Overview
Defecating and urinating is a way of getting rid of the toxic substances or waste from the body. Therefore, the inability to empty the bowels can be a concerning sign, but it may also be a result of something not too dangerous. But all in all, Tenesmus isn’t a normal sign and often indicates an underlying GI problem. Physicians or medical professionals can help you differentiate between the common and concerning.
What is Tenesmus?
Doctors often talk about a phenomenon called Rectal Tenesmus. But what is it exactly? It is described as a person wanting to poop but is unable to have any bowel movements. At the same time, the person might experience cramping, feeling of discomfort, or pain.
Have you ever felt like you have to poop, but nothing comes out? Well, you are not alone. Around 15% of the US population is believed to be suffering from at least some kind of incomplete bowel movements or constipation.
Tenesmus feels like:
- Wanting to poop, but nothing comes out
- Wanting to poop, but little poop comes out
- Constantly having the urge to defecate
- A bloated feeling in your abdomen
- Feeling that you still need to poop even if you just went to the toilet
- Feeling constipated
Vesical Tenesmus:
What differentiates Tenesmus from Vesical Tenesmus is that the latter is characterized by the urge to pee even if your bladder is empty or you have just peed. The feeling, however, is just as frustrating as the original one but the causes are very different, though.
Why do I feel like I have to poop, but little comes out?
Tenesmus can be due to serious conditions such as inflammatory diseases or Colorectal Cancer, or it could be due to something as benign as taking the wrong diet and making your poop hard. Let’s take a deep dive into some of the reasons why you can’t empty your bowels.
Inflammatory Bowel Disease (IBD)
People suffering from IBDs generally have an inflamed rectum, which leads to a constant urge to defecate. This is particularly common in people who have Ulcerative Colitis due to the presence of rectal hypersensitivity.
STDs
Pathogens, especially those that cause gastrointestinal symptoms, inflame the lining of the mucosa or cause rectal irritation, leading to the constant urge to defecate even if the bowels are already empty. STD’s to watch out for include Chlamydia and Anorectal Gonorrhea.
Infectious Colitis:
In the same way that most STDs can affect our mucosal lining, other pathogens can do too. You might ask, “But which ones in particular should we be weary of ?” In that case, you should keep an eye out for Bacteria like Salmonella and Shigella and viruses such as Norovirus. These pathogens are known for not only causing rectal and mucosal inflammation but also increasing bowel motility, which at times leads to a feeling of incomplete evacuation.
Radiation Colitis:
Patients undergoing cancer treatments, especially radiation therapies for colon cancers, can have an inflamed colorectal area, which in turn leads to abnormal sensations.
Colorectal Polyps:
Certain groups of people are prone to having polyps in their GI region. Moreover, these patients may also later complain of Tenesmus. But Why? Because colorectal polyps often cause mechanical obstruction, meaning that they make the colonic surface irregular, which obstructs fecal motility, so your poop gets stuck on its way out.
Diverticulitis:
Individuals with Diverticulitis might complain of frequent abdominal pain or cramping. This often coincides with a seemingly abnormal feeling of having a full abdomen. Other than that, changes in bowel movements and stool texture due to Diverticulitis might also lead to constipation or Tenesmus.
Colorectal Cancer:
The feeling of incomplete extraction is common in people with Colorectal Cancer. It shares some similarities with Polyps; that is, both polyps and tumors cause mechanical obstruction of feces. However, Tumors can be large enough to press neighboring nerves, leading to abnormal sensations in the bowel and rectum.
Perianal Abscess:
Abscesses in the anal or perianal region can cause pain in the neighboring areas; this feeling of discomfort, along with the presence of pus, can lead to reflexes in the anal sphincters and pelvic muscles, which is why patients with perianal abscesses often complain of frequent bowel evacuation feeling without actually passing stool.
Hemorrhoids:
Swollen Hemorrhoids are often extremely painful during defecation and can often lead to phantom feelings of wanting to defecate even if the rectum isn’t full. Similarly, ruptured hemorrhoids can ooze blood, which can cause abnormal sensations in the sphincter area. Moreover, the presence of a large number of hemorrhoids within the rectal area results in a fullness sensation for the patient, which confuses the body to produce an urge for defecation.
Rectal Prolapse:
People with weak pelvic floor muscles might experience “Rectal Prolapse,” which means that the rectum slips out from its original position or protrudes through the anal opening. This is an obvious cause of Tenesmus since the protruding rectum provides an abnormal feeling through the anus.
Stress and Anxiety:
Stress, Anxiety, or Depression aren’t commonly known to induce Tenesmus. However, they can indeed exacerbate an already existing Tenesmus. It is often harder to control sensations with an upset nervous system, which may lead to phantom feelings in the rectum without any obvious trigger.
What is the treatment for Tenesmus?
Tenesmus isn’t a disease itself; rather, it is an indication of an underlying illness and, therefore, should be taken seriously. You should consult a physician if Tenesmus is accompanied by:
- Severe Abdominal Pain
- Sudden Weight Loss
- Blood in Stool
- Fever
- Mucus or Changes in Stool Color
Prescription Medications
It is important to fix the underlying condition to eliminate Tenesmus. However, generalized treatments to manage the feeling of Tenesmus are available.
Antispasmodics such as Buscopan to relieve abnormal spasms and cramping.
Corticosteroids such as prednisone to mitigate the impact of IBD-induced inflammation.
Antibiotics such as Metronidazole to cure bacterial infections, thereby lowering mucosal inflammation.
Prescription Laxatives such as Lactulose to manage constipation and hard stool.
Over the Counter Antibiotics
A doctor will suggest over-the-counter options prescription medications after assessing the severity of your condition. In general, OTC Antibiotics are not available but can be prescribed by a doctor, depending on the condition or cause of the underlying symptoms.
Home Remedies
While serious conditions causing Tenesmus might almost always require medical intervention, management of the feeling itself can be achievable through home remedies such as
Exercises: Pelvic Floor exercises or Kegel Exercises can be quite beneficial, especially for people with weak pelvic floor muscles. Having weak pelvic floor muscles can lead to rectal prolapse or can weaken the anal sphincter.
Create a diet plan: People suffering from certain diseases such as IBD can manage their Tenesmus quite well if they create a diet plan. However, your IBD might have characteristics specific to you; therefore, the best way to do this is to consult a nutritionist.
Dealing with constipation and diarrhea: Both constipation and diarrhea are abnormal gut conditions that can lead to the feeling of Tenesmus. However, just like Tenesmus, these aren’t diseases at self, but rather symptoms of underlying conditions. Therefore, managing your electrolyte levels and maintaining hydration during diarrhea and constipation is a good way of keeping your poop moving in a regular way.
Taking care of your gut health: An unhealthy gut is more susceptible to infections and disorders, which may lead to irregular bowel movements and phantom sensations. Taking probiotics either naturally through yogurt or fruits such as bananas or even by taking probiotic supplements can help.
Creating a Stress free environment or Managing Stress: Stress exacerbates Tenesmus especially when you are already suffering from gut conditions that’s because if you have a preexisting gut condition you might already have abnormal bowel motility. Bowel motility is controlled by a connection between the gut and the brain which is why stress and other psychological conditions may play an important role in exacerbating the feeling of Tenesmus.
Can Tenesmus go away by itself?
Tenesmus induced as a result of infections, particularly viral infections goes away on its own after the virality or infective stage. However, in patients suffering from chronic conditions such as IBD we might see aggravations and reductions from time to time. In general, adjusting to a less irritating diet and managing stress levels can help alleviate Tenesmus in conditions where the causes are minor.
At the same time, staying in touch with medical professionals is wise, even if the Tenesmus feels manageable. There are several serious conditions out there which lead to Tenesmus such as perianal abscess or colorectal cancer. These conditions are not known to resolve spontaneously and always require professional intervention from a doctor.
When should I consult a doctor?
Tenesmus is a symptom of several conditions. Some are relatively benign, such as constipation, while others can be life-threatening, like colorectal cancer. That is why there are certain signs and symptoms accompanying Tenesmus that you should watch out for. Consult a physician if your Tenesmus persists for over two weeks or if you experience signs of severe disease.
FAQs about Tenesmus
Keeping yourself hydrated, eating lots of fiber- containing foods like bananas and keeping a steady probiotic supply can help maintain your natural bowel motility. In case of severe constipation Laxatives can be prescribed by doctors.
