What to Know About Tenesmus

Medically Reviewed by Minesh Khatri, MD on May 28, 2023
3 min read

Tenesmus is the physical feeling that you need to have a bowel movement, even if you just had one and know your colon is empty. You may try to pass stool and find that nothing comes out or only small amounts of stool leave your bowels. The sensation can be quite uncomfortable. You may experience pressure, pain, the urge to strain, or cramping. You may have other digestive tract symptoms such as nausea or vomiting. ‌

Tenesmus isn’t a condition by itself. It’s a symptom of other health issues that affect your gastrointestinal system — and may be a sign of an intestinal movement disorder. It’s most often associated with conditions that cause inflammation in your GI (gastrointestinal) tract. It can also be a sign of digestive issues due to your system not moving food through your gastrointestinal 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 feelings or symptoms of tenesmus, you should make an appointment to talk to your doctor. You may need tests to diagnose the condition that is causing your bowel discomfort. Once you know the reason behind the issue, you can start treating the underlying problem.

If constipation isn't the reason for pressure on your colon and rectum, tenesmus may be an indication that part of your GI system is not operating properly. There are multiple conditions that list tenesmus as a symptom, including:‌‌

Anorectal abscess. An abscess is an infection that has led to 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, diabetes, and inflammatory bowel disease can increase your risk of anorectal abscesses.

Colorectal cancer.Colorectal cancer 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 to 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 digest properly. If nerves and muscles in the gastrointestinal tract don’t work correctly, it can lead to unusual muscle contractions in the GI system. The result can be a variety of digestive symptoms, including constipation, diarrhea, and tenesmus.

Proctitis.Proctitis is inflammation of the skin lining your rectum. Proctitis can be a complication of inflammatory bowel disorders, or it can happen as the result of a sexually transmitted infection. ‌

If tenesmus is ongoing or comes and goes frequently, you should call a doctor to determine what is causing the discomfort. Your doctor will ask about your health history and do a physical exam. They will want to know if you have an existing condition such as Crohn's disease or a history of colorectal cancer.

They may also 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
  • Computed tomography (CT) scan 
  • Stool cultures
  • X-rays of the abdomen

Once your doctor knows the reason for your tenesmus, they will treat the underlying issue. The treatment will vary, depending on what the root cause is. You may need medication to control an inflammatory disorder in your bowel or to treat an infection. If you have cancer, you will need treatment for that. You may need to make lifestyle changes, such as dietary restrictions to improve digestive function. You may need additional medications to completely relieve the symptoms.

If you are experiencing tenesmus, speak to your doctor about the possible causes and what treatment is right for you.