If you often have trouble pooping but aren't constipated, tenesmus could be the culprit.

    Image Credit: agrobacter/iStock/GettyImages

    In This Article

    • What Is Tenesmus?
    • Symptoms
    • Causes
    • Treatments
    • When to See a Doctor

    "I feel like I have to poop but only a little comes out." "I can't poop, but I feel like I have to." "Why do I always feel like I have to poop?"

    If this inner monologue runs through your mind on a daily basis, you could have a bowel problem .

    While it's not uncommon to have trouble going to the bathroom or get hit with a crampy, have-to-go-​nowfeeling every once a while, constantly feeling like you have to poop and not being able to go may be a sign of a condition called tenesmus.

    Tenesmus isn't just annoying and uncomfortable. It's often indicative of an underlying colorectal problem like poorly managed IBD.

    Here's what you should know about the condition, plus the steps you can take to get your bathroom trips under control.

    What Is Tenesmus?

    Tenesmus is the name doctors use to describe the sensation of needing to pass stool when your bowels are empty. That might sound sort of like constipation — where you have to poop but the stool is too hard, firm or dry to be pushed out — but the two are actually very different.

    With tenesmus, "it's the urge or feeling that you need to have a bowel movement, but there are no stool or contents to evacuate," explains Adam Faye, MD , a gastroenterologist at the Inflammatory Bowel Disease Center at NYU Langone Health. "This sensation can often be quite uncomfortable and necessitate frequent trips to the bathroom in an attempt to evacuate."

    How can you tell if your bowel problems are caused by tenesmus? The most common symptom is frequently having intense urges to poop, but when you go to try, nothing (or very little) actually comes out, says Siamik Tabib, MD , a gastroenterologist, hepatologist and assistant professor of medicine at University of California Los Angeles.

    In some cases, the feeling like you need to poop could be almost constant and cause abdominal cramping and pain, per the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

    In short, the signs include:

    • Frequently feeling the urgent need to poop
    • Often passing only a small amount of stool
    • Discomfort during bowel movements
    • Feeling as if you can't empty your bowels completely, or not feeling empty after a bowel movement

    What Causes a Constant Urge to Poop?

    Most often, tenesmus occurs alongside inflammatory bowel diseases like ulcerative colitis or Crohn's disease.

    "The rectum is a reservoir to hold stool, and when it's inflamed, its ability to do so is decreased," Dr. Faye says. "This can lead to contractions of the musculature in an attempt to evacuate any content that may be present."

    IBDs aren't the only possible culprit though. "Other conditions causing inflammation or irritation to the area of the rectum may also cause tenesmus," Dr. Faye says.

    According to the National Institutes of Health (NIH), these can include:

    • Anorectal abscess
    • Colorectal cancer or tumors
    • Colon infections
    • Colon or rectal inflammation from radiation
    • Movement or motility disorders of the intestines

    Tenesmus Treatments

    If you feel like you need to poop all the time, the treatment will depend on the underlying cause.

    "Since rectal inflammation often drives the sensation of tenesmus, our therapeutic goal is to heal this inflammation," Dr. Faye says.

    That may involve making lifestyle adjustments, such as:

    • Changing your fiber intake
    • Cutting out foods that seem to trigger inflammation
    • Drinking more water
    • Managing stress

    In some cases, medical therapies like the following may be needed:

    • Enemas
    • Suppositories
    • Oral drugs
    • Infusions or injections

    Once the inflammation trigger is addressed, tenesmus symptoms can start to ease up within a matter of days or weeks. However, it's important to note that because IBD is a lifelong condition, tenesmus symptoms have the potential to come and go over time, Dr. Tabib says.

    Tenesmus triggered by a problem other than IBD often involves addressing the root cause. "In the instance of a cancer or tumor, removal, resection or chemotherapy may be attempted, depending on several clinical factors," Dr. Faye says.

    Your gastroenterology care team will determine the best treatment for you based on your diagnosis.

    When to See a Doctor

    Occasionally having trouble going to the bathroom probably isn't cause for concern. But you should talk with your doctor if you're experiencing frequent or ongoing symptoms of tenesmus, especially if you often feel like you have to poop but nothing comes out.

    Seek medical care, too, if your bowel symptoms are accompanied by any of the following problems, per the NIH :

    • Pain
    • Bloody stool
    • Chills
    • Fever
    • Nausea
    • Vomiting
    Why do I feel like I still need to poop after pooping?
    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. more
    Does childbirth feel like pooping?
    Your baby is positioned low right before and during labor, and certain positions can put pressure on your colon and sacral nerve, giving you the very real and intense sensation that a bowel movement is imminent. In truth, it may even feel like your bottom is about to burst. more
    Why do I feel skinnier after pooping?
    It takes an average of 33 hours for food to be processed into poop and pass out of your body. If we only lose a little bit of weight when we poop, why do we feel so much slimmer finally pooping after being constipated or after a large meal? It's because pooping reduces gas and bloating. more
    Why does it feel good after pooping?
    According to the authors, this feeling, which they call “poo-phoria,” occurs when your bowel movement stimulates the vagus nerve, which runs from your brainstem to your colon. Your vagus nerve is involved in key bodily functions, including digestion and regulating your heart rate and blood pressure. more
    Why do I still feel like I need to poop after pooping?
    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. more
    Why do I feel sick after pooping?
    The sensation you are describing is most likely due to a reflex called a "vasovagal reaction." Here's what I mean. Often people need to tense their abdominal muscles and strain a bit during a bowel movement. This tends to stimulate the vagus nerve, which slows the heart rate. more
    Why do I feel weak after pooping?
    Often people need to tense their abdominal muscles and strain a bit during a bowel movement. This tends to stimulate the vagus nerve, which slows the heart rate. At the same time, blood flow back to the heart decreases, so blood pressure drops. more
    Can not pooping make you feel sick?
    Also, constipation can lead to stomach distention and bloating, which occurs the longer stools remain in your colon. This triggers an increase of bacteria in you colon, prompting a nauseous feeling. more
    Why do we feel good after pooping?
    According to the authors, this feeling, which they call “poo-phoria,” occurs when your bowel movement stimulates the vagus nerve, which runs from your brainstem to your colon. Your vagus nerve is involved in key bodily functions, including digestion and regulating your heart rate and blood pressure. more
    Why do I feel dizzy before pooping?
    The overstimulation of your vagus nerve (aka vasovagal syncope) can lead to a drop in your pulse rate, and without enough blood going to your brain, you can get dizzy and faint — yep, on the toilet. Fainting is pretty extreme, but pooping can be a trigger. more
    Why do I feel lighter after pooping?
    Your vagus nerve is involved in key bodily functions, including digestion and regulating your heart rate and blood pressure. Stimulation of the nerve can give you the chills and drop your heart rate and blood pressure enough to cause you to feel lightheaded and super-relaxed. more

    Source: www.livestrong.com

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