Tenesmus

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Lower digestive anatomy

Definition

Tenesmus involves constantly feeling the need to empty the bowels, along with pain, cramping, and straining.

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.

People with tenesmus feel as though they need to pass stool. Although they strain, they pass little stool.

Common 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)
• Ulcerative colitis

Home Care

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

Call your health care provider if

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 health care provider's office

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-- and prostate check for men -- 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

Review Date: 8/22/2008

Reviewed by: Christian Stone, M.D., Division of Gastroenterology, Washington University in St. Louis School of Medicine, St. Louis, MO. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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