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:

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

If you experience tenesmus often, talk with your doctor about your symptoms. Tell them about any:

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.