Tenesmus is a medical term used to describe the feeling of not being able to have a bowel movement after having a bowel movement. Tenesmus is commonly associated with inflammatory bowel disease (IBD) , but it can also be caused by conditions such as hemorrhoids, infections, and cancer.
Diagnosis may include stool culture, blood tests, colonoscopy, or biopsy to identify the underlying cause. Pain relievers and antispasmodics may be prescribed during treatment of the underlying cause to relieve symptoms.
Symptoms of tenesmus can be persistent or intermittent, but generally include some or all of the following:
- Rectal pain
- Rectal discharge
- Rectal bleeding
- Involuntary exertion
When to call your healthcare provider
Get immediate medical attention if you experience tenesmus accompanied by a high fever (over 100.4 F), chills, severe rectal bleeding, nausea, vomiting, or fainting.
The cause of tenesmus is not well understood, but it is believed that inflammation or irritation can stimulate the somatic nerves (which transmit physical sensations) and autonomic nerves (which modulate smooth muscle contractions) in the intestine.
Overstimulation of these nerves can make the intestines feel like there is sediment and can trigger contractions that we recognize as the beginning of a bowel movement.
Additionally, severe diarrhea or constipation can also cause scar tissue in the intestines. In this case, the passage of stool becomes difficult and it may appear that there is more to the intestines than there really is. Ulcers or growths around the rectum or colon can do the same.
Tenesmus can be triggered by a variety of conditions, including:
Radiation proctitis can develop and cause tenesmus after radiation therapy for cervical cancer, rectal cancer, prostate cancer, or colon cancer.
Tenesmus is not a disease, but a symptom of a disease. Therefore, your healthcare provider will look for the root cause by looking at your medical history, family history, and current symptoms. This will likely include questions about your gut, diet, and lifestyle.
Based on these diagnostic clues, your healthcare provider will perform additional tests to determine the cause of your symptoms.
Physical examination is important in diagnosing tenesmus. This will help your healthcare provider see if there are any swelling or abnormalities around the rectum, pain in the abdomen, or signs of a sexually transmitted infection .
The procedure may include a digital rectal exam (DRE) . This involves inserting a gloved finger into the anus to check for hemorrhoids, blood, mucus, infection, or abnormal growths.
After the physical exam, your healthcare provider will usually order a series of blood and stool tests to help identify causes.
They may include:
Before proceeding with more invasive procedures, your healthcare provider may order images to help visualize your digestive tract.
They may include:
A test that could include:
- Colonoscopy : A procedure that uses a flexible scope called a colonoscope to examine the entire colon.
- Rigmoidoscopy : A variant of colonoscopy limited to the lower colon, the sigmoid colon.
- Colon Biopsy – Performed during a colonoscopy or sigmoidoscopy to obtain a tissue sample for evaluation.
If colorectal cancer is the cause of tenesmus, a biopsy is the only test that can definitively confirm the diagnosis. Blood tests and imaging tests can confirm the diagnosis, but cannot diagnose the disease.
Urge tenesmus tends to improve after the underlying cause is identified and treated. Because the causes of tenesmus are as varied as the treatments. Below are tenesmus treatments for each condition.
Get the word of drug information
While it may be uncomfortable for you to discuss urgency with your doctor, it is important. This is especially true if the symptom is persistent, worse, or accompanied by bleeding, tarry stools, tight stools, weight loss, fever, vomiting, or an inability to defecate. None of these symptoms can be ignored or ignored.