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Rome IV Diagnostic Criteria for Proctalgia Fugax
Symptom-based diagnosis of brief, self-limited episodes of rectal pain.
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.