Definition of Tenesmus: Causes, Symptoms, Considerations, Diagnosis and Treatment

Definition:

It is the sensation that you go through at the moment of evacuating your stool, even though your intestines are already empty, with which you can experience exertion, pain and cramps.

Alternative names

Pain passing stools, painful bowel movements or difficulty defecating.

Considerations

Tenesmus usually occurs due to inflammatory diseases of the intestines, which can be caused by infection or other conditions.

It can also occur with diseases that affect the normal movements of the intestines. These pathologies are called motility disorders . People with tenesmus can make an effort too hard (strain) to try to empty their bowels.

Common causes of Tenesmo

  • Abscess in the anus and rectum
  • Colorectal cancer or tumors
  • Crohn’s disease
  • Colon infection (infectious colitis)
  • Inflammation of the colon or rectum of radiation (radiation proctitis or colitis)
  • Inflammatory bowel disease (IBD)
  • Movement (motility) disorder of the intestines
  • Ulcerative colitis

Home care

If you feel you are constipated, try to increase the intake of fluids and fiber .

Call your health care provider if you continue to have symptoms of tenesmus that may be constant or intermittent.

symptom

  • Abdominal pain
  • Blood in the stool
  • Shaking chills
  • Fever
  • Sickness
  • Vomiting

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

Diagnosis

The doctor will examine you and ask you questions such as:

  • Time pattern.
  • If the problem has developed recently.
  • If it is the first time you have had tenesmus.
  • If it is an intermittent sensation or is constant.
  • If you have presented a constant need to empty your bowels .
  • If you have had abdominal pain
  • If you have cramps.
  • If you have always felt the need to make an effort.
  • If you have had diarrhea or vomiting.
  • You will also be asked if you have had other symptoms such as blood in your stool and fever.
  • Dietary history
  • If you have eaten something unusual or without cooking.
  • If you have had a medical problem in the past.
  • If someone else in your family or social group had similar problems.

A complete medical evaluation and physical examination will be performed to diagnose tenesmus and identify its cause.

Severe underlying causes, such as cancer or IBD, must be found quickly, since early intervention is key to recovery and management.

The doctor will take a person’s complete medical and family history and may ask other questions about:

  • Symptoms, such as duration, frequency, severity and beginning.
  • Intestinal habits
  • Other health problems
  • A detailed abdominal examination and a rectal exam will also be performed.

Other tests that can be carried out include:

  • Blood test.
  • A culture of feces.
  • Simple x-ray film or computed tomography of the abdominopelvic area.
  • Colonoscopy , to examine the entire colon.
  • Sigmoidoscopy, to examine the last sections of the colon.
  • Detection of sexually transmitted diseases.

When to see a doctor:

A person should see a doctor when it is difficult or painful to pass stool. It is especially important if the symptoms persist beyond a few days or are recurrent.

Immediate medical treatment should be sought if other symptoms associated with IBD or other potentially serious intestinal conditions are experienced, including:

  • Blood in the stool.
  • Cold.
  • Fever.
  • Nausea.
  • Vomiting
  • Abdominal pain.

Treatment

The treatment depends on the severity of the tenesmus and its underlying cause. According to a 2017 review of research on tenesmus in people with cancer, it may be necessary to use a combination of treatments to help control the symptoms.

Inflammatory bowel disease :

The treatment for IBD aims to relieve discomfort, achieve and maintain the remission of symptoms and avoid any complications. Medications and surgery are the most common options.

Medications available to relieve the symptoms of IBD, including tenesmus, include:

Anti-inflammatory medications : taken orally or rectally to reduce inflammation and help achieve or maintain remission.

Suppressors of the immune system: to inhibit the response of the immune system that causes inflammation.

Corticosteroid therapy : rapid-acting systemic steroids for the management of IBD outbreaks by causing immunosuppression and reducing inflammation.

Biological therapy: another subclass of immunosuppressants, such as a monoclonal antibody, that targets substances in the body that lead to inflammation.

Antibiotics: are used against bacteria that may be causing or worsening symptoms.

Laxatives: prescribed for those with tenesmus related to constipation.

Relief of pain: symptoms that cause severe pain can be treated with analgesics. These may be additional to other medications for the cause of pain and tenesmus.

Surgical procedures can be used to widen a small intestine or to remove blockages that are causing tenesmus and other symptoms of IBD.

Motility disorders:

Any abnormal movement of food or waste in the digestive tract can be considered a disorder of intestinal motility. Diarrhea and constipation are the two most obvious signs of abnormal bowel motility.

Tenesmus that is associated with infectious diarrhea can be treated with antibiotics or antiparasitics to kill an underlying bacterial or parasitic infection. If certain foods or medications cause diarrhea, a doctor may recommend that a person avoid them.

Constipation that causes tenesmus can be treated with a laxative so that the stool can pass through the colon more easily.

Impacted stools, where debris gets stuck in the colon, can be removed manually by a doctor or eliminated with a rectal laxative enema or irrigation with water.

Treatment for other causes:

Tenesmus that is caused by other medical conditions, such as cancer or a sexually transmitted infection, can be resolved once the underlying disease is treated effectively.

The doctors will adapt the treatment plans according to the unique needs of each individual.