Gupta Riya, Jencks Kara J, Damianos John A, Wang Xiao Jing Iris
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
ACG Case Rep J. 2025 Sep 11;12(9):e01826. doi: 10.14309/crj.0000000000001826. eCollection 2025 Sep.
Levator ani syndrome (LAS) explains up to 7.4% of anorectal pain cases. Classic symptoms include rectal pain or pressure with sitting. We present 2 patients, ages 32 and 25 years, presenting initially with "diarrhea" and perianal hyperhidrosis. History revealed rectal discomfort, tenesmus, urgency, and sensation of incomplete evacuation. Puborectalis tenderness was present on digital rectal examination. Therapies were tailored to each patient, including pelvic floor physical therapy with biofeedback, bowel regulation, rectal diazepam, and ileostomy. These presentations offer insights into potential pathophysiological mechanisms in LAS and highlight the importance of considering LAS in non-pain presentations.
耻骨直肠肌综合征（LAS）可解释高达7.4%的肛肠疼痛病例。典型症状包括坐位时直肠疼痛或有压迫感。我们报告2例患者，年龄分别为32岁和25岁，最初表现为“腹泻”和肛周多汗。病史显示有直肠不适、里急后重、便急和排便不尽感。直肠指检时有耻骨直肠肌压痛。针对每位患者进行了个体化治疗，包括盆底生物反馈物理治疗、肠道调节、直肠用安定和回肠造口术。这些病例展示了对LAS潜在病理生理机制的见解，并强调了在非疼痛表现中考虑LAS的重要性。
