Why Do I Have Tenesmus? (2024)

Tenesmus is the frequent and urgent feeling that you need to pass stool, even if your bowels are already empty. Prevention and treatment can depend on the underlying condition.

Tenesmus is a symptom that may occur if you have a health condition that affects your gastrointestinal (GI) tract.

According to the International Continence Society, tenesmus may involve straining and discomfort during bowel movements and only produce a small amount of stool.

Keep reading to learn more about the potential causes, symptoms, and treatments of tenesmus.

Tenesmus may be a symptom of several conditions that involve the GI tract, including:

  • Crohn’s disease
  • ulcerative colitis
  • constipation
  • proctitis, which is usually caused by an infection or inflammatory bowel disease (IBD)
  • irritable bowel syndrome (IBS)
  • rectal prolapse
  • sexually transmitted infection (STI) of the rectum
  • viral, bacterial, or parasitic infections of the colon
  • anorectal motility disorders
  • certain types of abdominal surgery
  • rectal abscesses
  • colorectal cancer

Irritable bowel disease (IBD)

Ulcerative colitis and Crohn’s disease are two forms of IBD, which is one of the most common causes of tenesmus.

These chronic conditions cause long-term inflammation in all or some parts of your GI (digestive) tract.

Over time, this inflammation may narrow your bowels, giving the sensation of fullness even with little stool. Inflammation may also cause the nerves around the bowel to be overactive, which could lead to symptoms like tenesmus.

A small 2018 study found that participants with ulcerative colitis were more likely to experience tenesmus than those with Crohn’s disease.

The exact cause of IBD isn’t known, but researchers suggest genetics, environmental factors, and the immune system may all contribute to its development and progression.

Tenesmus is a symptom itself that may involve:

  • frequently feeling like you need to pass stool
  • the urgency to evacuate your bowels
  • straining, discomfort, or cramping during bowel movements
  • passing only a small amount of stool
  • feeling as if you can’t completely empty your bowels

Speak with a healthcare professional if you experience tenesmus often, it doesn’t go away after a few days, or it’s accompanied by the following symptoms:

  • abdominal pain
  • blood in your stool
  • vomiting
  • fever
  • chills

Tenesmus is a symptom of many different health conditions.

To find the underlying cause, a doctor will perform a physical and rectal examination. They’ll ask you about the type, frequency, and severity of any symptoms you’ve been experiencing.

A doctor may also use some of the following tests to help identify the underlying cause of tenesmus:

  • colonoscopy
  • imaging studies, such as X-ray, MRI, or CT scan
  • stool samples
  • blood tests
  • anorectal manometry

Many of these tests are also used to diagnose IBD, IBS, and colorectal cancer.

If a doctor suspects you have an STI, they may take a culture (sample) from the rectum and run bloodwork.

Treatment for tenesmus will depend on the cause behind this symptom. Your treatment plan may include a combination of dietary and lifestyle changes, home remedies, and medical treatments.

Dietary changes

If IBD, IBS, constipation, or a motility disorder is causing your symptoms, making some dietary changes may help relieve cramps and discomfort.

For example, eating a high fiber diet may help soften and bulk up your stool, which could make it pass more easily.

The Dietary Guidelines for Americans 2020 to 2025 recommend adults eat between 25 and 31 grams of fiber each day.

It’s important to note that high fiber foods may trigger tenesmus and other GI symptoms if you’re living with IBD. As such, temporarily eating a low fiber diet during a flare-up could help relieve tenesmus.

Drinking more water

Drinking enough water is important for keeping your stool soft.

The Academy of Nutrition and Dietetics recommends consuming 11.5 cups (2.7 liters) of water daily for females and 15.5 cups (3.7 liters) of water daily for males.

Keep in mind these are general recommendations, and everyone’s needs are different.

Learn more about how much water you should drink per day.

Physical activity

Physical activity stimulates movement in your intestines. This might boost intestinal waste movement through your GI tract, which could help relieve constipation and tenesmus.

Bowel training

If tenesmus is linked to constipation, a doctor may recommend bowel training. This may involve:

  • setting a schedule for bowel movements every day, often within 1 hour of eating breakfast
  • giving yourself time to use the restroom
  • using the bathroom whenever you have an urge to go
  • relaxing your muscles when you try to pass stool

Medical treatment

Medical treatments will vary depending on the cause of your tenesmus:

  • IBD: Medical treatment aims to help stop inflammation causing your symptoms. This may involve taking 5-aminosalicylic acids, immunomodulators, corticosteroids, or biologics.
  • Infections: If your tenesmus is linked to a GI tract infection or STI, a doctor will prescribe antibiotics.
  • Constipation: A doctor may recommend laxatives, stool softeners, or fiber supplements to help regulate and soften your stool.
  • Colorectal cancer: Depending on the stage of cancer you have, a doctor may recommend chemotherapy, radiation therapy, or surgery to remove the tumor.

If you have a health condition and experience tenesmus, speak with a healthcare professional. They could help modify or develop a treatment plan to ease your symptoms.

What is the cause of tenesmus?

Tenesmus is usually caused by a condition that affects your gastrointestinal tract, such as infection, inflammatory bowel disease, constipation, colorectal cancer, and rectal prolapse.

How do you get rid of tenesmus?

Treatment for tenesmus will depend on the underlying cause. It may include lifestyle changes like eating more fiber, drinking more water, and getting regular exercise. Medical treatments range from taking over-the-counter stool softeners to prescription drugs and surgery.

Is tenesmus temporary?

The duration and frequency of tenesmus will depend on the underlying cause. If it’s caused by an infection, it may stop once the infection is treated. If it’s caused by a chronic condition, you may need medical treatment to keep tenesmus from flaring up.

Do hemorrhoids cause tenesmus?

Hemorrhoids may cause you to feel like you still need to have a bowel movement, despite just having one.

Tenesmus is the urgent feeling that you need to have frequent bowel movements. But even with pushing and straining, you might not be able to pass much stool.

Tenesmus can be a sign of several health issues, so it’s a good idea to talk with a doctor if you’re experiencing this condition frequently.

Why Do I Have Tenesmus? (2024)
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