Tenesmus or Rectal tenesmus (Latin: tēnesmus, from Greek τεινεσμός teinesmos, from τείνω teínō to stretch, strain) is a feeling of incomplete defecation. It is the sensation of inability or difficulty to empty the bowel at defecation, even if the bowel contents have already been evacuated. Tenesmus indicates the feeling of a residue, and is not always correlated with the actual presence of residual fecal matter in the rectum. It is frequently painful and may be accompanied by involuntary straining and other gastrointestinal symptoms. Tenesmus has both a nociceptive and a neuropathic component.
Vesical tenesmus is a similar condition, experienced as a feeling of incomplete voiding despite the bladder being empty.
Often, rectal tenesmus is simply called tenesmus. The term rectal tenesmus is a retronym to distinguish defecation-related tenesmus from vesical tenesmus.
Tenesmus is a closely related topic to obstructed defecation.
Tenesmus is characterized by a sensation of needing to pass stool, accompanied by pain, cramping, and straining. Despite straining, little stool is passed. Tenesmus is generally associated with inflammatory diseases of the bowel, which may be caused by either infectious or noninfectious conditions. Conditions associated with tenesmus include:
Chronic arsenic poisoning
Cytomegalovirus (in immunocompromised patients)
Hemorrhoid, which are prolapsed
Inflammatory bowel disease
Irritable bowel syndrome
Kidney stones, when a stone is lodged in the lower ureter 
Pelvic organ prolapse
Rectal lymphogranuloma venereum
Rectal lower gastrointestinal parasitic infection, particularly Trichuris trichiura (whipworm)
Tenesmus (rectal) is also associated with the installation of either a reversible or non reversible stoma where rectal disease may or may not be present. Patients who experience tenesmus as a result of stoma installation can experience the symptoms of tenesmus for the duration of the stoma presence. Long term pain management may need to be considered as a result.
Pain relief is administered concomitantly to the treatment of the primary disease causing tenesmus. Methadone has been shown to be an effective pain-reliever.
- “Wrong Diagnosis”. Retrieved 2007-07-09.
- Sanchiz Soler, V.; MÍnguez Pérez, M.; Herreros Martínez, B.; Benages Martínez, A. (2000). “Protocolo de actuación ante la disquecia o el tenesmo”. Medicine – Programa de Formación Médica Continuada Acreditado. 8 (7): 367–369. doi:10.1016/S0304-5412(00)70072-2. ISSN 0304-5412.
- Bejarano-García, A.; C. Núñez-Sousa; V. Aviñó-Tarazona; R. González-Gutiérrez (24 February 2011). “NEOPLASIA ANAL EN PACIENTE CON TENESMO”. Revista de la Sociedad Andaluza de Patología Digestiva. 34 (1).
- Mwenda, Aruyaru Stanley (2013). “Imperforate Hymen – a care cause of acute abdominal pain and tenesmus: case report and review of the literature”. Pan African Medical Journal. 15. doi:10.11604/pamj.2013.15.28.2251.
- Nephrolithiasis: Acute Renal Colic, Stephen W Leslie. eMedicine.
- SÁNCHEZ POSADA, R.; P. VARILLAS LÓPEZ; C. CENTENO CORTÉS (2004). “Metadona como opioide inicial en pacientes con tenesmo rectal” (PDF). MED PAL. 11 (4): 201–204. Retrieved 21 May 2012.