What is tenesmus a symptom of?
Rectal tenesmus and vesical tenesmus are symptoms of different conditions.
Rectal tenesmus
Inflammation or constipation can cause rectal tenesmus.
Inflammation
The most common cause of rectal tenesmus is inflammatory bowel disease. Up to 30% of people with ulcerative colitis or Crohn’s disease experience some tenesmus. In these cases, rectal tenesmus is a side effect of chronic inflammation in the lower bowel. Your large bowel includes your rectum and anus.
Inflammation in your lower bowel will make it swollen and sensitive. There’s less room for normal poop passing through, which can make your bowel feel fuller, and the nerves that line your bowels are already irritated. These nerves may overreact, telling your brain or muscles that you need to clear your bowels.
Other conditions that can cause inflammation in your lower bowel include:
- Sexually transmitted infections, such as chlamydia.
- Endometriosis, if it spreads to your bowel.
- Colorectal polyps and tumors.
- Anal cancer.
- Radiation colitis from radiation therapy.
- Infectious colitis from a bacteria, parasite or virus.
- Diverticulitis.
- Celiac disease.
- Perianal abscess.
- Hemorrhoids.
Constipation
Constipation may also cause the feeling that you constantly need to poop even though you can’t. In this case, your bowels may not be empty, but you have trouble getting anything out, despite frequent efforts. Hard, impacted poop stuck in your bowel can irritate it, making it constantly want to evacuate.
Constipation has many causes, including:
- Diet and lifestyle factors, such as lack of fiber and exercise.
- Certain medications, such as pain relievers and antidepressants.
- Motility disorders that affect the nerves and muscles in your bowels.
- Large bowel obstructions.
- Irritable bowel syndrome.
- Pelvic floor dysfunction.
Vesical tenesmus
The feeling of frequently needing to pee even after you’ve just peed is caused by constantly activated peeing muscles. These muscles might be responding to residual pee left in your bladder. Or they might be overreacting to irritated nerves in your urinary tract if you have an inflammatory condition.
You may have residual pee in your bladder if you have a disorder that makes it hard to get everything out, such as:
Your urinary tract may be irritated and inflamed if you have:
- Urinary tract infection.
- Prostatitis (prostate inflammation).
- Vaginitis (vagin* inflammation).
- Bladder cancer.
- Prostate cancer.
Is tenesmus related to stress or anxiety?
Tenesmus can certainly cause stress and anxiety, and they may also trigger it. While stress and anxiety aren’t enough to cause tenesmus, they can upset your nervous system and make it harder to control your muscles. This can help set the stage for the involuntary muscle contractions in tenesmus.
