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Rome IV Diagnostic Criteria for Proctalgia Fugax
Rome IV Diagnostic Criteria for Proctalgia Fugax
Recurrent episodes of pain localized to the rectum, unrelated to defecation
Episodes last from seconds to minutes, with a maximum duration of 30 minutes
No anorectal pain between episodes
ResultCriteria not met
Does not meet Rome IV criteria for proctalgia fugax; consider levator ani syndrome (pain lasting ≥20-30 minutes or longer, often with tenderness on posterior traction) or another anorectal cause of pain.
When to use
- Recurrent brief episodes of rectal pain unrelated to bowel movements, to distinguish proctalgia fugax from levator ani syndrome or a structural anorectal cause.
Formula
Diagnosis requires all of: recurrent episodes of rectal pain unrelated to defecation; episodes lasting seconds to a maximum of 30 minutes; no anorectal pain between episodes.
Pearls and pitfalls
- Episode duration is the key discriminator from levator ani syndrome, in which pain typically lasts ≥30 minutes and rectal exam often reproduces tenderness.