Rectal pain or proctalgia occurs in approximately 8-18% of the general population as a whole, but is a very common complaint in PPOD syndrome patients. The specific location and distribution of rectal pain however, is somewhat variable. In some individuals the pain is confined to the lower portion of the rectum or in and around the anus, while in others it can extend quite high up within the pelvis. Although proctalgia can be caused by hemorrhoids, abscesses and fissures, when it is an accompanying symptom of the PPOD syndrome local physical examination and diagnostic procedures such as colonoscopy, CT scan and MRI will usually reveal no abnormalities.
In the PPOD syndrome patient, the pain is usually described as a deep aching or burning pain, however in some individuals it can be a sharp, stabbing or shooting type of pain, while in others still, typically those with accompanying bowel dysfunction of either chronic constipation, diarrhea or alternating constipation and diarrhea, it tends to be more of cramping or spasming type of pain. Oftentimes it will be aggravated by sitting, sexual intercourse or various types of physical activity. However, like most of the symptoms associated with the PPOD syndrome, and, as is demonstrated by the case reports, proctalgia usually responds extremely well to appropriate treatment following the PPOD therapeutic protocols. Refer to Pelvic Pain and Organic Dysfunction cases studies 4, 5, 7, 9, 11, 14, 15 and 16 to see the response of rectal pain to PPOD therapeutic protocols.