How to Treat Tenesmus During Bowel Movements

Tenesmus, or the feeling of needing to pass stools immediately followed by a sensation that the bowel movement is incomplete, is not a diagnosis but rather a symptom. In normal circumstances, when there is a need to defecate, individuals can manage based on the situation. For example, if someone feels the urge to go but is in the middle of work or does not have immediate access to a restroom, they can usually control the urge. However, tenesmus refers to an urgent need to defecate immediately, often with the fear of soiling oneself if a restroom is not quickly accessible. The feeling of "rectal fullness" or "incomplete evacuation" after a bowel movement is known as tenesmus, where the individual continues to feel the need to pass more stool even though the rectum is empty.

Common Causes and Treatments

One of the most common causes of tenesmus is acute bacterial dysentery. Inflammation and swelling in the rectum can cause secretions, sometimes including pus or blood. Due to the swelling and irritation, the urge to defecate becomes urgent and difficult to control. Even when the bowel is empty, the inflamed rectal tissue can send signals to the brain that the bowels are still full, resulting in the sensation of needing to go again. In such cases, immediate stool tests are typically recommended. Doctors will also ask about recent food consumption or possible exposure to contaminated sources. Based on the findings, appropriate antibiotic treatment is prescribed. In some instances, a stool culture may be necessary to identify the specific bacteria and determine which antibiotics will be most effective.

Other Potential Causes

Rectal Tumors

Less commonly, rectal tumors can also cause tenesmus. In advanced stages of rectal cancer, ulcers or lesions may develop, leading to irritation and the sensation of needing to defecate frequently. These symptoms can mimic those of an infection, making further diagnostic testing essential for accurate treatment.

Radiation Therapy Side Effects

Some patients undergoing radiation therapy for rectal conditions—often referred to colloquially as "electrotherapy"—may also experience tenesmus. Radiation can cause inflammation in the rectal area, leading to discomfort and the false sensation of needing to pass stool. In these cases, anti-inflammatory medications or corticosteroid treatments may be recommended to reduce swelling and alleviate symptoms.

Medical Management and When to Seek Help

If tenesmus persists, it's important to consult a healthcare provider to determine the underlying cause. While bacterial infections may be treated with antibiotics, other conditions such as rectal cancer may require surgical intervention. Early diagnosis and targeted treatment are key to managing symptoms effectively and improving overall outcomes. For persistent or recurring cases, a visit to a gastroenterologist or colorectal surgeon may be necessary to explore further diagnostic options like colonoscopy or imaging studies.