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Tenesmus

Pain - passing stool; Painful stools; Difficulty passing stool

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

Considerations

Tenesmus most often 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. These diseases are known as motility disorders.

People with tenesmus may push very hard (strain) to try to empty their bowels. However, they will only pass a small amount of stool.

Causes

The condition may be caused by:

  • Anorectal abscess
  • Colorectal cancer or tumors
  • Crohn 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 or ulcerative proctitis

Home Care

Increasing the amount of fiber and fluid in your diet can help ease constipation.

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 provider will examine you and ask questions such as:

  • When did this problem occur? Have you had it before?
  • What symptoms are you having?
  • Have you eaten any raw, new, or unfamiliar foods? Have you eaten at a picnic or large gathering?
  • Do any others in your household have similar problems?
  • What other health problems do you have or have had in the past?

The physical exam may include a detailed abdominal exam. A rectal exam 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)
  • Proctosigmoidoscopy (an examination of the lower bowel)
  • Stool cultures
  • X-rays of the abdomen

References

Abdelnaby A, Downs JM. Diseases of the anorectum. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 129.

Camilleri M. Disorders of gastrointestinal motility. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 136.

Lichtenstein GP. Inflammatory bowel disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 141.

Quick CRG, Reed JB, Harper SJF, Saeb-Parsy K, Desakin PJ. Non-acute abdominal pain and other abdominal symptoms and signs. In: Quick MB, Reed JB, Harper SJF, Saeb-Parsy K, Deakin PJ, eds. Essential Surgery: Problems, Diagnosis and Management. 5th ed. Philadelphia, PA: Elsevier; 2014:chap 18.

  • Lower digestive anatomy

    Lower digestive anatomy - illustration

    Food passes from the stomach into the small intestine. In the small intestine all nutrient absorption occurs. Whatever has not been absorbed by the small intestine passes into the colon. In the colon most of the water is absorbed from the food residue. The residue is then eliminated from the body as feces.

    Lower digestive anatomy

    illustration

    • Lower digestive anatomy

      Lower digestive anatomy - illustration

      Food passes from the stomach into the small intestine. In the small intestine all nutrient absorption occurs. Whatever has not been absorbed by the small intestine passes into the colon. In the colon most of the water is absorbed from the food residue. The residue is then eliminated from the body as feces.

      Lower digestive anatomy

      illustration


     

    Review Date: 6/21/2018

    Reviewed By: Michael M. Phillips, MD, Clinical Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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