Proctalgia Fugax (PFF) is a condition where the body produces excessive amounts of prostaglandins which cause inflammation and pain. These are chemicals produced naturally by your own immune system to fight off infection or injury. They are not harmful but they can have side effects such as headaches, fatigue, nausea, dizziness and other symptoms. PFF is caused when these chemicals accumulate over time due to prolonged exposure.
The most common symptom of PFF is headache, which may become severe enough to affect daily life. Other symptoms include:
Fatigue
Nausea/Vomiting
Diarrhea/Constipation/Abdominal Pain (may occur with vomiting)
Proctalgia Fugax Symptoms – What Causes Them?
There are several possible reasons why PFF occurs. Some of them include:
Excessive use of certain drugs (such as NSAIDs) that increase the production of prostaglandins. Examples include aspirin, ibuprofen, naproxen, ketoprofen and others.
Many prescription medications can also contribute to PFF. For example, some antidepressants can increase the levels of prostaglandins in your body causing headaches and other symptoms.
Foods that are high in arachidonic acid content such as meat, eggs, milk and cheese can also increase the levels of prostaglandins in your body.
Poor diet or malnutrition can contribute to PFF by lowering your overall immune system strength. This makes it harder for your body to fight off infection and inflammation, causing the body to produce more prostaglandins as a defense mechanism.
Allergies that affect your airways can also trigger PFF. For example, if you’re allergic to something in your environment such as dust, or animal dander, this can trigger an asthma attack or cause your body to go into “defense mode” causing excessive inflammation.
Smoking cigarettes has been known to cause PFF in a small number of cases.
Removing yourself from the source of the problem (eg. getting away from the animals that you’re allergic to, or avoiding NSAIDs) will eventually “reset” your body and reduce the chances of PFF occurring again in the future.
In other words, your body won’t be so stimulated to produce excessive prostaglandins anymore.
If you are unable to remove yourself from the problem, taking medication can help prevent and treat the symptoms of PFF.
Antihistamines are often effective at relieving the symptoms of allergy-related PFF. These drugs block histamine receptors to reduce the effects of the released histamine in your body.
Corticosteroids are a type of medication that suppresses the immune system to help reduce the effects of inflammation. They are commonly taken as pills or injections, and can be very effective at treating PFF.
Muscle relaxants are drugs that relieve muscle tension and allow your body to rest more easily. They are often combined with other drugs such as painkillers and anti-inflammatories for treating PFF.
Over-the-counter painkillers such as paracetamol (acetaminophen), aspirin and ibuprofen (NSAIDs) can be taken to reduce headaches and muscle aches caused by PFF.
One of the best ways to treat PFF is with lifestyle changes – especially diet changes. Eating more fresh fruits and vegetables, whole grains, lean meats and low fat dairy products can reduce the chances of your body producing excess prostaglandins in the first place.
It is also recommended that you stay away from certain types of food such as those high in arachidonic acid (as mentioned earlier) and refined sugars. These types of food have been known to cause inflammation in some people.
You may even wish to try an elimination diet to find out which foods are causing PFF symptoms in your case.
If you suffer from PFF, one of the best and most immediate ways you can reduce inflammation is to use an ice pack on the affected area of your body.
In some cases, you may also be able to reduce swelling in your airways by inhaling steam with the use of a vaporizer or hot water bottle. (Just don’t burn yourself).
In more serious cases of PFF such as asthma, your doctor may recommend that you carry an inhaler with you at all times. These inhalers can open up your airways and help increase your lung capacity.
You should only use these during an asthma attack or when you’re having trouble breathing.
Other lifestyle changes that may help reduce the effects of PFF include quitting smoking and reducing your alcohol intake.
In more serious cases such as arthritis, your doctor may recommend that you take part in physical therapy to learn how to manage your condition and prevent further inflammation and pain.
As with any condition, the earlier PFF is caught and treated the better chance you have of living a normal life, so it’s important to visit your doctor or dermatologist if you ever think you’re experiencing symptoms of PFF.
Let’s quickly summarize the treatment options for PFF:
Avoid known triggers
Medication (antihistamines, NSAIDS, corticosteroids)
Diet and Lifestyle: (includes exercise and other healthy habits)
Treatments for serious cases (inhalers for asthma, physical therapy)
Proper treatment can help to reduce and even prevent the effects of PFF. There are many options available so you should work with your doctor or dermatologist to find a treatment plan that works for you.
PFF usually develops slowly over time so it may take a while to find a treatment plan that works. You should be patient with your treatment and not give up, because PFF can be managed.
If you do find that your medication is causing unpleasant side effects, make sure to let your doctor know as soon as possible so you can switch to a treatment that works better for you.
You may find that one treatment works well for your condition but later stops being effective. This may mean that you have to try a couple of different treatments before you find the right one for you.
Finally, if the condition becomes especially bad and interferes with your ability to lead a normal life, there is one last resort treatment available:
Lasers: Laser treatments can help reduce the effects of PFF by destroying affected areas such as tattoos. These types of treatment are still in their experimental stages and not covered by most medical insurance.
Sources & references used in this article:
Proctalgia fugax by WG Thompson, KW Heaton – Journal of the Royal College of …, 1980 – ncbi.nlm.nih.gov
Treatment of proctalgia fugax with salbutamol inhalation. by VF Eckardt, O Dodt, G Kanzler… – American Journal of …, 1996 – search.ebscohost.com
Proctalgia fugax by WG Thompson – Digestive Diseases and Sciences, 1981 – Springer
The psychologic aspects of proctalgia fugax by LF Pilling, WM Swenson, JR Hill – Diseases of the Colon & Rectum, 1965 – Springer
