Differential Diagnosis for Tenesmus and Pain Relieved by Bowel Movement
- Single Most Likely Diagnosis
- Irritable Bowel Syndrome (IBS): This condition is characterized by abdominal pain and changes in bowel habits, including relief of symptoms with bowel movements. Tenesmus, a feeling of incomplete evacuation, is also common in IBS.
- Other Likely Diagnoses
- Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause chronic inflammation of the gastrointestinal tract, leading to symptoms such as tenesmus, abdominal pain, and relief with bowel movements.
- Anal Fissure: A tear in the lining of the anus can cause severe pain during and after bowel movements, as well as tenesmus due to spasm of the anal sphincter.
- Hemorrhoids: Although often associated with pain, especially if thrombosed, hemorrhoids can also cause a feeling of incomplete evacuation and relief with bowel movements.
- Do Not Miss Diagnoses
- Colorectal Cancer: While less common, colorectal cancer can present with tenesmus, changes in bowel habits, and abdominal pain. It is crucial to rule out this diagnosis, especially in older adults or those with a family history.
- Infectious Colitis: Certain infections, such as those caused by Clostridioides difficile, can lead to severe diarrhea, abdominal pain, and tenesmus. Prompt diagnosis and treatment are essential to prevent complications.
- Ischemic Colitis: Reduced blood flow to the colon can cause sudden onset of abdominal pain, tenesmus, and changes in bowel habits. This condition requires immediate medical attention to prevent tissue death.
- Rare Diagnoses
- Solitary Rectal Ulcer Syndrome: A condition characterized by the presence of an ulcer in the rectum, often associated with chronic constipation, straining during bowel movements, and tenesmus.
- Proctalgia Fugax: A rare condition causing sudden, severe anal pain that may be accompanied by tenesmus, but typically does not have a clear association with bowel movements.
- Rectal Prolapse: Although more common in older adults, rectal prolapse can cause a feeling of incomplete evacuation and tenesmus due to the protrusion of the rectal mucosa through the anus.