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:Â -CausesÂ
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 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 a wonderful remedy in Homeopathy 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 wonderful remedy for tenesmus when the person rushes to pass stool immediately after eating or drinking.
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 medicine for tenesmus cases when there is a continuous, ineffectual urge to pass stool.
It is best indicated in persons who feel constant uneasiness in the rectum. There is a scanty stool that is passed each time with severe sharp pain in the rectum that will follow the passing of stool.
It is a wonderful remedy for frequent urge to pass stool renews soon after the stools are passed.
Nux vomica is indicated for unsatisfactory stool and there is always the feeling that some stool has remained in the rectum, there is an Ineffectual urge to pass stool which is the most prominent complaint.
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
Symptoms
This is a wonderful remedy for rectal tenesmus where there are blood and mucus in the stool.
There is burning and rawness at the anus that is present.
It is a wonderful remedy for itching at anus with frequent stools. It is one of the top listed remedies when the tenesmus of the rectum is marked with a never get done feeling.
It is a great remedy for weakness and sometimes feeling of faintness that arise with a chilly feeling.
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 Recal tenesmus with ulcers and itching at the anus
Symptoms
Nitric Acid is a very effective Homeopathic medicine for rectal tenesmus with tearing pain in the rectum on passing stool
Nitric Acid has a wonderful curative action in cases where the patient complains of tearing pain in the rectum on passing stool.
It is also indicated for treating tenesmus where there is cutting pain in the rectum after passing stool with bright bleeding from the rectum that is present along with stool.
It is indicated when there is ulceration at the anus, along with irritation or itching at the anus that is observed.
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
It is a great remedy for when there is severe pain in the anus and rectum while passing stools, it is usually accompanied by burning at the anus.
It is one of the top listed medicines almost specific for tenesmus when there is burning at the anus that may continue for long hours after passing stool.
There is Knife-like stitching pain at the anus and sharp pain in the rectum as if from stepping on broken glass.
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
It is a wonderful remedy for tenesmus caused by alcoholism and suppression of skin eruptions, where there is marked itching and burning in the skin around the ano-rectum.
It is indicated when there is severe tenesmus the stools are hard knotty, dry as if burnt, and very painful the patient is afraid to pass the stools due to pain.
It is indicated when there is abnormal craving for sweet food, the skin area affected appears dirty, with a fetid smell, still, the patient thinks he is neat and clean.
It is indicated when there is alternate diarrhea and constipation.
It is a wonderful remedy for tenesmus along with piles, there is severe pain when passing stools, 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
It is a wonderful remedy for cases of tenesmus due to constipation that occurs along with extreme inactivity of the rectum, even soft stools require great straining, and there is no desire for stools for days together.
It is indicated when there is obstinate constipation due to paretic condition of intestine and rectum as a result the patient requires much straining even for a soft stool which adheres to the rectum like clay.
It is indicated in cases where there is chronic constipation with chronic eructations for years, up and down, and worse 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
It is a wonderful remedy for tenesmus with burning and pricking type of pain in the rectum, there is catarrhal proctitis with mucus piles with ichorous discharge from the anus that may be noticed.
It is indicated when there is a sensation that many stools would pass but only little hard stools are evacuated and there is much flatus.
There may be hemorrhages from the bowels along with 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
It is a great remedy for tenesmus with agonizing pain in the abdomen with pinching colic, compelling the patient to bend double with painful bleeding from the rectum with stools.
It is indicated when there is gastralgia with acidity, bloating, and sour eructations; after eating the abdomen feels full and tight.
It is a wonderful remedy when the tenesmus is accompanied by severe debility from exhausting discharges and 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.