TenesmusPain - 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.
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.
Persons with tenesmus may push very hard (strain) to try to empty their bowels. However, they will only pass a small amount of stool.
The condition may be caused by:
- 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)
- Movement (motility) disorder of the intestines
- Ulcerative colitis
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
These symptoms could be a sign of a disease that might be causing the problem.
What to Expect at Your Office Visit
The doctor 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
Camilleri M. Disorders of gastrointestinal motility. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 138.
Cook IJ, Brookes SJ, Dinning PG. Colonic motor and sensory function and dysfunction. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 98.
Lichtenstein GP. Inflammatory bowel disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 143.
Review Date: 8/19/2014
Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Aria Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.