Symptoms, Causes, Treatment & More

Tenesmus can occur if you have health conditions that affect your gastrointestinal tract. Prevention and treatment can depend on the underlying condition.

Tenesmus is the frequent and urgent feeling that you need to pass stool, even if your bowels are already empty. It may involve straining and discomfort during bowel movements, only to produce a small amount of stool.

Symptoms of tenesmus include:

• frequently feeling like you need to pass stool
• urgency to evacuate your bowels
• straining and discomfort during bowel movements
• passing only a small amount of stool
• feeling as if you can’t completely empty your bowels

If you have tenesmus, you’ll often feel the need to empty your bowels, even if there’s little to no stool to pass. Bowel movements may involve significant cramping and discomfort.

You may often find yourself straining to pass small amounts of fecal matter.

Tenesmus may be a symptom of a number of conditions involving the gastrointestinal (GI) tract. Potential causes for tenesmus may include:

• Crohn’s disease
• ulcerative colitis (UC)
• constipation
• proctitis, which is usually caused by an infection or inflammatory bowel disease (IBD)
• irritable bowel syndrome (IBS)
• rectal prolapse
• sexually transmitted infection (STI) of the rectum
• viral, bacterial, or parasitic infections of the colon
• anorectal motility disorders
• certain types of abdominal surgery
• rectal abscesses
• colorectal cancer

Both UC and Crohn’s disease are forms of IBD, which is one of the most common causes of tenesmus. These chronic conditions cause long-term inflammation in all or some parts of your GI (digestive) tract.

Crohn’s disease and UC cause ulcerations that scar your GI tract. This scarring can make it harder for you to pass your stool, leading to symptoms like tenesmus.

If you have Crohn’s disease, ulcerations can spread throughout your GI tract. In the case of ulcerative colitis, these ulcers are located only in your colon and rectum.

The cause of IBD isn’t known. You’re more likely to develop IBD if you also have a relative with the disease. Doctors also believe that your digestive tract could become inflamed if your immune system overreacts when fighting off an invading organism, such as bacteria or viruses.

Other common symptoms of IBD include:

• weight loss
• fatigue
• diarrhea
• abdominal cramps
• abdominal pain
• rectal bleeding

To diagnose the cause of tenesmus, your doctor will likely do a physical exam. They’ll also ask about any other symptoms you’ve been experiencing, such as weight loss or bloody stools.

Tests you’ll receive to diagnose tenesmus will depend on what your doctor thinks is the most likely cause of this symptom.

Some tests that may be used to identify the causes of tenesmus include:

• endoscopy
• colonoscopy
• imaging studies, such as:
  • radiography
  • magnetic resonance imaging (MRI)
  • computed tomography (CT)
• assessment of stool samples, to check for infections
• blood tests
• anorectal manometry

Many of these same tests are also used to diagnose IBS and colorectal cancer.

If your doctor suspects you may have an STI, they may take a culture (sample) from the rectum and run bloodwork.

The treatment for tenesmus depends on the cause behind this symptom.

Treatment at home

If IBD, IBS, constipation, or a motility disorder is causing your symptoms, you can help relieve your cramps and discomfort by making some diet and lifestyle changes. These home treatment options also double as tenesmus prevention methods.

Changes to your diet

Eating a high fiber diet is one of the best ways to relieve tenesmus that’s caused by IBS or constipation. Consuming at least 20 grams of fiber every day will make your stool softer and add weight to it. This helps your body pass the stool more easily.

If tenesmus is caused by IBD, certain high fiber foods can actually trigger symptoms. Your doctor may instead help you identify trigger foods that you should avoid, especially during an IBD flare.

Drinking more water

Drinking enough water is important in making sure your stool is soft as well.

The U.S. National Academies of Sciences, Engineering, and Medicine recommends 11.5 cups (2.7 liters) of water daily for women and 15.5 cups (3.7 liters) of water daily for men.

Keep in mind these are very general recommendations, and everyone’s needs are different.

Physical activity

Physical activity stimulates movement in your intestines. Exercising regularly can help your tenesmus by helping your intestines move waste through your GI tract, particularly if you have IBS or constipation.

Bowel training

If your tenesmus is linked to constipation, your doctor may recommend bowel training. This may involve:

• setting a schedule for bowel movements every day, often within an hour of eating breakfast
• giving yourself time to use the restroom
• using the bathroom whenever you have an urge to go
• relaxing your muscles when you try to pass stool

Medical treatment

Medical treatments will vary depending on the cause of your tenesmus.

IBD

Medical treatment of IBD is aimed at stopping the inflammation causing your symptoms. The following medications might be prescribed:

• Anti-inflammatory medications that reduce your inflammation are usually the first step in treatment. Corticosteroids and aminosalicylates are common examples.
• Medications that reduce immune system activity can also be used to treat IBD. These might include immunomodulators or biologic therapies.
• Antibiotics may be prescribed due to gastrointestinal infection or very rare, complex IBD cases as a last resort.

Infections

If your tenesmus is linked to an infection of your GI tract, your doctor might treat your condition with antibiotics. Most STIs are also treated with antibiotics.

If a virus is the cause, antibiotics won’t work.

Constipation

If constipation led to your tenesmus, laxatives, stool softeners, or fiber supplements might be an option for you. Or your doctor may prescribe another medication that can help make your bowel movements more regular.

Rectal prolapse

Research from 2015 suggested tricyclic antidepressants may be effective in treating tenesmus in people with rectal prolapse. However, this was a very small study, and this treatment would be considered “off label.”

The typical treatment for rectal prolapse is surgery.

Tenesmus is the urgent feeling that you need to have frequent bowel movements. But even with pushing and straining, you might not be able to pass much stool.

Tenesmus can be a sign of several health issues, so it’s a good idea to talk with your doctor if you’re experiencing this condition frequently.

What’s Causing My Sweet Smelling Poop?

“Sweet smelling” is not often a description associated with human stool, although there is a bacterial infection that can result in a recognizable sickeningly sweet excrement: Clostridioides difficile infection.

Sometimes, when a person is prescribed antibiotic therapy, the normal intestinal ecosystem is disrupted. And these changes can lead to bacterial infections and chronic intestinal inflammatory diseases.

One such bacterial infection could come from Clostridioides (formerly Clostridium) difficile, also known as C. difficile, a toxin-producing anaerobic bacterium that causes antibiotic-associated colitis. C. diff infection (CDI) often includes:

• cramps
• fever
• diarrhea
• nausea
• leukocytosis (white cells above the normal range in the blood)

Another clinical feature sometimes accompanying CDI is a sweet stool odor often likened to horse manure.

Although any antibiotic can result in susceptibility to CDI, the antibiotics most frequently implicated with CDI are:

• cephalosporins
• clindamycin
• fluoroquinolones
• penicillins

Other risk factors include:

• age over 65
• recent hospitalization
• proton pump inhibitor use

A study was undertaken in 2013 to train a beagle to identify the distinct smell of C. difficile. The dog was able to correctly identify 25 of the 30 cases of CDI and 265 of 270 of the non-infected control group.

It has been a long-standing urban myth that nurses can identify patients with C. diff solely by the odor of their stool. A 2007 study concluded that, based on 138 nursing staff surveys, nurses were 55 percent sensitive and 83 percent specific in diagnosing C. diff by the smell of patients’ diarrhea.

A follow-up study in 2013, in a controlled laboratory setting concluded that nurses are not able to identify stool samples with C. diff by odor.

The study suggested that the results were different because in previous studies the nurses were not properly blinded and could observe the characteristics of the patients and their stool during the sniff test.

Urban legend disproven.

If your stool has become noticeably more foul smelling, it could be due to something you ate. According to University of California San Diego Health, meat and spicy food will often result in a strong unpleasant odor.

Other potent offenders may include cruciferous vegetables, fatty and sugary processed foods, and eggs.

Also, consistently noxious stool could be an indication of an underlying medical condition such as:

• celiac disease
• Crohn’s disease
• infection
• lactose intolerance
• malabsorption
• pancreatitis
• ulcerative colitis

If your stool odor has become consistently more unpleasant, talk about it with your doctor.

If you have Clostridioides difficile (C. diff) infection (CDI), it can result in diarrhea that has an unusual odor that some might describe as sickeningly sweet. High risk factors for CDI include being over the age of 65, having recently been hospitalized, and having finished a course of antibiotics.

If you match that description and are having intestinal discomfort, especially if you notice sweet smelling poop, talk to your doctor about the possibility of CDI.

bowel movements for constipation, regular stools, is it harmful to push in the toilet

What to do?

000Z” itemprop=”datePublished”> 11/14/22

Gennady Popov

asked in the Community T⁠—⁠F

I don’t experience problems with bowel movements, but I constantly hear that there are some special rules on how to go to the toilet in a big way. Allegedly, they will help to avoid problems in the future. Is this true or, if nothing bothers you, these rules can not be followed?

Polina Kalmykova

pooping too

Author’s profile

There really are such rules. They are based on human physiology, and it is useful for each of us to know them.

I will tell you exactly how a bowel movement occurs, how to facilitate bowel movements and why we need to think about it at all.

Go see a doctor

Our articles are written with love for evidence-based medicine. We refer to authoritative sources and go to doctors with a good reputation for comments. But remember: the responsibility for your health lies with you and your doctor. We don’t write prescriptions, we make recommendations. Relying on our point of view or not is up to you.

How the mechanism of defecation works

Defecation is a process that allows you to remove feces from the human body, that is, all undigested food residues. We control defecation, unlike many other processes that accompany digestion, such as salivation or intestinal motility. Normally, feces leave the body only when a person is ready for it.

We begin to feel the urge to defecate when feces accumulate in the rectum

Defecation starts in the final section of the intestine – the rectum. When it fills with feces, the receptors react to the stretching of the intestine and transmit a signal to the brain that it is time to go to the toilet.

Textbook “Fundamentals of Human Physiology” edited by N. A. Agadzhanyan

To prevent the intestine from emptying as it fills, the rectum is closed by two circular muscles – sphincters: internal and external. The inner one opens involuntarily when the receptors transmit a signal to the brain about the need to defecate. But the man himself controls the outside. Even if the rectum is already full, the sphincter will hold back feces until the person gets to the toilet and gives the body the command to act.

When a person is ready to defecate and signals this to the body, the external sphincter opens and the walls of the rectum begin to contract, pushing the feces out.

Sometimes these contractions are not enough – then the person has to push: tighten the diaphragm and abdominal muscles in order to increase the pressure inside the abdominal cavity and use it to push out the stool.

Additional force is required due to the fact that the end of the rectum is at an angle. When a person is standing, this angle is approximately 90°.

Effect of Posture on Defecation Restraint – International Journal of Colorectal Diseases

To poop easily, the person should assume a position that makes this angle as blunt as possible: this will help the stool not get stuck in the bend. Otherwise, pooping will still work, but you will have to make extra efforts to feel relief.

The curved arrow indicates the anorectal angle. Fecal masses must overcome it in order to leave the body. Source: Research Gate

How to poop properly

The sitting position helps smooth out the curve between the rectum and the anal canal, and the deeper the person sits, the easier it will be for the feces to descend to the anus.

Thus, the best position for defecation is squatting. Although this position may not be very comfortable, it allows you to empty your bowels quickly and without extra effort.

Comparison of strain during defecation in three positions: results and implications for human health – Pubmed

Despite the benefits for the body, many are not ready to give up the usual toilet in favor of a floor-standing structure. In this case, a footrest will help you to take the desired position.

Another way to soften the anorectal angle is to assume the thinker’s posture by bending the upper body. Studies have shown that 11 out of 22 volunteers who experienced problems with bowel movements in a sitting position were able to completely empty their bowels in this position.

Effect of Body Posture on Defecation: A Perspective Study of the Thinker Position – Pubmed

The more familiar way of sitting on the toilet does not smooth out the anorectal angle as much – it is more difficult to poop in this position than when the knees are raised above the pelvis. You can fix this with the help of a footboard – on Yandex Market it costs from 453 R. The more familiar way of sitting on the toilet does not smooth out the anorectal angle so much – it is more difficult to poop in this position than when the knees are raised above the pelvis. You can fix this with the help of a footboard – on Yandex Market it costs from 453 R

The “Genoa” bowl, or a toilet like a hole in the floor, allows you to take the most physiological position for defecation. Such a design on Yandex Market costs from 2710 R

The thinker’s pose is named after Rodin’s sculpture: this is what a pose looks like that facilitates defecation in a sitting position. Source: Wikipedia

The “Genoa” bowl, or a toilet bowl similar to a hole in the floor, allows you to take the most physiological position for defecation. Such a design on Yandex Market costs from 2710 R. The pose of the thinker is named after Rodin’s sculpture: this is exactly what the pose looks like, which facilitates defecation in a sitting position. Source: Wikipedia

Regardless of the position , doctors do not recommend sitting on the toilet for more than two minutes: this can aggravate hemorrhoidal disease, if it already exists, or lead to its development.

After defecation, the anus area must be cleaned of the remaining fragments of stool. To avoid irritation and itching, doctors recommend giving up toilet paper and giving preference to cleansing methods that do not require rubbing the skin: rinsing with clean water without soap and other detergents, blotting with damp wipes without fragrance or a damp cloth. If you have to use toilet paper in a public restroom, it is best to flush your anus with water as soon as possible.

Anal Itching – Drugs.com

Basic Anal Care – Permanente Magazine

Flush the anus from front to back to prevent infection from the rectum into the urinary tract.

Why pushing is bad and how to avoid constipation

Although the body has the ability to push stool, pushing often and hard is not safe: it can become one of the causes of hemorrhoids or rectal prolapse. Correct posture will help prevent severe straining only if a person has a normal stool, but with constipation this may not be enough.

Constipation: Symptoms, Causes and Complications – Mayo Clinic Article

Normal bowel movements are between three times a day and once every three days if the stools are soft and formed. If a person feels the urge to empty the bowels less than three times a week, and the stool is hard, dry and difficult to pass from the body, this condition is called constipation.

Stool types 3 and 4 are considered ideal. Types 1 and 2 indicate constipation.

Constipation forces a person to strain during bowel movements and also leads to complications: in addition to problems due to straining, hard stool can lead to tears in the anus or anal fissures. And this condition can make going to the toilet uncomfortable – too tiring or painful.

What to do with constipation?

Constipation can occur for a variety of reasons: due to other diseases, such as diabetes, certain medications, dietary habits, pregnancy or age, one in two people over 80 suffer from constipation.

But sometimes constipation is caused by factors associated with the defecation process itself. So, frequent suppression of the urge to empty the intestines can lead to regular constipation.

To determine the cause of constipation and choose the right treatment, you need to seek help from a general practitioner. Perhaps, based on the results of the consultation, he will give a referral to a gastroenterologist and a proctologist. Figuring out on your own which part of your digestive tract is causing constipation can be tricky.

What else affects defecation

To ensure that bowel movements do not cause inconvenience, it is important not only to properly organize the process itself, but also to prepare the body for it in advance with the help of diet, sports and routine.

Diet. The quality of stool is affected by the amount of fiber we consume. Its deficiency can cause both constipation and diarrhea. The more dietary fiber in the feces, the less stress is required during defecation, bowel movements occur more completely and with greater regularity.

How to cure hemorrhoids

Most fiber is found in vegetables, fruits with skins, and raw grains such as whole grain pasta or cereals with minimal refining. The normal amount of fiber per day for an adult is about 30 grams.

It is worth increasing the amount of fiber in the diet gradually: it can provoke bloating and increased gas formation.

Physical exercise. Sports activities increase muscle activity, including in the intestines – this helps the body to remove feces faster and more efficiently.

Mode. The habit of going to the toilet at the same time, without haste and stress, also contributes to the normalization of bowel movements.

Relationship between sleep disorders and bowel dysfunction – Journal of Neurogastroenterology and Digestion

The quality of sleep can also affect bowel movements: if a person wakes up frequently during the night or does not get enough sleep, he is at increased risk of constipation.

What is the result

Signs of a good bowel movement – regular, fast and painless bowel movements, formed, but soft stools.

Even if there are no current problems with defecation, they can develop if going to the toilet is not correct.

The best position for defecation is squatting. You can take it on a regular toilet with the help of a special footrest.

Ignoring the urge to go to the toilet or sitting on the toilet for a long time is dangerous: it can lead to constipation or hemorrhoids.

A proper diet, regular exercise, regular sleep and toileting will help ease bowel movements.

What to do? Readers ask – experts answer

False urge to defecate – causes, symptoms in men and women | Medical Center

Multidisciplinary Medical Center MedProsvet
St. Petersburg, Engels Ave. 147 building 1
+7 (812) 374-84-00

False urge to defecate – a symptom of a lesion of the digestive system, characterized by frequent painful urge to go to the toilet “in a big way” without subsequent excretion of feces. The scientific name for these urges is tenesmus. The problem significantly affects the life of a person and can temporarily maladjust him. Beyond that, tenesmus cannot exist on its own, but is merely a specific syndrome of many (sometimes dangerous) gastrointestinal disorders.

Multidisciplinary medical center “MedProsvet” employs proctologists, endoscopists and gastroenterologists with many years of experience. The use of modern diagnostic equipment allows doctors to quickly find out the cause of pseudo-urges and choose the optimal treatment.

Symptoms

Tenesmus of the rectum is usually accompanied by severe cutting or drawing pains in the lower abdomen. The pain is spastic, that is, it comes and goes in a paroxysmal manner.

Particularly intense pain is felt in the area of ​​the sphincter, where erosion of the skin and intestinal mucosa may subsequently appear. If untreated, the frequency of attacks can increase, and the intensity of pain can increase.

Due to false urges, a person is forced to constantly go to the toilet, but the act of defecation does not occur. In the process, a small amount of feces, mucus or blood may be released.

Causes of tenesmus

Normally, the process of defecation starts when the intestinal walls are irritated by feces. If there are urges, but defecation does not occur, the intestines are irritated for other reasons. Consider the main causes of false urge to defecate.

Hemorrhoids

Hemorrhoids is a pathology characterized by the formation of varicose nodes around the rectum. The disease is accompanied by dilation and tortuosity of the veins, often accompanied by an inflammatory process and thrombosis. Thus, false urges to the toilet occur due to the protrusion of the veins into the intestinal lumen.

The main causes of hemorrhoids include: physical inactivity, excessive physical activity and sedentary work.

Irritable bowel syndrome

Irritable bowel syndrome can be suspected by intense pain in the abdomen and impaired stool. This often results in painful tenesmus. Irritable bowel syndrome develops against the background of stress, malnutrition and hormonal failure.

Proctitis

Proctitis is a chronic inflammation of the intestinal mucosa. The disease is accompanied by discomfort, pain, burning and itching in the rectal area, as well as tenesmus. The stool may contain mucus, pus, or blood.

The disease develops due to frequent consumption of spicy foods, parasitic diseases, intestinal infections, alcohol abuse

Sigmoiditis

Sigmoiditis is an inflammatory process of the sigmoid colon. The main symptoms of the disease include: pain on the left side of the lower abdomen, bloating, loose stools with mucus and false urges. The appearance of tenesmus signals an active inflammatory process.

The disease occurs due to the abnormal structure of the sigmoid colon, infection, irritation or mechanical damage to this part of the intestine.

Dysbacteriosis

One of the main signs of dysbacteriosis is abdominal pain, diarrhea, streaks and blood clots in the feces. In addition, there is often an urge to defecate without feces. The disease is caused by the penetration of pathogens into the human gastrointestinal tract.

Anal fissures

This pathology occurs more often in women and is characterized by damage to the skin and mucous membranes of the anus. The occurrence of cracks is associated with constipation, inflammation of the gastrointestinal tract and mechanical injuries. Often, pathology develops in women during pregnancy and childbirth.

Benign and malignant neoplasms

The most common neoplasms that provoke false urges are:

1. Polyps are tumor-like neoplasms of the intestinal mucosa. May be single or multiple. In tissues, cell division is activated, which is accompanied by the formation of polyps with or without atypia.
2. Adenomas are benign tumors of glandular tissue.
3. Adenocarcinoma – cancerous tumors that develop from glandular cells lining the intestines.

Other causes

Pregnancy is a wonderful stage in the life of every woman. However, in some cases, the expectant mother has problems with the intestines. So, pregnant women often complain that they are constantly pulling to the toilet “for the most part.” This unpleasant symptom is quite understandable – during gestation, the uterus exerts strong pressure on the intestines and other organs of the gastrointestinal tract, which causes a false desire to empty.

This condition can also be of a psychological nature. Tenesmus is a frequent companion of stress, neuroses and, in rare cases, disorders of the nervous system.

Diagnosis

The main thing in the treatment of false urge to defecate is to eliminate not only the symptom, but also the cause of its occurrence. To do this, before prescribing treatment, the doctors of MedProsvet send the patient for a comprehensive diagnosis of the body, including the following studies:

1. Laboratory diagnostics:

• blood when detecting pathological changes)
• Coprogram
• Fecal occult blood test
• Giardia test (fecal antigen test) Giardia lamblia, antigen
• Screening for helminthiases (Opisthorchis IgG, Toxocara IgG, Trichinella IgG, Echinococcus IgG)

Laboratory examination of feces allows one to judge the nature of the pathological process in the intestine. So, for example, the detection of streaks or blood clots can signal a severe intestinal lesion.

2. Colonoscopy. These are endoscopic diagnostic methods that allow you to examine the intestinal mucosa using a small camera that is inserted through the anus. During the research, the doctor may take a biopsy – a small piece of the intestinal wall for further diagnosis.

3. MRI or CT. Additional instrumental diagnostic methods are necessary in difficult diagnostic situations. With their help, the doctor examines the structure of the abdominal organs in layers, thereby determining and clarifying the localization of pathological changes.

Treatment

Treatment depends on the cause of false bowel movements in men and women. After carefully studying the results obtained during the research, the doctors of our clinic individually select the methods of therapy. Conservative (medical treatment) may be used or additional procedures may be required.

The purpose of drug therapy is to restore intestinal motility, relieve inflammation, eliminate infection and normalize the microflora. To do this, doctors prescribe anti-inflammatory, antibacterial, wound healing, antidiarrheal, or laxatives in the form of tablets, creams, or suppositories. In addition, the patient is prescribed drugs that reduce the frequency and intensity of urges, as well as relieve pain.

In some cases, manipulation may be required – removal of polyps, removal of hemorrhoids, etc.

An integral part of the treatment of tenesmus is the observance of the principles of proper nutrition. A person needs to consume a sufficient amount of drinking water (at least 1.5 liters), exclude sour, spicy, highly salted, smoked and fried foods that irritate the intestinal mucosa. Recommended fractional meals in small portions 5-6 times a day. The diet should be soups, cereals, lean meat in boiled or stewed form.

Where to go in case of false urges?

If you experience a false urge to defecate, you should immediately seek help from a medical facility. In the multidisciplinary clinic “MedProsvet” you will be met by doctors with many years of professional experience.