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    Pain - passing stool; Painful stools; Difficulty passing stool

    Tenesmus is the feeling that you need to pass stools, even though your bowels are already empty. It may involve straining, pain, and cramping.


    Tenesmus usually occurs with inflammatory diseases of the bowels. These diseases may be caused by an infection or other conditions.

    It can also occur with diseases that affect the normal movements of the intestines. Such diseases are called motility disorders.

    Persons with tenesmus may push very hard (strain) to try to empty their bowels, but they pass little stool.


    • Anorectal abscess
    • Colorectal cancer or tumors
    • Crohn's disease
    • Infection of the colon (infectious colitis)
    • Inflammation of the colon or rectum from radiation (radiation proctitis or colitis)
    • Inflammatory bowel disease (IBD)
    • Movement (motility) disorder of the intestines
    • Ulcerative colitis

    Home Care

    If you feel that you are constipated, try to increase your fluid and fiber intake.

    When to Contact a Medical Professional

    Contact your health care provider if you continue to have symptoms of tenesmus that are constant or come and go.

    Also call if you have:

    • Abdominal pain
    • Blood in the stool
    • Chills
    • Fever
    • Nausea
    • Vomiting

    These symptoms could be a sign of a disease that might be causing the problem.

    What to Expect at Your Office Visit

    The doctor will examine you and ask questions such as:

    • Time pattern
      • Did this develop recently?
      • Is it the first time you have had tenesmus?
      • Does the feeling come and go, or is it constant?
    • Symptom history
      • Do you have a constant need to emptyyour bowels?
      • Do you have abdominal pain?
      • Do you have cramping?
      • Do you always feel like you're straining?
      • Do you have diarrhea or vomiting?
      • What other symptoms do you have (such as blood in stool, fever)?
    • Dietary history
      • Have you eaten anything unusual or uncooked?
      • Have you been at a picnic, gathering, or similar event recently?
    • Other
      • Have you had any medical problems in the past?
      • Have any other people in your family or social group had similar problems?

    The physical examination may include a detailed abdominal examination. A rectal examination is performed in most cases.

    Tests that may be done include:

    • Colonoscopy to look at the colon and rectum
    • Complete blood count (CBC)
    • CT scan of the abdomen (in rare cases)
    • Proctosigmoidoscopy (an examination of the lower bowel)
    • Stool cultures
    • X-rays of the abdomen


    Camilleri M. Disorders of gastrointestinal motility. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 138.

    Cook IJ, Brookes SJ, Dinning PG. Colonic motor and sensory function and dysfunction. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 98.

    Lichtenstein GP. Inflammatory bowel disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 143.


    • Lower digestive anatomy


      • Lower digestive anatomy


      Review Date: 9/2/2012

      Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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