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Tenesmus

Definition

Tenesmus is the constant feeling of the need to empty the bowel, accompanied by pain, cramping, and involuntary straining efforts.

Alternative Names

Pain - passing stool; Painful stools; Difficulty passing stool

Considerations

Tenesmus is generally associated with inflammatory diseases of the bowel, which may be caused by an infection or by other conditions. Tenesmus is characterized by a sensation of needing to pass stool, accompanied by pain, cramping, and straining. Despite straining, little stool is passed.

Common Causes

• Inflammatory bowel disease (IBD)
• Crohn's disease
• Ulcerative colitis
• Anorectal abscess
• Infectious colitis (infection of the colon)
• Colorectal cancer or tumors
• Radiation proctitis or colitis (inflammation of the colon or rectum from radiation)

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 tenesmus continues, whether it is constant or comes and goes. Also call if you have abdominal pain, fever, chills, blood in the stool, nausea, or vomiting. Such symptoms could be a sign of an underlying disorder.

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
  • 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.

Diagnostic tests that may be performed include:

• Laboratory tests: CBC (blood count), electrolytes, and stool cultures
• X-rays of the abdomen
• A CT scan of the abdomen (may be done in rare instances)
• Colonoscopy to look at the colon and rectum

Review Date:11/13/2007
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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