Tenesmus
Tenesmus is the feeling that you need to have a bowel movement, even if your bowels are already empty. Inflammatory bowel diseases like ulcerative colitis and Crohn’s disease often cause tenesmus, but infections, constipation, or colon and rectal cancers can also trigger it.
This constant urge can be uncomfortable and affect daily life. Learning about the different causes of tenesmus can help people understand what might be happening with their health.
Definition of Symptom
Tenesmus means feeling a frequent and urgent need to have a bowel movement, even when the colon or rectum is mostly empty. It can cause discomfort, cramping, or rectal pain. People may spend time straining, but pass little or no stool. There are two main forms:
- Rectal tenesmus affects the rectum and causes a constant urge to pass stool.
- Vesical tenesmus involves the bladder, causing the urge to urinate even when the bladder is not full.
Key features of tenesmus include:
- Persistent sensation of incomplete emptying.
- Urgency to use the bathroom.
- Pain or pressure in the lower abdomen.
| Type | Area Affected | Key Sensation |
|---|---|---|
| Rectal tenesmus | Rectum or colon | Urge to defecate |
| Vesical tenesmus | Bladder | Urge to urinate |
This symptom may or may not be painful, but it is often distressing and can lead to frustration. Tenesmus is not a disease itself. Instead, it signals an underlying problem in the gastrointestinal or urinary tract.
Possible Causes/Diseases Condition
Many conditions affecting the colon and rectum can cause tenesmus. Inflammation, infection, or growths that disrupt normal bowel function are common triggers. Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, leads to swelling and irritation in the digestive tract. These conditions make the colon sensitive and often trigger tenesmus.
Certain cancers, such as colorectal, rectal, and anal cancer, can cause tenesmus by blocking or irritating the rectum. Motility disorders like irritable bowel syndrome (IBS) may cause tenesmus even without physical blockage or visible inflammation. In these cases, unusual muscle movement in the colon sends wrong signals about needing to pass stool.
Infections, including some sexually transmitted infections (STIs), can inflame the rectal area and trigger a constant urge to defecate. Anorectal abscesses, which are pockets of pus from bacterial infections near the anus or rectum, can press on local nerves and tissues, leading to tenesmus. The table below shows common causes of tenesmus:
| Cause | Description |
|---|---|
| Inflammatory Bowel Disease | Chronic gut inflammation |
| Crohn’s Disease | Inflammatory bowel disorder |
| Ulcerative Colitis | Inflammation in large intestine |
| Colorectal/Rectal/Anal Cancer | Growths blocking the bowel |
| IBS (Irritable Bowel Syndrome) | Gut motility disorder |
| Anorectal Abscess | Pus-filled infection |
| STIs | Infections that can inflame rectum |
Other Non-Disease Causes
Not all cases of tenesmus are related to illness or infection. Several non-disease factors can also trigger this uncomfortable urge. Constipation is a leading non-disease cause. When stool is hard or difficult to pass, it can make the rectum feel full even after a bowel movement, leading to repeated urges to go to the bathroom.
Stress and anxiety may also play a role. High stress levels can affect the nerves and muscles in the digestive tract, causing muscle tension and spasms that feel like tenesmus. Diabetes can affect the nerves that help control bowel movements. This nerve damage may result in abnormal sensations or the false feeling of needing to defecate. Other factors include:
- Overuse of laxatives
- Rectal muscle injuries
- Straining during bowel movements
| Factor | How It May Cause Tenesmus |
|---|---|
| Constipation | Hard stool irritates the rectum. |
| Stress/Anxiety | Alters gut muscle function and sensations. |
| Diabetes | Nerve damage impacts rectal sensations. |
How It Causes the Symptom
Tenesmus happens when the digestive tract sends signals that make a person feel like they need to have a bowel movement, even if their bowels are empty. Irritation or inflammation in the lower part of the colon or rectum often causes this feeling. When the lining of the bowel becomes inflamed, it swells and becomes sensitive. This can lead to:
- A strong urge to pass stool
- Abdominal pain or cramping
- Feeling like the bowel is never fully empty
Inflammation from conditions like ulcerative colitis or Crohn’s disease, as well as infections or constipation, can contribute to tenesmus. Below is a table showing how different causes can lead to tenesmus:
| Cause | How It Leads to Tenesmus |
|---|---|
| Inflammation | Irritates bowel lining, triggers urge |
| Infection | Swells tissue, causes discomfort |
| Constipation | Hard stool puts pressure on rectum |
| Tumors or growths | Block or irritate the bowel wall |
Other symptoms that may occur with tenesmus include nausea, vomiting, and ongoing abdominal pain. These symptoms happen because the irritated or blocked digestive tract cannot work properly, making the body respond with discomfort and the feeling that a bowel movement is needed.
Possible Complications
Tenesmus can disrupt daily life, as the feeling of needing to pass stool often does not go away easily. This can lead to many trips to the bathroom and increased stress. People who experience ongoing tenesmus may develop anal fissures or hemorrhoids from frequent straining, which can cause pain, bleeding, and swelling in the rectal area.
Tissue damage or the need for antibiotics for related conditions can increase the risk of infections. Overusing antibiotics may cause problems like diarrhea or resistant infections. If tenesmus is linked to chronic inflammation, such as in inflammatory bowel disease, further bowel damage can occur. Some people may need medicines to control inflammation.
More severe underlying conditions, such as colorectal cancer, may also be found. Treatments for these, like surgery, radiation, or chemotherapy, can bring their own risks, including bowel changes, pain, or new infections.
Complications Table
| Complication | Relation to Tenesmus |
|---|---|
| Anal fissures/hemorrhoids | From frequent straining |
| Infections | Tissue damage, antibiotic use |
| Bowel damage | Chronic inflammation |
| Treatment side effects | Surgery, cancer therapy |
| Pain and bleeding | Inflammation, tissue damage |
When to Seek Medical Attention
See a doctor if tenesmus is severe or does not go away. Seek medical help right away if any of the following symptoms appear:
- Blood in the stool or rectal bleeding
- Severe abdominal pain or cramping
- Unexplained weight loss
- High fever (over 100.4°F)
- Vomiting or chills
- Fainting or dizziness
Doctors use tests to find the cause of tenesmus. Some common tests include:
| Test | What It Checks For |
|---|---|
| Colonoscopy | Problems in the colon or rectum. |
| Sigmoidoscopy | Lower part of the colon. |
| Blood tests | Signs of infection or inflammation. |
| CT scan | Images of the abdomen and pelvis. |
| Stool culture | Infections in the digestive tract. |
If you have ongoing discomfort or new, serious symptoms, do not ignore them. Listen to your body and get medical advice if symptoms are worrying or limit daily activities.
