Tenesmus: causes of false urge to defecate in men and women, methods of diagnosis and treatment

Rectal tenesmus, or false urge to defecate, is a symptom of diseases of the large intestine, leading to significant discomfort for the patient, and a possible sign of a serious pathology. In addition to the urge to defecate without defecation itself, a person may experience additional symptoms: pain, a feeling of discomfort in the anus, etc.

Diagnosis of the condition is based on a clinical examination of the patient and the use of laboratory and instrumental examination methods. Therapy includes various methods of conservative treatment aimed at eliminating the immediate cause of the disease.

Main reasons

A false urge to have a bowel movement, or tenesmus, is a characteristic symptom of damage to the colon .

Important! If tenesmus is observed for 2 days, and there is mucus or blood in the stool, then you should immediately seek medical help, as such a symptom may indicate dysentery and other serious diseases.

The main reason for false urges to defecate is irritation of the colon mucosa by some factor .
They may be infectious agents, tumor growth and other reasons.

It is important to note that inflammatory changes are usually accompanied by pain of varying degrees of intensity .

With tumors, any clinical manifestations may be absent for a long time, and tenesmus may be the first symptom of cancer.

Most often, the appearance of tenesmus is observed under the following conditions:

  • infectious lesions of the gastrointestinal tract: dysentery, salmonellosis, cholera, etc.;
  • hemorrhoids with rapid progression, as well as necrosis of hemorrhoids;
  • damage to the rectal mucosa in the form of cracks or erosions;
  • organic changes in the intestinal wall in the form of polyps, fistulas or stenosis;
  • proctitis and paraproctitis;
  • nonspecific ulcerative colitis or Crohn's disease, etc.

Sometimes, the reasons for the frequent urge to defecate cannot be identified. In these cases, the patient is diagnosed with idiopathic tenesmus. In some patients, disturbances in bowel movement may occur due to neurological disorders .

There are false urges with hemorrhoids

The main causes of false urge to defecate (rectal tenesmus) are pathological conditions in which a futile urge to empty the bowel occurs. This symptom of various diseases is quite painful and does not lead to a full-fledged act of defecation: it ends with the release of only a small amount of feces. Tenesmus is essential to a person’s life - they limit freedom of movement and force them to make adjustments to their vacation plans. False urge to defecate is accompanied by a disorder of the digestive system: increased gas formation and impaired intestinal motility.

Under the influence of provoking factors, the excitability of the autonomic nervous system is disrupted, which causes spasms of the smooth muscle muscles of the intestine. False urge to defecate most often occurs as a result of spastic contractions of the muscular walls of the sigmoid and (or) rectum. The pathological process affects the abdominal wall, pelvic organs and perineum - their muscle tone rapidly increases. Spasmodic contractions are unproductive:

  • the intestinal contents do not move forward;
  • feces are not excreted from the body.

The cuts are chaotic and uncoordinated. In this condition, normal peristalsis is impossible, which becomes the cause of intestinal tenesmus. The pathology is accompanied by the development of chronic constipation. The disease is characterized by inflammation of hemorrhoids and impaired blood supply to the pelvic organs. People who lead a sedentary lifestyle often suffer from false urges to defecate. In the absence of medical intervention, the severity of symptoms increases:

  • the color of the skin around the anus changes and darkens;
  • erosion develops;
  • anal fissures appear.

A bacterial infection often attaches to the damaged rectal mucosa, increasing the spread of the inflammatory process. To prevent the development of events in such a negative scenario, you should make an appointment with a gastroenterologist at the first sign of a false urge to defecate.

Rectal tenesmus is one of the symptoms of diseases of the digestive system. If no such pathologies were identified when diagnosing the patient, then a neurologist is involved in the treatment. Often false urges are provoked by a disruption of the central nervous or autonomic system of the human body.

After pathogenic viruses or bacteria penetrate the intestinal lumen, they begin to actively multiply. In the process of life, microbes produce a huge amount of toxic products. Harmful substances cause not only general intoxication of the body, but also damage to the intestinal mucosa. As a result of digestive disorders, dyspepsia occurs:

  • rumbling and seething in the stomach;
  • sour belching, heartburn;
  • bloating.

The causative agents of rectal tenesmus include: salmonella, staphylococci, Escherichia coli and Pseudomonas aeruginosa, Shigella, streptococci. They enter the human body along with spoiled food products - milk, meat, vegetables.

Warning: “If a person is frivolous about food poisoning and prefers self-medication, then it is not surprising that he soon develops an inflammatory process in the small or large intestine.”

Damage localized in the rectum leads to diarrhea, pain and false urge to have a bowel movement. The clinical picture is complicated by fever, nausea, vomiting, and weakness.

If the mucous membrane of the lower intestine is damaged, bowel movements are disrupted. The main causes of tenesmus are:

  • hemorrhoids;
  • rectal fissures;
  • a chronic form of paraproctitis, characterized by the formation of deep pathological canals.

Such diseases are accompanied by constipation, pain with each bowel movement, and the appearance of blood clots, mucus, and pus in the stool. Tenesmus occurs due to the development and progression of the inflammatory process affecting the rectum or perirectal tissue.

After the formation of tumors on the mucous membrane or in the deeper layers of the intestine, peristalsis is disrupted, and the urge to defecate without feces occurs. Tens of thousands of people die from colon cancer every year. The danger of the pathology lies in the absence of any symptoms at an early stage. After the gradual growth of the tumor, pain appears during bowel movements, and blood and pus are released along with the stool.

The main reasons for the development of rectal tumors are precancerous diseases:

  • one or more polyps in the intestines;
  • chronic constipation;
  • ulcerative lesions of the rectum;
  • decreased immunity;
  • genetic predisposition.

Warning: “Gastroenterologists, proctologists and surgeons never tire of repeating that timely treatment of anal fissures and hemorrhoids is an important part of the prevention of rectal cancer.”

Neoplasms provoke the occurrence of spastic contractions, slow movement of feces, the release of a small amount of feces or their complete absence. Often the cause of problems with bowel movements is not the tumor itself, but the metastases that have formed. The tumor cell spreads through the blood or lymph flow to healthy areas of the rectum, where it begins to grow rapidly. Often, metastases significantly exceed the size of the initial malignant formation.

Intestinal dysbiosis often provokes not only chronic constipation, indigestion, but also rectal tenesmus. The disease develops after penetration of pathogenic pathogens into the gastrointestinal tract or activation of opportunistic microflora bacteria. A person experiences the following negative signs:

  • abdominal pain;
  • chronic diarrhea;
  • the appearance of blood streaks or clots in the stool.

After antibiotic therapy, the patient may develop dysbiosis. To prevent it, doctors recommend that patients take a course of probiotics and (or) prebiotics containing lactobacilli, bifidobacteria, and saccharomycetes. Dysbacteriosis can be provoked by food poisoning, poisons of plant and animal origin, heavy metals, caustic alkalis and acids. The false urge to defecate that occurs in this case disappears after detoxification therapy.

Nonspecific ulcerative colitis and Crohn's disease are autoimmune inflammatory pathologies, one of the symptoms of which is a constant urge to defecate. The etiology of the development of diseases has been little studied. Most scientists are inclined to believe that the inflammatory process of the intestinal mucosa occurs as a result of a decrease in the functional activity of the human body’s immune system. Symptoms of nonspecific colitis and Crohn's disease accompanying rectal tenesmus are a sharp decrease in body weight, iron deficiency anemia, as well as a lack of vitamins and microelements due to impaired absorption.

The reasons for the urge to defecate, which does not bring relief to a person, are disorders of the central nervous system:

  • neurotic conditions;
  • mental disorders;
  • specific reactions to stressful situations;
  • emotional instability.

Recently, patients are often diagnosed with “irritable bowel syndrome,” which can be caused by diseases of the central nervous system. The pathogenesis of tenesmus is based on a violation of the transmission of nerve impulses in the colon.

Diagnosis of rectal tenesmus begins with interviewing the patient, assessing general health, and studying a history of diseases. If a bacterial infection is suspected, a biological sample is inoculated in a nutrient medium to identify the type of pathogen and its sensitivity to antibiotics. Laboratory and biochemical tests will help detect qualitative and quantitative changes in blood composition. To determine the cause of false urge to defecate, instrumental studies are carried out:

  • Magnetic resonance imaging;
  • ultrasonography;
  • CT scan;
  • X-ray examination.

Treatment of intestinal tenesmus is aimed at eliminating its cause. For this, patients are prescribed drug therapy, and in case of detection of benign or malignant tumors, surgical intervention. Most often used in etiotropic treatment:

  • antibiotics;
  • antimicrobials;
  • probiotics and prebiotics;
  • antiulcer drugs;
  • hemostatic drugs;
  • adsorbents and enterosorbents;
  • drugs to reduce excess gas formation with simethicone.

To reduce the severity of tenesmus, antispasmodics are used - Drotaverine or its analogue No-shpa in the form of tablets or solutions for parenteral administration. They have the ability to normalize the functioning of intestinal smooth muscle muscles, eliminate pain systems and prevent the occurrence of tenesmus.

Treating false urges to defecate on your own is extremely dangerous. If you constantly put off visiting a doctor and take pharmacological medications at random, the underlying disease will begin to progress rapidly. A timely visit to a doctor often saves a person’s life.

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A healthy person normally has stool 1-2 times a day. But sometimes a malfunction occurs in the functioning of the digestive system, which affects the process of bowel movement. One of the common symptoms is false urge to defecate. Due to the sensitivity of the problem, few people immediately consult a doctor. And in vain, since this unpleasant phenomenon may be one of the signs of a serious illness.

The symptom is manifested by a subjective feeling of the need to empty the intestines, while the act of defecation itself does not occur. False (imperative) urges to defecate can be painless or cause excruciating pain to a person. Such urges are called tenesmus in medicine.

Tenesmus is often accompanied by flatulence, bloating, constipation or diarrhea. The futile urge to empty is based on the high sensitivity of the rectum to pressure from the inside, so even a small amount of intestinal contents - mucus, feces, blood, foreign body, inflammatory substrates - causes an increased reflex urge to visit the toilet. In this case, the anal sphincters (compressor muscles) do not relax and defecation does not occur. Spasms of the muscle layer of the sigmoid and rectum, as well as the muscles of the perineum and abdominal press, make these urges painful.

False urges can be completely painless and bring only slight discomfort, or they can cause excruciating pain

False urges to have a bowel movement can be a symptom of a number of diseases:

  • hemorrhoids, which is the formation of nodes as a result of congestion, inflammation and expansion of the veins. Obesity, physical inactivity, hereditary predisposition, stress, heavy physical activity can lead to pathology;
  • proctitis - inflammation of the inner lining of the rectum, which can be caused by frequent constipation, helminthic infestations, hypothermia, hemorrhoids, prostatitis, abuse of alcoholic beverages, spicy, spicy dishes;
  • sigmoiditis - inflammation of the sigmoid colon due to infections, dysbiosis, Crohn's disease (granulomatous enteritis), radiation sickness, intestinal ischemia;
  • rectal cracks that occur during inflammatory processes or mechanical trauma;
  • fistulas, which can form as a result of chronic intestinal pathology, most often occur with paraproctitis;
  • polyps - outgrowths of the mucous membrane that arise at the site of inflammation, with the growth of healthy tissue or atypical cells. The reason for the formation of polyps can be heredity, frequent constipation, poor nutrition - lack of fiber and excess protein foods;
  • adenocarcinoma - a malignant neoplasm that forms from glandular cells lining the walls of the rectum;
  • stenosis (or stenoses) of the rectum - a pathological narrowing that occurs as a result of inflammation, a tumor, or is a congenital anomaly;
  • pararectal lymphadenitis - inflammation of the lymph nodes caused by staphylococcal or streptococcal infection;
  • periproctitis - inflammation of the tissues surrounding the rectum, with the formation of purulent exudate. Often develops with hemorrhoids or proctitis.

Hemorrhoids can cause tenesmus - a reflex urge to defecate

In addition to these diseases, tenesmus can occur against the background of:

  • accumulation of a large number of fecal stones in the intestines;
  • irritable bowel syndrome, which occurs due to a disruption of healthy microflora and a malfunction of the autonomic nervous system;
  • infectious diseases - dysentery, cholera, typhus, intestinal tuberculosis, acute intestinal infection;
  • pathologies of the nervous system (rectal crisis, myelitis, anismus or desynergic defecation - uncontrolled spasm of the sphincter);
  • spasms caused by frequent diarrhea, large stools, and prolonged riding in a sitting position.

To determine which disease symptom is the imperative urge to defecate, it is necessary to conduct a thorough diagnostic examination of the patient.

The proctologist makes the main diagnosis; if necessary, the patient is referred for consultation to a gastroenterologist and neurologist. A patient interview, examination, laboratory and instrumental examination are carried out.

Laboratory diagnostic methods:

  1. Clinical blood test:
      assess the level of hemoglobin and red blood cells to exclude anemia;
  2. leukocytosis and high ESR indicate an inflammatory process.
  3. A general urine test is necessary to exclude urological pathology.
  4. A coprogram is prescribed to assess the composition of stool, the presence of undigested food residues, and pathological elements, for example, pus.
  5. Feces for occult blood can exclude internal bleeding.
  6. A stool test for worm eggs is carried out to detect helminthic infestation.
  7. Stool culture is done to identify pathogenic microorganisms.

In order to find out the cause of tenesmus, you need to submit feces for coprogram

Examination of the patient consists of a digital examination of the rectum through the anus. The doctor determines muscle tone, mobility of the mucous membrane, its integrity, the absence or presence of hemorrhoids. If palpation examination is not enough, sigmoidoscopy and colonoscopy are prescribed.

A visual examination of the rectal mucosa is carried out using a sigmoidoscope - a special device equipped with a light source and lenses. Colonoscopy is carried out using a thin fiber optic probe, which allows you to examine in detail all areas of the colon and detect tumors, ulcers, polyps, as well as perform a biopsy - collecting material for histological examination. In addition to these methods, the patient undergoes an ultrasound of the abdominal organs.

Sigmoidoscopy allows you to study in detail the mucous membrane of the large intestine and find out the cause of tenesmus

After studying the results of laboratory tests and evaluating the data obtained during instrumental studies, the doctor makes a diagnosis and prescribes treatment for the identified pathology.

There are a number of symptoms from which tenesmus should be distinguished:

  • Proctalgia is a pain syndrome in the rectal area. This pain is not associated with the urge to have a bowel movement and usually manifests itself in the form of night attacks.
  • With coccydynia (pain in the coccyx area, most often associated with injuries), the pain is also not associated with the urge to defecate, becomes stronger in a sitting position, and sometimes radiates to the hip joints.
  • Proctospasm is characterized by a feeling of compression of the anal sphincter, pain radiating to the thigh or lumbar region, while the person does not experience the urge to empty the intestines.
  • Impaired sensitivity - its decrease or increase (paresthesia or hyperesthesia), in the rectal area occurs with tabes dorsalis (damage to the spinal nerve endings in late neurosyphilis).

Therapy is primarily aimed at eliminating the disease that caused the symptom.

Drug therapy is determined by the specific disease:

  • intestinal infections require the use of antibacterial agents, for example, Nifuroxazide, enterosorbents - Sorbex, Enterosgel;
  • colitis and proctitis are treated with sulfonamide drugs;
  • for hemorrhoids and anal fissures, anti-inflammatory, emollient, wound-healing agents are prescribed in the form of ointments or suppositories - Proctosan, Ultraproct, Methyluracil, drugs to improve blood circulation - Detralex;
  • diarrhea is treated with Imodium or Loperamide; for flatulence, Espumisan is recommended;
  • constipation is eliminated with mild laxatives - Duphalac, Lactulose;
  • They use sedatives - Novo-Passit, Alora syrup, valerian tincture.

Symptomatic treatment of tenesmus itself is based on the use of antispasmodics:

  • No-Shpy (Drotaverina);
  • Papaverina;
  • Dicyclomine;
  • Hyoscyamine;
  • Duspatalina.

Microenemas with silver nitrate or warm vegetable oil are used.

Treatment of tenesmus as a symptom of the underlying pathology, in addition to medications, includes correction of lifestyle, nutrition and physical activity.

Therapeutic nutrition for futile urge to defecate is adjusted taking into account the underlying disease. Avoid foods that irritate the intestines:

It is better to boil or steam foods.

Meals should be fractional: often and in small portions.

It is imperative to remove from your diet foods that provoke processes of rotting and fermentation in the intestines:

  • non-dietary meat;
  • coarse vegetable fiber (cabbage, legumes);
  • fresh baked goods;
  • sweets;
  • canned food;
  • alcohol.

If you are prone to constipation, we recommend:

  • vegetable purees: pumpkin;
  • beet;
  • carrots;
  • bran bread;
  • natural juices;
  • decoctions of dried fruits;
  • dairy products.
  • You can eat soups, cereals, boiled, stewed lean meat (rabbit, turkey, veal) and fish.

    Depending on the underlying disease, the doctor recommends dietary nutrition to the patient

    Traditional recipes can serve as a complement to basic therapy. Sitz baths with a cool infusion of medicinal plants are effective: chamomile, marigold, sage. Microclysters with herbal decoctions of chamomile, St. John's wort, and sea buckthorn oil relieve inflammation and irritation of the intestinal mucosa.

    If the inflammation is not limited only to the rectum, therapeutic enemas of 200–400 ml with herbal decoctions are recommended. Marshmallow root, elderberry blossom, sage leaves, and oak bark have enveloping and anti-inflammatory properties.

    Herbs with antispasmodic effects can be taken orally in the form of tea:

    Chamomile infusion is prepared and taken as follows:

    1. Pour boiling water (200 ml) over a large spoon of crushed raw materials and leave for an hour.
    2. Strain the infusion and drink a third of a glass three times daily.
    1. Take a teaspoon of centaury, chamomile and sage herbs, pour a glass of boiling water, leave for half an hour.
    2. Strain and take 2 tablespoons 4 times a day.

    Chamomile infusion has an antispasmodic and anti-inflammatory effect; for tenesmus, it can be taken orally or made into microenemas

    The prognosis depends on the underlying disease causing the symptom. If you consult a doctor in a timely manner and follow all medical recommendations, you can get rid of this delicate problem forever.

    Since false urges to defecate are often the result of poor nutrition and a violation of a healthy lifestyle, for prevention it is necessary:

    • organize a complete healthy diet, minimize the amount of foods harmful to the intestines;
    • make up for the lack of physical activity with a sedentary lifestyle: walk;
    • do morning exercises;
    • organize breaks with warm-up during the working day;
  • Consult a doctor promptly and treat diseases of the digestive tract.
  • Walking in the fresh air is important for maintaining the health of all body systems, including the intestines.

    Tenesmus associated with hemorrhoids more often bothers men, since the stronger sex is more susceptible to this disease. Women often experience tenesmus associated not only with pathology of the large intestine, but also with gynecological problems and diseases of the urinary tract (cystitis, urethritis), which is associated with the anatomy of the female body.

    Tenesmus in women can be associated not only with diseases of the rectum, but also with gynecological and urological pathologies

    Over the past 2 days, I began to be bothered by frequent, mostly false urges to defecate, and bowel function remained as usual, stool was of the usual consistency, normal color, without impurities. Before this, two days earlier, she suffered severe stress, for which she even had to call an ambulance. The ambulance found the blood pressure to be 150/90. The doctors gave me a table. for blood pressure and soothing, and was advised to take valerian + motherwort + hawthorn for a couple of weeks.

    https://www.forum.nedug.ru/threads/747417-%D0%A2%D0%B5%D0%BD%D0%B5%D0%B7%D0%BC%D1%8B#.WPMqh2_yiUt

    I have already written about the appearance of false urges to defecate, against the background of normal stool in terms of frequency and consistency - perhaps after suffering from stress... Today I had an appointment with a therapist. After questioning, the doctor said that it looked like colitis! Then she told me about the diet I needed to follow and wrote out a prescription.

    https://medcanal.ru/topic76106.html

    For a month I suffered from pain in the area of ​​the sacrum and rectum, I went to a proctologist, had a sigmoidoscopy and x-ray, and was diagnosed with coccydynia. About two weeks have passed since the examination, and now I am tormented by false urges to defecate. The urge is constant, without the release of feces, mucus, or blood; when pushing, it goes away for a short time, then appears again.

    https://www.consmed.ru/proktolog/view/695716/

    Despite the delicacy of the problem, under no circumstances should you delay visiting a doctor in order to find out the cause of tenesmus. False urges can signal a serious illness, the effectiveness of treatment of which directly depends on the speed of diagnosis and assistance to the diseased organ. It is worth listening to your body, which sends distress signals, and responding to them in time.

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    The question of how to distinguish hemorrhoids from rectal cancer has probably arisen in the minds of those people who have at least once been bothered by unpleasant symptoms in the anus. Thanks to the Internet, many people today have access to information about various diseases, their symptoms and treatment. Therefore, literate patients do not rush to see a doctor at the first sign of illness in a sensitive area, but try to solve the problem on their own, which does not always end with a favorable outcome. An example is hemorrhoids and rectal cancer - the symptoms are similar, the treatment methods are fundamentally different, and the prognosis is different. It is impossible to do without special diagnostic methods. Only timely medical care can save a person’s life.

    The compared diseases have different etiologies and differ in the mechanism of development. Hemorrhoids are a hereditarily caused pathological expansion of the veins of the rectal plexuses. Cancer is a malignant degeneration of epithelial cells in the intestinal mucosa, accompanied by their growth and reproduction to form a tumor.

    The causes of hemorrhoids have been well studied, which cannot be said about rectal cancer; what they all have in common is a clear connection with hereditary predisposition.

    In the first case, the failure of connective tissue structures that provide support for the vascular walls and low venous tone are genetically transmitted.
    In the second case, a family history of colon cancer is clearly visible. The risk group for hemorrhoids are people with problems such as:

    • chronic constipation or frequent diarrhea;
    • obesity;
    • sedentary lifestyle;
    • unhealthy diet - fast food, hot, spicy dishes, seasonings and sauces;
    • excessive physical activity and heavy lifting;
    • abuse of alcoholic beverages, coffee and cigarettes.


    The risk group for colorectal cancer is people with the following diseases:

    • nonspecific ulcerative colitis (20 or more years after the appearance of the first signs);
    • colon polyps (diffuse and solitary);
    • Crohn's disease (complete damage to the gastrointestinal tract throughout);
    • chronic anal fissures, advanced hemorrhoids, paraproctitis, fistulas.

    Provoking factors are poor ecology, poor quality nutrition, chronic stressful situations, and infection with the human papillomavirus during anal sex.


    The initial stages of both diseases are very similar in symptoms, or rather their insignificant severity. Both diseases are characterized by an imperceptible onset and prolonged development. In the case of hemorrhoids, the count goes on for months and years before the first exacerbation; in the case of cancer, one and a half to two decades pass before a pronounced clinical picture appears and the patient seeks medical attention. Let’s compare the two diseases based on their main symptoms:

    1. Pain . With hemorrhoids in the initial stage there is discomfort and heaviness in the anal canal, pain appears from the second stage during bowel movements, at stages 3 and 4 the pain becomes very severe, disturbing when sitting, walking, or bowel movements. With rectal cancer, there is no pain in the initial stage, it appears when the tumor grows into the intestinal wall (stage 3) and metastases (stage 4) - it is localized in the anus, radiating to the genitals, perineum, and back.
    2. Discharge from the anus . With hemorrhoids, there are often drops of blood on toilet paper and on top of scarlet-colored stool (from the arteriovenous anastomoses of the rectal plexus). Cancer is characterized by discharge of mucus and (or) pus before defecation, blood mixed with stool, darker in color, with clots. Sometimes black pieces of the tumor itself stand out when damaged.
    3. Character of the chair . With hemorrhoids, it does not change much, but with an expanded tumor, the lumen of the rectum narrows, the feces become thin as a pencil and are released in the form of a ribbon.
    4. Constipation . In case of hemorrhoids, they respond well to dietary correction and treatment; in case of cancer, they are persistent, accompanied by bloating and signs of intestinal obstruction (abdominal pain, lack of stool for several days, vomiting).
    5. Tenesmus . Frequent false urge to defecate, a feeling of fullness in the anus are characteristic of a tumor
    6. General symptoms are malaise, fever, pallor, anemia, weight loss, taste disturbances. Expressed during a malignant process.
    7. Impaired functioning of other organs (with metastases and germination of neighboring organs) - discharge of feces from the vagina in women or urine from the rectum, enuresis, encopresis.

    Patients with complaints of problems in the anus and rectum are subject to a mandatory set of laboratory and instrumental research methods. Laboratory blood tests are performed to determine the degree of inflammation and anemia, serum is taken for cancer markers, and feces are taken for occult blood.

    Retromanoscopy of the intestine will help establish an accurate diagnosis

    A digital rectal examination is the first thing a proctologist does at an appointment. This method allows you to feel internal hemorrhoids or a tumor in the lower intestine. To clarify, anoscopy and sigmoidoscopy (examination of the rectum and part of the sigmoid colon) are performed, during which suspicious areas of the mucosa can be taken for a biopsy and then a corresponding histological examination can be performed.

    Suspicion of the location of the tumor in the overlying parts of the colon is an indication for irrigoscopy and endoscopic colonoscopy. To detect metastatic foci, an ultrasound scan of organs in the abdominal cavity and pelvis is performed.

    The final diagnosis of a cancerous tumor or hemorrhoids is made after a histological examination of the material taken for a biopsy during an endoscopic examination.

    Differential diagnosis of two diseases that are similar at first glance should be based not only on complaints and characteristic external manifestations of the disease, but also rely on data from special research methods.

    Since the approaches to the treatment of hemorrhoids and rectal cancer are completely different, it is extremely important to convey to every person the need to promptly consult a doctor and conduct an examination for any suspicion of a serious disease.

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    Clinical manifestations

    The main clinical symptom is a sharp pain syndrome, accompanied by an imperative urge to defecate . In this case, the pain is cramping in nature.

    When attempting to defecate, no fecal discharge is observed or the patient experiences small amounts of feces that may contain mucus or blood. This phenomenon of contractions of the rectum without emptying the organ can cause cracks and erosions in its mucous membrane.

    The intensity of pain varies significantly among individual patients - from mild to unbearable, in which the patient is forced to maintain a motionless body position.

    Such a pain syndrome leads to a significant decrease in the quality of life and disruption of the normal functioning of the digestive system . The duration of the pain varies, but most often lasts for several days.

    If tenesmus is observed with a certain frequency, then the person should seek medical help . When visiting a hospital, it is possible to conduct a full diagnosis and prescribe effective treatment.

    As a rule, if you have a frequent urge to defecate with scanty but soft stools, you should visit a general practitioner or gastroenterologist. An integrated approach to the examination allows us to identify the main cause of the development of the symptom, eliminating it and ensuring the restoration of quality of life.

    Symptoms

    The clinical picture largely depends on the cause of the urge to go to the toilet, mostly without bowel movement. At the same time, the lower abdomen hurts. The pain syndrome persists for a long time.

    The following negative changes are also possible:

    • feeling of a full stomach;
    • excessive gas formation;
    • rumbling in the stomach;
    • rise in temperature;
    • migraine;
    • dizziness;
    • nausea;
    • gagging;
    • sudden change from constipation to diarrhea;
    • general increasing malaise;
    • loss of appetite;
    • feces with pus and blood.

    The formation of cracks and erosions in the anal area is also possible. In this case, minor rectal bleeding is noted.

    Patient examination

    When a patient comes to the hospital with complaints of painful urge to defecate, the following diagnostic algorithm is used:

    1. Clinical examination of a person to identify concomitant diseases, as well as possible factors in the development of tenesmus. For this purpose, all complaints, the patient’s life history and the history of the development of the current illness are also collected.
    2. A general blood and urine test allows you to assess your general health and identify inflammatory processes in the internal organs.
    3. Anoscopy is a method of examining the rectum using a small endoscope. Allows you to assess the condition of the mucous membrane of the organ over a distance of 10-15 cm, which is enough to make an accurate diagnosis in most cases. This study is complemented by digital examination of the rectum.
    4. Colonoscopy is an endoscopic method of examining the large intestine, carried out using a special probe with a video camera. The procedure allows you not only to examine the intestinal mucosa, but also to take a biopsy or perform minor surgical operations if necessary. Colonoscopy is the “gold standard” for detecting colon diseases in patients of any age.

    Interpretation of examination results should always be carried out only by a doctor, due to the risk of their incorrect interpretation. Based on comprehensive research, it is possible to quickly identify the causes of frequent bowel movements without diarrhea and select an effective approach to therapy.

    Carrying out diagnostics

    When establishing a diagnosis that provokes the occurrence of rectal tenesmus, the subjective individual sensations of the patient and the results of laboratory and instrumental diagnostic methods are taken into account:

    • digital examination of the rectum;
    • sigmoidoscopy;
    • colonoscopy.

    A general blood test is required to establish a diagnosis.
    A general blood test (level of hemoglobin, leukocytes and red blood cells), a stool test for worm eggs, bacterial culture of stool and a coprogram - physical, chemical and microscopic examination of stool - are required. In addition, an ultrasound examination of the abdominal organs is recommended.

    Digital examination of the rectum

    This is an initial examination through the anus of the rectum. Palpation of the anal canal focuses on determining the elasticity and functional state of the main muscles of the anus, relaxed mobility of the mucous membrane, identifying possible changes and pathologies of the walls of the anus. Digital rectal examination helps detect pathological changes in areas that are difficult to reach with other types of examination. In addition, it is necessary to examine the ampullary part of the rectum, located at the level of the sacrum. Approximate palpation is carried out to determine the condition of the tissues of the walls and mucous membrane, after which the question of a more in-depth study is raised: sigmoidoscopy and colonoscopy.

    Sigmoidoscopy

    It is carried out using a special tube - a tube, equipped with an illuminator, lenses and an instrument for pumping air, which is inserted into the anus along the longitudinal axis of the anal canal for several centimeters. During a visual examination, attention is paid to the color indicator, humidity, the relief of the walls of the inner surface of the anal canal, modification of the pattern of blood vessels, and various neoplasms in the rectum are identified. If necessary, material can be collected for histological examination.

    Colonoscopy helps detect pathologies of the rectum.

    The examination is carried out in a supine or lateral position using a long fiber optic probe, which allows endophotographing of individual sections of the intestine, identifying thickenings and polyps, small ulcers and performing a biopsy. The image during the procedure is displayed on a high-resolution monitor. If polyps are found on the inner walls of the rectum, they can be removed endoscopically. Before the procedure, the intestines are cleansed with special laxative solutions.

    Effective treatment

    Defecation after each meal in an adult, accompanied by the appearance of pain in the anal area, requires treatment based on the identified cause of this condition.
    Otherwise, no treatment methods will be highly effective.

    If a patient has an inflammatory lesion of the colon or hemorrhoids, it is most effective to use antibacterial agents (Amoxiclav, Amoxicillin, etc.), anti-inflammatory drugs (Indomethacin, Ketorolac), as well as vitamin complexes.

    If a patient is diagnosed with malignant neoplasms or severe stages of hemorrhoids, the doctor may choose a surgical treatment method that allows one to quickly determine the cause of tenesmus.

    Due to severe spasm of the colon wall, the use of antispasmodics (Drotaverine, Papaverine, etc.) allows one to cope with the patient’s complaints. If taking these medications orally in the form of tablets does not lead to a positive effect, then their intramuscular administration is possible.

    It is important to note that all medications should always be prescribed in therapeutic dosages in accordance with the instructions for use. Otherwise, side effects of medications or progression of the underlying disease may occur.

    The use of traditional medicine methods is not indicated due to their low degree of evidence and effectiveness . Traditional methods (table salt, decoctions of herbs and berries) should be used only after consultation with your doctor and as an additional remedy to medications.

    Causes of rectal tenesmus

    Hemorrhoids are one of the causes of rectal tenesmus.
    One of the main reasons provoking the appearance of tenesmus is a disruption of the central nervous system, which provokes involuntary contraction of the muscles of the lower pelvis and anus. Such contractions are chaotic and do not lead to the removal of intestinal contents. Spasm can occur with frequent diarrhea, large and painful stools, or prolonged sitting. Infectious diseases such as dysentery, acute colitis, typhus, can also be causes of tenesmus.

    Features of the disease in children

    The appearance of a frequent urge to defecate in a child may indicate any acute disease of the colon .
    Such conditions are accompanied by the occurrence of tenesmus, cramping pain in the abdomen, and an admixture of blood and mucus in the stool.

    In addition, children experience significant discomfort, scream loudly, and may experience redness of the facial skin due to straining.

    The abdomen is very often dense and enlarged, which is associated with impaired bowel movement and the development of flatulence.

    Approaches to making a diagnosis and organizing treatment do not differ from those in adults. Methods aimed at eliminating the underlying cause, as well as antispasmodics, are key. It is very important to use medications taking into account the age and weight of the child.

    Folk remedies

    An infusion of calendula flowers has good choleretic properties.
    For the active work of the intestines and to prevent the appearance of tenesmus, choleretic herbs are indicated - calendula, yarrow. An infusion of flax seeds has an enveloping and laxative effect, peppermint and lemon balm soothe and relax. To reduce inflammation of the rectum and cleanse the intestines of stagnant feces, traditional healers offer microenemas using medicinal plants. Microclysters using decoctions of sage, chamomile, and yarrow soften and nourish the large intestine well. To treat microcracks in the mucous membrane of the rectum and remove mucous accumulations from the intestines, it is advisable to use an enema from plantain leaves. Sitz baths made from cool infusions of calendula flowers will relieve pain and spasms. You can use an enema of warm vegetable oil. It is important to remember: before starting treatment, you need to know the exact diagnosis.

    Anxiety is a direct path to the development of IBS

    Extraintestinal symptoms that trouble patients with irritable bowel syndrome include chronic stress and depression, bad taste in the mouth, migraine headaches, insomnia, spinal pain, decreased libido, frequent urination and rapid heartbeat without any visible external influence. Most often, such symptoms in IBS sufferers appear after eating or during stress. If you notice such signs in yourself, it’s time for you to consult a gastroenterologist.

    It is also worth remembering that a number of dangerous diseases of the intestines and other internal organs, including cancer, can present with exactly the same symptoms as IBS. Therefore, consult a doctor immediately, without waiting for the situation to worsen.

    Prevention

    Tenesmus, as a consequence of nervous breakdowns, disruption of a healthy lifestyle and unhealthy diet, requires increased attention from both the patient and the specialist. Changing your attitude towards life and frequent walks in nature are true helpers in the fight against stress. And moderate physical activity and simple exercises, especially with a sedentary and sedentary lifestyle, will reduce the risk of intestinal and rectal diseases. When diagnosing intestinal diseases, adjustments to the diet are mandatory. Foods containing coarse fiber, dairy products, and vegetables improve digestion. Fatty and smoked foods, sweets and spices should be excluded. It is important to remember that prevention of tenesmus is timely diagnosis and treatment of the main provoking diseases.

    The urge to defecate is a signal that it is time to have a bowel movement. But in some cases such symptoms are false, that is, unproductive. They force a person to repeatedly visit the toilet, causing him discomfort, but without bringing a sense of relief. What is the cause of this pathology and how can it be dealt with?

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