It is a sudden, cramping, severe pain around the back passage area that
occurs on several occasions over few weeks, each time lasting only seconds to minutes. In between episodes, there is no pain at all. The cause is not exactly understood, but is believed to be due to spasms of the muscle of the anus. Most of the time it is not obvious what has set it off. It seems to be more common in people who have IBS, and people who have anxiety symptoms. In some cases, the pain can be triggered by having sex, being constipated, having a period, or during times of stress. If examination and further investigations are not showing any other conditions, there is often no treatment required. For many, the episodes are infrequent and can be reassured after being investigated. In a few people, it can be troublesome, and may need treatment. Simple pain killers and creams which work on the blood vessels around the anus, such as Glycryl trinitrate and calcium channel blockers (Deltiazem) can be tried.