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Levator ani syndrome (LAS) is a condition which more often affects women than men, and is thought to result from spasm of the upper most layer of the anal sphincter (puborectalis muscle).
It typically causes a dull aching pain or discomfort of the anus, that lasts more than 20 minutes, and frequently hours to days. It is often exacerbated by sitting for long periods or lying down, and relieved by walking.
Examination of the anus is usually unremarkable with only palpable tenderness of the levator ani muscles, signifying puborectalis spasm. Anal manometry typically shows increased anal pressures.
Management
The aim of treatment is to reduce anal canal or levator ani tension.Hot Sitz-baths (38 degrees Celsius) have been shown to be of some use, on their own, as well as in combination with massage and muscle relaxants (diazepam). Digital massage of the muscle, electrogalvanic stimulation by a rectal probe and biofeedback regimes utilising pressure-measuring probes have variable success [1].
References
- Wald A. Anorectal and Pelvic Pain in Women. J Clin Gastroenterol 2001; 33(4): 283-28