Tenesmus (What Causes the Urge to Poop? + 6 Natural Treatments)

Fact Checked

By Jillian Levy, CHHC

August 6, 2018

Experts consider tenesmus to be both a physical and mental condition. It feels as if there is stool to pass, but there usually isn’t. Tenesmus is different than diarrhea because when you go to the bathroom not much, or nothing at all comes out. The sensation of needing to poop can be caused by faulty nerve signals or small amounts of stool stuck in the rectum due to constipation.

Many people describe tenesmus as a very distressing symptom because you never know when it’s going to be triggered and return.

How long does tenesmus last? It depends on the underlying cause. Symptoms can last for weeks or months. Women are more frequently affected by tenesmus than men, since they experience more GI issues in general. Some people experience chronic tenesmus that comes and goes. Tenesmus can be temporary if it’s caused by an infection, acute traumatic stress, surgery or another short-term illness. If IBS, IBD or cancer is causing tenesmus, then it’s likely that it will return from time to time without treatment.

Treating tenesmus usually involves identifying the underlying cause (such as inflammatory bowel disease, IBS or an infection), making lifestyle and diet changes, and sometimes taking medications to control symptoms if needed.

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What Is Tenesmus?

Tenesmus is defined as “the sensation of urgently needing to evacuate the bowels even though they are empty.” (1) It’s one of the most common symptoms associated with inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis. (2) Tenesmus is sometimes called rectal tenesmus because it primarily results from inflammation of the rectum, the final section of the large intestine that ends at the anus.

Vesical tenesmus is similar to rectal tenesmus, but instead of affecting the rectum it affects the bladder. Vesical tenesmus is characterized by the feelings of being unable to completely empty the bladder and having to frequently urinate even though not much urine comes out.

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Tenesmus Symptoms & Signs

The most common tenesmus symptoms include: (3)

• Feeling like you need to go to the bathroom (empty the bowels) right away. This can happen suddenly out of nowhere, or right after you finish using the bathroom. You might get up from the toilet and feel like you need to sit right back down again, but then nothing will actually happen.


• Having multiple very small bowel movements throughout the day.


• Abdominal pain and discomfort. Pain usually goes away after passing a bowel movement.


• Cramping in the intestines and stomach.


• Straining when trying to go to the bathroom.


• Feeling like you cannot completely empty the bowels. This can be associated with constipation, which may come while you’re dealing with tenesmus.


• Anxiety and distress over dealing with tenesmus, including reduced quality of life, trouble sleeping, insecurity around others, and nervousness about when the symptoms will return.


• Depending on the cause of your tenesmus, you might also experience signs of an infection, such as a fever. If tenesmus is caused by cancer affecting the colon/rectum, then it’s also possible to have blood in your stools.

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Tenesmus Causes & Risk Factors

The most common reason that people experience tenesmus is due to inflammatory bowel disease (IBD), or Crohn’s disease and ulcerative colitis. It’s believed that tenesmus affects people with ulcerative colitis (UC) more often than those with Crohn’s disease because of how UC causes rectal hypersensitivity, although both conditions can cause tenesmus.

Aside from IBD, other tenesmus causes can include:

• Irritable bowel syndrome (IBS).


• Anxiety.


• A colonoscopy or surgery that affects the bowels.


• Infections that affect the gut/digestive system, which rarely can include sexually transmitted diseases like chlamydia, that may lead to pelvic inflammation. (4)


• Motility disorders that affect movement of the intestines.


• Pregnancy and sometimes PMS or PMDD.


• Radiation of the rectum or colon (called radiation proctitis or colitis).


• Anorectal abscess, a painful condition that causes pus to develop near the anus.


• Colon cancer, colorectal cancer or tumors.

What exactly causes the constant urge to poop? The underlying reason that tenesmus occurs is due to inflammation of the bowel. The bowel is considered the part of the alimentary canal in the digestive system that is located below the stomach, including the small intestine, large intestine/colon and rectum.

Dysfunction of the rectum usually seems to be involved in development of tenesmus. Dietary Fiber Supplementation

Fiber is important for maintaining regular bowel movements and preventing constipation, which can worsen symptoms of tenesmus. Aim to consume at least 25-30 grams of fiber per day from whole food sources like fruits, vegetables, whole grains, nuts, and seeds. If needed, you can also consider taking a fiber supplement like psyllium husk or flaxseed to help increase your fiber intake.

3. Stress Management Techniques

Since stress can trigger tenesmus, it's important to incorporate stress management techniques into your daily routine. This can include practices like yoga, meditation, deep breathing exercises, mindfulness, and regular exercise. Finding ways to relax and unwind can help reduce the frequency and severity of tenesmus episodes.

4. Herbal Remedies

There are several herbal remedies that may help alleviate symptoms of tenesmus. Chamomile tea, peppermint tea, ginger tea, and licorice root tea are all known for their digestive benefits and calming effects on the gut. You can also consider taking herbal supplements like turmeric, slippery elm, marshmallow root, or aloe vera to support gut health.

5. Probiotic Supplementation

Probiotics are beneficial bacteria that can help restore balance to the gut microbiome and improve digestive health. Consider taking a daily probiotic supplement to support your gut health and reduce symptoms of tenesmus. Look for a high-quality probiotic with a variety of strains and a high CFU count.

6. Hydration and Lifestyle Changes

Staying hydrated is essential for maintaining healthy bowel function and preventing constipation. Aim to drink at least 8-10 glasses of water per day, and limit your intake of caffeine and alcohol, which can dehydrate the body. Additionally, incorporating regular exercise into your routine can help improve digestion and overall gut health.

By implementing these natural treatments for tenesmus, you can help alleviate symptoms and improve your overall quality of life. It's important to work with a healthcare provider to determine the best course of treatment for your individual needs and to address any underlying causes of tenesmus.

Natural Remedies for Diarrhea:

- Stay hydrated by drinking water throughout the day.
- Eat bananas and rice to help bind loose stools.
- Add raw honey and ginger to tea to soothe your stomach.
- Try flaxseed oil to reduce the duration of diarrhea.
- Avoid caffeine and alcohol.
- Avoid unripe or overripe fruits.
- Limit greasy foods.
- Manage stress and get enough rest.
- Avoid intense workouts until you feel better.
- Consult your doctor if medications are causing diarrhea.

Natural Remedies for Constipation:

- Eat high fiber foods like fruits, vegetables, seeds, nuts, and starchy veggies.
- Drink plenty of water and add apple cider vinegar or lemon juice.
- Use peppermint oil topically or internally.
- Try magnesium supplements or oil.
- Drink aloe vera juice.
- Eat smaller, balanced meals throughout the day.
- Try herbs like slippery elm, licorice root, and ginger.
- Use natural soaps and wipes for hemorrhoids or bloody stools.

Managing Stress:

- Practice meditation, yoga, deep breathing, and journaling.
- Seek therapy or counseling for chronic stress.
- Spend time outdoors and get natural sunlight.
- Join a support group or spiritual center.
- Get enough sleep and maintain a consistent sleep schedule.
- Use essential oils like ginger, peppermint, lavender, and fennel.

Exercise:

- Be active for 30-60 minutes daily to reduce inflammation.
- Exercise in the morning for better bowel regulation.
- Try to exercise outside for vitamin D.

Supplements:

- Consider probiotics, digestive enzymes, omega-3 fish oil, adaptogen herbs, and L-glutamine powder to prevent IBS/IBD symptoms.

Precautions Regarding Tenesmus:

- If tenesmus symptoms are severe, recurrent, or unresponsive to treatment, consult a doctor to rule out serious underlying health conditions. If you experience any of the following symptoms, it is important to seek medical advice promptly in order to prevent the symptoms from worsening:

- Bloody stools
- Severe abdominal pain
- Symptoms of infection such as fever, chills, and body aches
- Persistent nausea and vomiting, which can lead to dehydration and electrolyte imbalance
- Continual loss of appetite and weight loss

Key Points about Tenesmus:

- Tenesmus is characterized by the urgent sensation of needing to empty the bowels even when they are already empty.
- Symptoms of tenesmus may include cramping, frequent small bowel movements, constipation, pain, diarrhea, and sometimes signs of infection like fever and bloody stools.
- Underlying causes of tenesmus can include inflammatory bowel disease, IBS, infections, hormonal changes, stress, or colon/rectal cancer.

6 Natural Ways to Relieve Tenesmus Symptoms:

1. Addressing underlying health conditions, such as IBD
2. Following an anti-inflammatory diet and staying hydrated
3. Managing constipation and diarrhea
4. Managing stress, sleep, and exercise
5. Limiting consumption of caffeine, alcohol, and tobacco
6. Taking certain supplements like probiotics, digestive enzymes, and omega-3 fatty acids

For more information, you can also refer to the article "Poop: What’s Normal, What’s Not + 7 Steps to Healthy Pooping."