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Tenesmus refers to cramping rectal pain. Tenesmus gives you the feeling that you need to have a bowel movement, even if you already have had one. When you have tenesmus, you might strain harder to produce only a small amount of stool during bowel movements.

What causes tenesmus?

Any number of inflammatory bowel diseases (IBDs) can cause tenesmus. An IBD causes long-term inflammation in all or some parts of your gastrointestinal (GI) tract, or digestive tract. The most common forms of IBD are Crohn’s disease and ulcerative colitis.

Both Crohn’s disease and ulcerative colitis cause you to have ulcerations in your GI tract. These ulcers cause scarring along the walls of your digestive organs. This scarring can make it harder for you to pass your stool normally, which can lead to tenesmus. If you have Crohn’s disease, these ulcerations can spread throughout your GI tract. In the case of ulcerative colitis, these ulcers are located only in your colon and rectum.

What causes these IBDs is not known. Both genetics and the immune system are thought to play a part.


You’re more likely to develop IBD if you also have a relative with the disease. But a genetic history of IBD does not guarantee that you will develop it.

Immune system

Doctors believe that your digestive tract might become inflamed in the process of your immune system fighting off an invading organism.

Less common causes

While IBDs are the most common causes of tenesmus, your symptoms can be caused by a number of other conditions. Certain movement or motility disorders of the GI tract can cause problems when you try to pass a stool. These disorders can affect the ability of your intestinal system to move your waste along. Some of the most common motility disorders are constipation and diarrhea.


Constipation is a problem that occurs when there is difficulty during bowel movements. The condition might also cause a lack of bowel movements. Constipation can lead to straining and infrequent bowel movements. Possible causes of constipation include:

  • colon cancer
  • rectal abscesses
  • colon infection


Diarrhea is the rapid and frequent expulsion of feces in liquid form. Many disorders and diseases can cause diarrhea, including:

  • Viral infections
  • Food poisoning
  • Drug overdoses

When should I call my doctor?

If you experience tenesmus often, talk to your doctor about your symptoms. Be sure to tell them about any:

  • abdominal pain
  • blood in your stool
  • vomiting
  • fever
  • chills

What can be done about my symptom?

If you are struggling with tenesmus, there are a number of treatment options available. In most cases, your symptom can be relieved using home remedies.

Treatment at home

If an IBD or motility disorder is causing your symptoms, you can help relieve your cramps and discomfort by making some diet and lifestyle changes. These home treatment options also double as great tenesmus prevention methods.

High-fiber diet

Eating a diet that is high in fiber is one of the best ways to relieve your tenesmus. Eating at least 20 grams of fiber every day will make your stool softer and add weight to it. This helps your body pass the stool more easily. If you have ulcers or scarring in your GI tract, you should be able to pass a softer stool more easily and with less pain.

Drink water

Drinking enough water is important in making sure your stool is soft as well.

Physical activity

Physical activity stimulates movement in your intestines. Exercising regularly can help your tenesmus by helping your intestines move your waste through your GI tract.

Medical treatment

Medical treatment will vary depending on the cause of your tenesmus.

Inflammatory bowel disease (IBD)

Medical treatment of IBD is aimed at stopping the inflammation that causes your symptoms. The following medications might be prescribed:

  • Anti-inflammatory drugs that reduce your inflammation are usually the first step in treatment.
  • Medications that lower your immune system might also be used when treating IBD.
  • Antibiotics might be prescribed to help kill bacteria in your intestines that could be causing your IBD and tenesmus.

Motility disorders

If diarrhea has caused your tenesmus, your doctor might treat your condition with antibiotics, which are effective in fighting bacteria and parasites. If a virus is the cause of your diarrhea, antibiotics won’t be effective. Your doctor might take you off certain medications if they cause your diarrhea.

If constipation led to your tenesmus, laxatives and medications that help add water to your stool. These might be an option for you. In more severe cases, your doctor might break up the compacted stool manually. Your doctor will do this by breaking up the stool using their finger.

Content licensed from:

Written by: Carmella Wint
Medically reviewed on: Nov 14, 2016: Alana Biggers, MD, MPH

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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