Tenesmus is the feeling you need to have a bowel movement, even if you just had one and your colon is empty. You may try to pass poop and find nothing comes out, or only small amounts leave your bowels. This sensation can be uncomfortable. You may experience pressure, pain, the urge to strain, or cramping. You also may have other digestive tract symptoms, like nausea or vomiting.
Tenesmus isn't a condition by itself. Instead, it's a symptom of other health issues affecting your gastrointestinal (GI) system. It may be a sign of an intestinal movement disorder. Most often, it's linked to conditions that cause inflammation in your GI tract. It can also be a sign of digestive issues due to your system not moving food through your GI tract the way it should.
You may also have other symptoms, including:
- Abdominal pain
- Blood in your stool
- Chills or fever
- Nausea or vomiting
If you have symptoms of tenesmus, see your doctor. You may need tests to diagnose your condition. Once you know the underlying problem, you can start treating it.
Types of Tenesmus
There are two main types of tenesmus, rectal and vesical. One is related to pooping, and one is related to peeing. They're separate conditions with different causes and treatments.
Rectal tenesmus is the constant feeling you need to poop, even when you don't. Vesical tenesmus is the persistent feeling you need to pee, even when you can't.
Your doctor can find out if your symptoms are tenesmus or something else, and choose the best treatment for you.
Causes of Tenesmus
If constipation isn't the reason for pressure on your colon and rectum, tenesmus may be a sign that part of your GI system isn't operating properly. There are many conditions that list tenesmus as a symptom, including:
Anorectal abscess. An abscess is an infection resulting in a pocket of pus. They can happen anywhere on your body. If one develops around your anus, it can lead to pain, swelling, and a feeling of pressure. Anal fissures, certain sexually transmitted infections (STIs), diabetes, and inflammatory bowel disease can increase your risk of anorectal abscesses.
Colorectal cancer. It can lead to growths such as polyps or tumors in the rectum. The pressure from a mass can lead to tenesmus symptoms.
Cancer treatment. If you are undergoing radiation therapy for cancer, it can lead to inflammation of your colon or rectum.
Inflammatory bowel disease. Crohn's disease and other inflammatory bowel diseases are chronic conditions where areas of the digestive tract become inflamed. It can affect the rectum and cause inflammation in that area, leading to a feeling of fullness or pressure. People with inflammatory bowel conditions may also be more likely to get abscesses due to irritation of the skin from frequent bowel movements.
Infection of the colon. Infections from bacteria, viruses, or parasites in the colon can cause inflammation and severe diarrhea. The inflammation and irritation around your colon or anus can result in tenesmus.
Intestinal movement (motility) disorder. Food needs to move through your digestive tract for it to be digested properly. If nerves and muscles in the GI tract don't work correctly, it can lead to unusual muscle contractions in the GI system. It can cause many digestive symptoms, including constipation, diarrhea, and tenesmus.
Proctitis. It is inflammation of the skin lining your rectum. Proctitis can be a complication of inflammatory bowel disorders or a result of a sexually transmitted infection.
Tenesmus Anxiety
Your brain and gut are closely connected. When you have anxiety, it can disrupt that balance. That can lead to digestive problems like tenesmus. Studies show anxiety can cause a release of hormones and neurotransmitters that affect your gut and digestive processes. Anxiety can trigger tenesmus, and tenesmus can cause anxiety. This means they have a dual relationship. which can lead to a cycle of discomfort and worry. Anxiety alone isn't enough to cause tenesmus, but it can upset your nervous system and make it hard to control your muscles. That can lead to the involuntary muscle contractions that happen in tenesmus.
Diagnosing the Cause of Tenesmus
If tenesmus is ongoing or comes and goes frequently, see your doctor to find out what's causing it. They'll ask about your health history and do a physical exam. They need to know if you have an existing condition such as Crohn's disease or a history of colorectal cancer.
They may do more extensive tests to understand the cause of your tenesmus, including:
- Colonoscopy or proctosigmoidoscopy, where a tube-like lens is inserted into the rectum to view the colon
- Blood tests
- CT scan
- Stool cultures
- X-rays of the abdomen
Treatment for Tenesmus
Once your doctor knows the reason for your tenesmus, they'll treat your underlying issue. Treatment will vary, depending on the cause.
If your tenesmus is a result of an acute condition that's recent and treatable, they'll treat the condition directly. You might need antibiotics for an infection, or laxatives for severe constipation. You might have a condition that needs more aggressive treatment, such as surgery.
If you have inflammation causing or worsening your tenesmus, your doctor may treat your inflammation directly. They may give you anti-inflammatory meds such as corticosteroids. Some anti-inflammatory meds and pain relief meds can be put inside your bottom to treat rectal tenesmus. You insert them with a suppository. If you have inflammatory bowel disease (IBD), make sure to take your medications on schedule to prevent your tenesmus from flaring up.
Your doctor may also treat your muscles affected by tenesmus. They may prescribe anticholinergics, drugs that block involuntary muscle movements. These drugs can help with both types of tenesmus. Your doctor might also prescribe antispasmodics, also known as smooth muscle relaxers. They might also want you to take anticonvulsants to help soothe your nerves involved in tenesmus.
If you have cancer, you'll need treatment for that. But tenesmus that's caused by cancer can be difficult to treat. Common cancer treatments, such as radiation therapy and chemotherapy, may not help, and they may even cause or worsen tenesmus. Your doctor might prescribe strong pain relievers. Sometimes, surgery may help.
Some studies suggest physical therapy and biofeedback targeting your pelvic floor may help manage tenesmus symptoms in some people. But more research is needed.
Talk to your doctor about possible causes of your tenesmus and what treatment is right for you.
Tenesmus FAQs
Is tenesmus related to stress or anxiety?
Yes.Your brain and gut are closely linked. Anxiety can trigger tenesmus, and tenesmus can cause anxiety, making a cycle of discomfort and worry.
Which cancers cause tenesmus?
Tenesmus can be a symptom of colon and rectal cancers. Anal cancer, along with some less common cancers, can also be associated with tenesmus.
Can IBS cause tenesmus?
Yes. Irritable bowel syndrome (IBS) can cause tenesmus.
Why do I feel like I need a bowel movement all the time?
When you have Inflammation in your lower bowel, there's less room for poop to pass through. That makes your bowel feel fuller. Then, the nerves lining your bowel, which are irritated, may mistakenly tell your brain or muscles you need to have a bowel movement.
