Symptom of IBS: A Feeling of Incomplete Bowel Movement

Tenesmus is the medical term to describe the feeling that you need to go to the bathroom but cannot. There are 2 types of tenesmus: rectal tenesmus (needing to have a bowel movement, or poop) and vesical tenesmus (needing to urinate, or pee).^1,2

Rectal tenesmus is the feeling of an incomplete bowel movement. Even if you have just gone to the bathroom, you feel like you did not get everything out. The feeling may come along with pain and cramping. A person may need to push very hard (strain) while trying to poop. These feelings of incomplete bowel movements may be a sign of irritable bowel syndrome (IBS).^1,2

Who experiences tenesmus?

Rectal tenesmus typically occurs in people with gut and bowel issues such as:¹

• Inflammatory bowel diseases like Crohn’s disease or ulcerative colitis
• Problems with the movement of poop (stool) through the intestines (motility disorders)
• Irritable bowel syndrome (IBS)

People who have IBS with diarrhea (IBS-D) may feel incomplete bowel relief leading up to or after a bowel movement. People who have IBS with constipation (IBS-C) or mixed diarrhea and constipation (IBS-M) may have a similar feeling of incomplete relief after a bowel movement. But not everyone with IBS will experience tenesmus.³

What are the symptoms of tenesmus?

Tenesmus is the frequent urge to go to the bathroom but being unable to. Symptoms of tenesmus can include:^1,2

• Abdominal pain
• Cramping
• Straining to poop
• Painful bowel movements

A person with IBS who has tenesmus may strain to empty their bowels but only pass a small amount of stool. Tenesmus can be a painful, bothersome, and frustrating symptom.³

What causes tenesmus?

There are 2 main causes of rectal tenesmus: inflammation and constipation.²

Inflammation

Inflammation that leads to incomplete bowel movements can occur for many reasons and in several places in the body:^1,2

• Abscess in or around the rectum
• Hemorrhoids
• Celiac disease
• Colorectal cancer or anal cancer
• Crohn’s disease or ulcerative colitis
• Motility disorders
• Inflammation of small pouches located in the digestive tract (diverticulitis)
• Infection of the colon from a bacteria, parasite, or virus (infectious colitis)
• Radiation colitis (from getting radiation therapy)

Constipation

When stool is stuck (impacted) in your colon, it can lead to constipation. Stool impaction can occur because of:²

• Lack of fiber in your diet
• Lack of exercise
• IBS
• Motility disorders
• A blockage (obstruction) in your bowels
• Certain medicines, like pain relievers and antidepressants

When to see a doctor

If you have feelings of incomplete bowel movements, whether they are constant or come and go, visit your doctor. And if you have any of the following symptoms, seek immediate medical care:^1,2

• Fever
• Chills
• Nausea and vomiting
• Severe pain
• Blood in your poop

What to expect from your doctor's visit

In order to understand the underlying cause of your tenesmus, your doctor will ask several questions related to your symptoms. These questions may include:^1,2

• What are your symptoms?
• When did your symptoms first occur?
• Have you had the feeling of an incomplete bowel movement before?
• Have you eaten any raw, new, or unfamiliar foods?
• Have any others in your household experienced similar problems?
• Do you have any current or past health issues?

In addition to asking you questions about your symptoms, your doctor may perform 1 or more of the following exams:^1,2

• Digital rectal exam – Using a gloved and lubricated finger, your doctor will examine your anus and rectum.
• Anoscopy/flexible sigmoidoscopy – Using a tiny flexible, lighted camera (scope), your doctor will look at your anus, rectum, or lower colon for signs of inflammation or obstruction.
• Colonoscopy (exam of the large intestine) – Using a scope, your doctor will look at your entire large intestine while you are sedated.

How is tenesmus treated?

Treating tenesmus involves treating the underlying problem that is causing it. For people with IBS, that might mean treating constipation that is causing tenesmus. Treatment for tenesmus may involve:²

• Dietary changes, such as eating more fiber and drinking more water
• Certain medicines to treat IBS
• Psychological approaches, such as cognitive behavioral therapy (CBT)