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In Reply. —
We agree with the response from Drs Day and Day, which supplements our recommendations for a patient with persistent rectal pain. When conventional and sometimes unconventional recommendations are unsuccessful in relieving discomfort, referral to a specialist interested in pain management should be undertaken. There is little doubt that some patients benefit greatly from prudently performed anesthetic blocks. Indeed, pain management specialists are of great help in particularly difficult pain management problems.
Nelson H, Pemberton JH. Rectal Pain-Reply. JAMA. 1988;260(22):3277. doi:10.1001/jama.1988.03410220060020