Drug Treatments

The only randomized controlled study for anal pain used salbutamol (Ventolin) inhaler to treat proctalgia. This drug inhibits smooth muscle and two puffs at the onset of pain allowed rapid onset of action. Patients treated had significant reduction in pain over controls. Successful case reports using diltiazem (80 mg twice daily) and clonidine (150 mg twice daily for 3 days, then tapered to 75 mg twice daily for 2 days, then 75 mg daily for 2 days) for treatment of proctalgia-type pain have been reported. Both agents work by relaxing smooth muscle. Topical 0.2% nitroglyc-erin to the anal verge has also been reported to treat proc-talgia.8 This medication also produces smooth muscle relaxation.

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