Tenesmus describes a recurring sensation of incomplete bowel emptying or a strong need to pass stool despite little or no stool being produced. It can be accompanied by straining, cramping or rectal discomfort. This page explains typical symptoms, possible underlying causes, common diagnostic approaches and warning signs that need urgent attention, for general information only.
Tenesmus refers to a feeling of rectal fullness or an inability to fully evacuate after defecation. Patients may describe repeated urges to use the toilet, a sense of pressure, painful straining or cramp-like discomfort. The term usually refers to rectal (colonic) tenesmus rather than urinary causes.
Many conditions can produce tenesmus. Frequent causes include rectal or colonic inflammation (for example proctitis or inflammatory bowel disease), infectious proctitis, hemorrhoids or anal fissures, irritable bowel syndrome and pelvic floor dysfunction. Less commonly, tumors or changes after surgery or pelvic radiotherapy contribute. The precise cause is determined through clinical assessment and appropriate tests.
Evaluation begins with a careful history and physical exam, including an inspection of the anal area and a digital rectal exam when appropriate. Depending on findings, clinicians may order stool studies, blood tests, anoscopy, flexible sigmoidoscopy or colonoscopy, imaging and tests for infectious agents. Choice of tests depends on symptom pattern, duration and accompanying signs.
Seek immediate medical attention if tenesmus is accompanied by high fever, severe abdominal pain, heavy rectal bleeding, fainting or sudden worsening of symptoms. For non-urgent or chronic symptoms, start with a primary care physician who may refer to gastroenterology, colorectal surgery or infectious diseases specialists as needed.
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