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Tenesmus

Definition

Tenesmus is the feeling that you constantly need to pass stools, even though your bowels are already empty. It may involve straining, pain, and cramping.

Alternative Names

Pain - passing stool; Painful stools; Difficulty passing stool

Considerations

Tenesmus usually occurs with inflammatory diseases of the bowels. These diseases may be caused by an infection or other conditions.

It can also occur with diseases that affect the normal movements of the intestines. Such diseases are called motility disorders.

Persons with tenesmus may push very hard (strain) to try to empty their bowels, but they pass little stool.

Causes

• Anorectal abscess
• Colorectal cancer or tumors
• Crohn's disease
• Infection of the colon (infectious colitis)
• Inflammation of the colon or rectum from radiation (radiation proctitis or colitis)
• Inflammatory bowel disease (IBD)
• Movement (motility) disorder of the intestines
• Ulcerative colitis

Home Care

If you feel that you are constipated, try to increase your fluid and fiber intake.

When to Contact a Medical Professional

Contact your health care provider if you continue to have symptoms of tenesmus that are constant or come and go.

Also call if you have:

• Abdominal pain
• Blood in the stool
• Chills
• Fever
• Nausea
• Vomiting

These symptoms could be a sign of a disease that might be causing the problem.

What to Expect at Your Office Visit

The doctor will examine you and ask questions such as:

• Time pattern
  • Did this develop recently?
  • Is it the first time you have had tenesmus?
  • Does the feeling come and go, or is it constant?
• Symptom history
  • Do you have a constant need to empty the bowels?
  • Do you have abdominal pain?
  • Do you have cramping?
  • Do you have a persistent feeling of straining?
  • Do you have diarrhea or vomiting?
  • What other symptoms do you have (such as blood in stool, fever)?
• Dietary history
  • Have you eaten anything unusual or uncooked?
  • Have you been at a picnic, gathering, or similar event recently?
• Other
  • Have you had any medical problems in the past?
  • Have any other people in your family or social group experienced similar problems?

The physical examination may include a detailed abdominal examination. A rectal examination is performed in most cases.

Tests that may be done include:

• Colonoscopy to look at the colon and rectum
• Complete blood count (CBC)
• CT scan of the abdomen (in rare cases)
• Electrolytes
• Stool cultures
• X-rays of the abdomen

References

Camilleri M. Disorders of gastrointestinal motility. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 138.

Stenson WF. Inflammatory bowel disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 144.

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