examination, according to the American College of Surgeons 1, 2
• The lack of bleeding makes hemorrhoids, anal fissures, and colorectal pathology unlikely, and the pain quality and timing differ from anal fissure, which causes sharp, tearing pain during and after defecation, not isolated nocturnal episodes, as noted by the World Journal of Emergency Surgery 3
• The lack of visible external findings excludes thrombosed external hemorrhoids or perianal abscess, as stated by the World Journal of Emergency Surgery 2

Urgent Evaluation Criteria

• Patients should seek urgent evaluation if they develop fever, persistent pain, or visible swelling suggesting abscess formation, according to the American College of Surgeons and the World Journal of Emergency Surgery 1, 2