Rectal Tenesmus is the frequent and urgent feeling as if a person needs to pass stools even if the bowels are already empty.
Sometimes a person may require severe straining and discomfort during the period of bowel movements, even for a small amount of stool.
There is a persistent and painful sensation along with a desire to evacuate the bowel, despite having an empty colon. The patient also suffers from cramping, sometimes involuntary straining, and despite all this, there is very little fecal matter.
Rectal Tenesmus is not a condition that occurs by itself but a symptom of underlying health issues which are affecting the gastrointestinal system. These underlying conditions can include inflammatory conditions of the bowel or a few motility disorders that may affect the normal movements of the intestines.
Several medical conditions can cause Rectal Tenesmus. These include inflammatory bowel diseases, colorectal cancer, and disorders that interfere with how the muscles move food through the intestinal tract.
Rectal Tenesmus Types
Rectal tenesmus is of three types –
Mild tenesmus –
It is described as the feeling of having an incomplete bowel evacuation, urging to pass stools even after emptying after passing it once. It usually resolves in a few days on its own.
Moderate tenesmus-
It is described as a frequent and urgent feeling as if a person needs to pass stools even if the bowels are already empty. There is colicky pain when passing stools and requires medication.
Severe tenesmus –
It is described as the feeling of having an incomplete stool emptying after passing once and there are various health issues underlying the cause. It requires medical attention and sometimes hospitalization for treating the underlying cause.
Similar to rectal tenesmus, vesical tenesmus is a potential condition that affects the bladder.
Rectal Tenesmus: -Causes
Tenesmus can be a symptom of several disease conditions involving the gastrointestinal (GI) tract. The major causes of tenesmus may include:
- Crohn’s Disease
- Constipation
- Proctitis
- Infection or inflammatory bowel diseases(IBD)
- Irritable bowel syndrome(IBS)
- Rectal prolapse
- Anorectal motility disorders
- Infections of the rectum or colon by viruses, Bacteria, or Parasites
- Rectal abscess
- Fissures
- Piles
- Sexually transmitted infections of the rectum(STI)
- Some abdominal surgery
- Colorectal cancer
Ulcerative colitis and Crohn’s disease are the most common causes of rectal tenesmus.
These conditions are chronic and cause long-term inflammation in all or some parts of the gastrointestinal tract.
Due to these conditions, there is scar formation in the Gastrointestinal tract. This scarring will make it harder for a person to pass stool, leading to symptoms like tenesmus.
If one has Crohn’s disease, ulcerations can spread throughout the gastrointestinal tract.
When one has ulcerative colitis, the ulcers are usually located only in the colon and rectum.
Doctors have observed clinically that there is inflammation of the digestive tract leading to rectal tenesmus if the immune system overreacts when fighting off an invading organism, like bacteria or viruses.
Rectal Tenesmus – Symptoms
The common signs and symptoms of rectal tenesmus include:
- There is a frequently feeling as if one needs to pass stool
- The person gets an urgency to evacuate the bowels
- There are abdominal cramps
- One gets frequent abdominal pain
- Sometimes there is rectal bleeding
- Over some time, there is a weight loss
- There is fatigue
- One experiences straining and discomfort during bowel movements
- There is passing only a small amount of stool
- There is a feeling as if you can’t empty the bowels
Persons of rectal tenesmus, often feel the need to empty the bowels, even if little stool to pass or no stools at all. Bowel movements will be disturbed and there is significant cramping and discomfort, there is often straining to pass small amounts of fecal matter.
Complications of Rectal Tenesmus
It is also important to speak with a doctor as soon as possible if the following symptoms occur:
- Blood in the stool
- Severe abdominal
- Fever and body ache
- Chills pain
- Nausea and vomiting
Early detection and correct treatment of rectal tenesmus and any underlying causes or infections can significantly reduce the chances of complications and improve the outlook of treatment to be planned by the doctor.
Risk Factors For Rectal Tenesmus
The male population at any age can develop rectal tenesmus but those at higher risk are children and middle-aged adults.
People who have rectal tenesmus usually have chronic constipation tendency and frequent gastric disorders.
Diagnosis of Rectal Tenesmus
Doctors will usually make a diagnosis of rectal tenesmus with a medical history, occupational history, and physical exam. To diagnose the cause of tenesmus, your doctor will likely do a physical exam. A doctor will also ask about any other symptoms patient is experiencing, such as weight loss or bloody stools.
Tests the patient has to perform for diagnosing tenesmus will depend on what the doctor thinks is the likely reason for this symptom.
Some common tests that may be used to identify the reasons behind tenesmus include:
- Endoscopy
- Colonoscopy
- Imaging studies, such as radiography, magnetic resonance imaging (MRI), and computed tomography (CT).
- The assessment of stool samples, to check for infections
- Blood tests
- One can be advised anorectal manometry.
These same tests are also used to diagnose IBS, IBD, and colorectal cancer.
If there is a suspicion of STI, they may take a culture sample from the rectum and run bloodwork.
Rectal Tenesmus Management
The treatment for tenesmus depends on the cause behind this symptom.
Treatment at home
If one is suffering from IBD, IBS, chronic or acute constipation, or some motility disorder that is causing the symptoms, one can get relief from cramps and discomfort by making a few diet and lifestyle changes. These changes also work towards the prevention of rectal tenesmus.
Dietary modifications
Eating food high in fiber content is a major factor to relieve tenesmus caused by constipation and IBS. Intake of 20 grams of fiber every day will make the stool softer and add weight to it making the body pass the stools more easily.
Increase in daily intake of water –
Drinking enough water is adequate intake of water is very important in making the stool soft so that there is less pain while evacuation.
Researches suggest that 2.7 liters equivalent to 11.5 cups of water daily should be taken by women and 3.7 liters equivalent to 15.5 cups of water daily should be taken by men.
Everyone’s needs are different, these are just common recommendations.
Increase in Physical Activity –
Physical activity is a very important factor in improving the intestinal movement necessary for digestion and evacuation in the intestines. Exercising regularly is of great help to the intestines to move the waste through the gastric tract, particularly when one is suffering from Constipation and irritable bowel disorders.
Improving bowel habits
If rectal tenesmus is associated with constipation, your doctor may recommend, improving bowel habits and following bowel training.
- They will suggest following or setting a schedule for bowel movements daily.
- Giving adequate time to use the restroom for passing complete stools
- Few exercise for relaxing the muscles when one tries to pass stool
Medical Treatment-
Medical treatments will be different for different patients as it will depend on the cause of rectal tenesmus.
Inflammatory Bowel Disorders(IBD) –
Medical treatment of IBD is aimed at stopping or reducing the inflammation causing the symptoms.
The following medications might be prescribed by the Doctor:
- Anti-inflammatory medications that help in reducing inflammation are usually first used for treatment. They include Corticosteroids and aminosalicylates which are commonly prescribed.
- Medications that help in reducing the immune system activity can also be used to treat Inflammatory bowel diseases-IBD. These include immunomodulators.
- Antibiotics are prescribed when the cause of rectal tenesmus is gastrointestinal infection.
Anorectal infection-
If your tenesmus is associated with an infection of the gastric tract, the doctor may suggest you treat the condition with antibiotics, infections due to STI are also treated with antibiotics.
Constipation treatment–
If constipation is causing rectal tenesmus, then the doctor will prescribe laxatives, stool softeners, or fiber supplements. If the severity of tenesmus is high doctor might prescribe another medication that can help, make the bowel movements more regular.
Rectal prolapse treatment-
It is observed that tricyclic antidepressants may be effective in treating tenesmus in people with rectal prolapse.
The typical and most common treatment for rectal prolapse is surgery.
Precautions to be followed at home:
- Regular exercise will regulate activity in the intestines and encourage the body to establish a regular bowel movement schedule.
- When tenesmus is due to IBD, taking measures to reduce stress is very important.
- IBD and its symptom which include tenesmus usually flare up during periods of high stress one should use the techniques like meditation, and deep breathing exercises to manage stress and prevent a flare.
Best Homeopathic Medicines for Rectal Tenesmus
1. Aloe Socotrina -For rectal tenesmus due to proctitis
Symptoms
Aloe Socotrina is indicated for treating rectal tenesmus due to proctitis.
It is indicated when the person mainly complains of a constant bearing down in the rectum.
There is an urgency to pass more marked stool.
It is a useful remedy for tenesmus when the person rushes to pass stool immediately after eating or drinking.Â
Sometimes there is Involuntary passage of stool is observed in some cases. There is burning in the rectum and anus, cold water application provides relief from the burning. There is Soreness of the anus also.
It is of great curative effect when the accompanying symptom is the passage of jelly-like mucus with stool.
Potency & Dosage
30 CH Potency,4 globules three times a day is used. Gradually, one can increase the potency depending upon the case’s progress.
2) Nux Vomica –For Tenesmus with continuous, ineffectual urge to pass stool
Symptoms
Nux vomica is an excellent homeopathic remedy for cases of tenesmus, where there is a continuous and ineffective urge to pass stool.
This remedy is particularly helpful for individuals who experience constant discomfort in the rectum. The stools are scanty, and each passage is accompanied by severe sharp pain in the rectum.
Frequent urges to pass stool recur shortly after each bowel movement. Nux vomica is indicated when there is a feeling of unsatisfactory stool evacuation, and there’s a persistent sensation that some stool remains in the rectum. The most prominent complaint is the ineffectual urge to pass stool.
Potency & Dosage
200 CH Potency,4-8 globules daily are used. Gradually, one can increase the potency depending upon the case’s progress.
3) Merc Solubilis – For treating Rectal tenesmus with blood and mucus in stool
Merc sol is a highly effective remedy for rectal tenesmus, especially when there is the presence of blood and mucus in the stool.
Common symptoms include a burning and raw sensation at the anus.
This remedy is particularly beneficial for cases of itching at the anus accompanied by frequent stools. Merc sol is among the top remedies when rectal tenesmus is marked by a persistent feeling of never being fully relieved.
In addition, Merc sol is indicated for weakness and occasional feelings of faintness, often accompanied by a chilly sensation.
Potency & Dosage
30 CH Potency,4 globules three times a day is used. Gradually, one can increase the potency depending upon the case’s progress.
4) Nitric Acid -For Rectal tenesmus with ulcers and itching at the anus
Symptoms
Nitric Acid is a highly effective homeopathic remedy for rectal tenesmus, particularly when there is a tearing pain in the rectum during the passage of stool.
This remedy is beneficial for cases of tenesmus where cutting pain in the rectum follows the passage of stool, accompanied by bright bleeding from the rectum.
Nitric Acid is indicated when there is ulceration at the anus, along with irritation or itching at the anal region. The remedy showcases its curative action in addressing these specific symptoms associated with rectal tenesmus.
Potency & Dosage
30 CH Potency,4 globules three times a day is used. Gradually, one can increase the potency depending upon the case’s progress.
5) Ratanhia – Homeopathic medicine for tenesmus with severe rectal pain while passing stool
Symptoms
Ratanhia is an excellent homeopathic remedy for cases of severe pain in the anus and rectum during bowel movements. This pain is often accompanied by a burning sensation at the anus.
This remedy is particularly notable as it is among the top choices, almost specific, for tenesmus when there is a persistent burning sensation at the anus, which may continue for an extended period after passing stool.
Ratanhia is indicated when there is a knife-like stitching pain at the anus and a sharp pain in the rectum, described as if from stepping on broken glass.
The remedy is known for its efficacy in addressing these specific symptoms associated with rectal tenesmus.
Potency & Dosage
30 CH Potency,4 globules three times a day is used. Gradually, one can increase the potency depending upon the case’s progress.
6)Sulphur -For tenesmus due to suppression of skin eruptions and alcoholism.
Symptoms
Sulphur serves as an effective solution for tenesmus triggered by alcoholism and the suppression of skin eruptions. This remedy is particularly beneficial when there is intense itching and burning in the skin around the Ano-rectum.
It becomes necessary when severe tenesmus is present, and the stools are hard, knotty, and painfully dry, making the patient hesitant to pass them due to the associated pain.
Sulphur is the appropriate choice when there is an abnormal craving for sweet foods, and the affected skin area appears unclean with a foul smell, despite the patient believing they are neat and clean.
This remedy proves valuable in cases of alternating diarrhea and constipation.
Sulphur stands out as a remarkable solution for tenesmus accompanied by piles, where passing stools is extremely painful, and the anus is red and sore.
Potency & Dosage
30 CH Potency,4 globules three times a day is used. Gradually, one can increase the potency depending upon the case’s progress.
7) Alumina -For tenesmus due to constipation
Symptoms
Alumina is a remarkable remedy for tenesmus resulting from constipation, particularly in cases where there is an extraordinary lack of activity in the rectum.
Even with soft stools, significant straining is necessary, and there is a prolonged absence of the urge for a bowel movement.
This remedy becomes essential when obstinate constipation arises from a weakened condition of the intestine and rectum. Consequently, the patient must exert considerable effort, even for a soft stool that adheres to the rectum like clay.
Alumina is indicated in situations of chronic constipation accompanied by persistent eructation’s, experienced for several years. These eructation’s fluctuate up and down and tend to worsen in the evening.
Potency & Dosage
30 CH Potency,4 globules three times a day is used. Gradually, one can increase the potency depending upon the case’s progress.
8)Antimonium Crudum:-For tenesmus with severe pain
Symptoms
Antimonium Crudum proves to be a highly effective remedy for tenesmus accompanied by intense pain. This pain is characterized by a burning and pricking sensation in the rectum.
The condition may involve catarrhal proctitis, mucus piles, and an ichorous discharge from the anus.
This remedy is particularly indicated when there is a feeling that a significant number of stools are about to pass, but only small, hard stools are actually evacuated, often accompanied by a considerable amount of flatus.
Additionally, Antimonium Crudum is beneficial when there are hemorrhages from the bowels concurrent with the passage of stools.
Potency & Dosage
30 CH Potency,4 globules three times a day is used. Gradually, one can increase the potency depending upon the case’s progress.
9)Colchicum Autumnale -For tenesmus nausea and vomiting
Symptoms
It is indicated in cases of tenesmus with nausea and vomiting and faintness at the smell of cooking food.
The abdomen is immensely distended with gas and it feels as if it would burst.
There is severe cramping pain in the abdomen with stools containing scrapings of intestines, there is mucus and shreddy particles in stools passed out in large quantities.
Potency & Dosage
30 CH Potency,4 globules three times a day is used. External application of ointment along with internal medicine is advisable.
10) Chinchona Officinalis -For tenesmus with agonizing pain in the abdomen
Symptoms
Chinchona Officinalis stands out as a potent remedy for tenesmus associated with intense abdominal pain, characterized by pinching colic that forces the patient to bend double.
This abdominal pain is often accompanied by painful bleeding from the rectum during bowel movements.
This remedy is particularly indicated when there is gastralgia accompanied by acidity, bloating, and sour eructations. Post-meals, the abdomen feels full and tight.
Chinchona Officinalis is also a valuable remedy when tenesmus is coupled with profound debility resulting from draining discharges, loss of vital fluids, and hemorrhages.
Potency & Dosage
30 CH Potency,4 globules three times a day is used. Gradually, one can increase the potency depending upon the case’s progress.
Remember that homeopathic remedies are prescribed based on individual symptoms and characteristics. It’s crucial to consult with a qualified homeopath for proper evaluation and personalized treatment. Homeopathy focuses on treating the whole person, so a detailed case study is necessary to select the most appropriate remedy.
Homeopathic medicines should be taken only when prescribed by a homeopathic physician. Self-medication may aggravate the original conditions.