Episodes are generally brief in nature, ranging from seconds up to 30 minutes, with each painful episode resolving spontaneously. The exceptional patient may have an episode that lasts for days. Most patients have several episodes per year; it is the rare patient who has 2 or more episodes per month.
Treatment:
- A warm sitz bath
- Sitting on a hard ball (such as a lacrosse ball). This works by expanding and stretching the spasming anal sphincter in the same way that you stretch a calf muscle when you get a cramp there.
I have suffered from this for several years, and my current protocol is:
- Heating pad to anal area (or failing that, a hot bath). If you have more than one heating pad, put one on the front of your body too, just above the penis.
- Slow, deep diaphragmatic breathing, deep enough to feel pressure in the anal area.
- Insert a finger into the anus and pull the anal sphincter, which is the ring-shaped muscle in spasm, sideways. This is similar to pulling the toes of your foot towards you when stopping a calf spasm ("charley horse" spasm). This can sometimes stop the spasm almost instantly.
