From the Guidelines
Tenesmus is a sensation of incomplete evacuation, which is a symptom of constipation, characterized by the presence of any two of the following symptoms for at least 12 weeks in the previous 12 months, including straining during bowel movements, lumpy or hard stool, sensation of incomplete evacuation, sensation of anorectal blockage or obstruction, manual evacuation procedures to remove stool, and less than 3 bowel movements per week 1. This symptom is highly subjective and can significantly impact a patient's quality of life. The Rome III criteria provide a standard clinical definition of chronic constipation, which includes the sensation of incomplete evacuation as one of its key symptoms 1.
Key Characteristics of Tenesmus
- Sensation of incomplete evacuation
- Straining during bowel movements
- Lumpy or hard stool
- Sensation of anorectal blockage or obstruction
- Manual evacuation procedures to remove stool
- Less than 3 bowel movements per week The experience of constipation, including tenesmus, is highly subjective and should be taken into consideration when assessing and treating patients 1.
Importance of Addressing Tenesmus
Tenesmus can be a symptom of underlying conditions such as inflammatory bowel disease, infections, or colorectal cancer, and therefore, warrants medical attention to determine the underlying cause and provide targeted treatment 1. Some studies have investigated the treatment of constipation, including tenesmus, with medications such as tenapanor, plecanatide, and linaclotide, which have shown promise in reducing symptoms and improving quality of life 1. However, the most recent and highest quality study, which is the 2018 ESMO clinical practice guidelines, provides the most relevant information for defining and managing constipation, including tenesmus 1. In summary, tenesmus is a symptom of constipation that requires medical attention to determine the underlying cause and provide targeted treatment, and the 2018 ESMO clinical practice guidelines provide the most relevant information for defining and managing constipation, including tenesmus 1.
From the Research
Definition of Tenesmus
- Tenesmus is a painful sensation of incomplete evacuation of the bowel and is often associated with poorly localized perineal pain 2
- It is characterized by a feeling of incomplete defecation, which can be accompanied by rectal urgency, abdominal pain, and other symptoms 3, 4, 5
Association with Other Conditions
- Tenesmus is a common symptom in patients with ulcerative colitis (UC), a chronic idiopathic inflammatory bowel disorder 3
- It can also be associated with constipation, which is variably defined as persistent, difficult, infrequent, or seemingly incomplete defecation 4, 5
- Tenesmus can be a symptom of rectal prolapse, which can lead to a vicious circle of straining and deterioration of prolapse 6
Characteristics and Symptoms
- Tenesmus is often described as a painful or uncomfortable sensation in the rectum or perineum 2, 6
- It can be accompanied by other symptoms such as bloody diarrhea, mucus, rectal urgency, and abdominal pain 3
- The sensation of incomplete defecation can be distressing and affect a patient's quality of life 5