Imagine that you have gone to the toilet and come out completely empty. But within a few minutes, you feel a heavy feeling again, like you need to defecate again. No matter how hard you try, nothing comes out. Do you also suffer from this very uncomfortable condition? This is what we call Tenesmus in medicine. This is not just discomfort, but a signal that something is wrong inside your body.
What exactly is tenesmus?
Simply put, tenesmus is the persistent urge to defecate, even after you've emptied your bowels or bladder. You may experience abdominal pain, cramping, heaviness, or even a sudden urge to defecate.
This situation can occur in two main ways:
1. Rectal Tenesmus: This is related to defecation. It means that even after having a bowel movement, you still have the feeling of having to defecate.
2. Vesical Tenesmus: This is related to urination. It means that even after urinating, the bladder still feels full and the feeling of having to urinate again.
The important thing is that tenesmus is not a normal condition. It is a symptom of another underlying medical condition. Therefore, it is not advisable to ignore it.
What are the causes of rectal tenesmus?
There are two main categories of causes of tenesmus related to stool. These are inflammation and constipation. Let's look at these separately.
| Reason category | Description and examples |
|---|---|
| Inflammation | This condition can occur when the lower part of your colon (the rectum and anus) becomes swollen and sensitive. This can make you feel full when you pass stool, and it can also stimulate nerves that send signals to your brain telling you to continue having a bowel movement. The main reasons:
|
| Constipation | When hard stools become trapped in the intestines due to constipation, they constantly stimulate the intestinal walls. This causes a constant feeling of needing to empty the bowels, even though the bowels are not empty. Causes of constipation:
|
What are the causes of urinary tenesmus (vesical tenesmus)?
The same reason why you feel the need to urinate again after you've finished urinating is also true. This condition can be caused by urine remaining in the bladder or by inflammation or infection in the urinary tract.
| Reason category | Description and examples |
|---|---|
| Residual urine in the bladder | When the bladder cannot be completely emptied for some reason, the remaining urine stimulates the bladder muscles and causes the feeling of needing to continue urinating. Reasons:
|
| Urinary tract inflammation/infection | When the urethra becomes swollen and sensitive, nerves can be stimulated, resulting in this sensation. Reasons:
|
Is there a connection between stress and this condition?
Yes, there is a connection. Tenesmus is not caused by stress or anxiety. However, if you already have a condition that causes it, stress can make it worse. Remember, when we are stressed, the balance of our nervous system changes, making it harder to control our muscles. This can increase the involuntary muscle contractions that occur in Tenesmus. Also, having this condition persist can be very stressful.
How is tenesmus treated?
If you have these symptoms, the first thing you should do is see a doctor . The doctor will examine you and try to find out exactly what is causing your symptoms. They may do the following tests:
- Digital Rectal Exam: Manual examination of the rectum.
- Anoscopy/Flexible Sigmoidoscopy: Examination of the rectum and lower colon using a tube with a camera.
- Colonoscopy: Examination of the entire colon.
Once the cause is found, treatment is determined based on that cause.
- Treating the underlying condition: Antibiotics may be given for an infection, and medications for severe constipation may be given. Some conditions may require surgery.
- Treating inflammation: Medications such as corticosteroids may be given to reduce inflammation.
- Treatment for rectal symptoms: Medications that reduce pain and inflammation can be given as suppositories inserted into the rectum.
- Muscle-targeted therapy: Medications that control involuntary muscle contractions (anticholinergics) or (antispasmodics) may be given.
- Cancer symptom management: Treating tenesmus caused by cancer is complex. Sometimes painkillers or surgery may be necessary.
When should you see a doctor immediately?
Always talk to your doctor about this condition. However, if you have any of the following severe symptoms, don't forget to seek medical advice immediately .
If you have any of these symptoms: fever , nausea and vomiting , severe pain , or blood in your stool/urine , seek medical advice immediately. If necessary, go to the Emergency Department (ETU) of the nearest hospital.
Living with this kind of discomfort can be very difficult. Don't be embarrassed to talk to a doctor about it. Don't suffer in silence. Tenesmus is a symptom of a condition that needs to be treated. Even if the underlying condition is chronic and incurable (like IBD), with proper treatment, you can control these uncomfortable symptoms and live a normal life.
Take-Home Message
- Tenesmus is not a disease, but a symptom of another underlying condition.
- This discomfort can occur with defecation (rectal) or urination (vesical).
- It is essential to find the exact cause and treat it. So don't ignore these symptoms.
- If you have symptoms such as fever, severe pain, or blood in your stool/urine, see your doctor immediately.
👩🏽⚕️ Additional questions (FAQs)
💬 Are Disopyramide / Norpace capsules a very powerful medicine for a disease?
This is not an ordinary medicine! This is a powerful (Class 1A Antiarrhythmic) special occasion medicine that is used to control life-threatening Ventricular Arrhythmias / V-Tach / PVCs, which are sudden, uncontrolled, abnormal/rapid rhythms in the heart's 'lower chambers (Ventricles), causing the patient to fall into a coma and die, and to restore the heart to normal!
💬 When your heart is beating like crazy, how does this pill (Disopyramide) help to calm your heart rhythm?
In order for the heart to get an electrical impulse and beat faster, 'sodium' particles need to get into the cells! When this pill enters the heart, it blocks all the sodium channels (Moderate Sodium channel blocker). In addition, it forcibly prolongs and delays the time it takes for the heart's electrical cells to charge and reset (Repolarization / Potassium blockade)! With both of these actions, all the crazy electrical signals are cut off and the heart slows down.
💬 What are the anticholinergic and 'black box warnings' that people taking this medicine (Norpace) should know about?
The biggest problem with this is that it dries up the secretions of the entire body (Severe Anticholinergic effect)! Therefore, the tongue/mouth becomes dry and hard to handle, urine gets stuck in the bladder (Urinary retention), eyes become blurry and severe constipation occurs. The other fatal danger is that it greatly weakens the 'Negative inotropic effect' of the heart! So if a person with heart failure (Heart Failure) drinks this, the heart can stop and die (Proarrhythmic effect).
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