# Tenesmus - red flag or not ?



## Patrick70 (Oct 15, 2007)

Something has got me confused - and it is this darn word - Tenesmus.Here is how it is defined: Tenesmus: Straining, especially long-continued, ineffectual and painful straining, at stool or in urination.Now some sites equate incomplete evacuation with tenesmus and say that tenesmus is a common symptom of IBS.Other sites say tenesmus is rare in IBS (but common in IBD)Still others distinguish incomplete evacuation from temesmus this way:" It should not be confused with tenesmus which is a painful and violent urge to pass a stool. This rarely occurs in IBS"(Taken from this article: http://media.wiley.com/product_data/excerp...0470844965.pdf)Some sites list tenesmus as a 'red flag' that more than IBS is going on.So I am lost - because I do have the urge to go sometimes - and cannot pass anything. And from what I have read here that is pretty common for IBS (correct me if I am wrong on this). Now I wouldn't say it is a violent and painful urge - but still an urge. If it was a violent and painful urge would it then be tenesmus (it seems to me I see lots of IBS'rs saying they get cramping and urgency but little or nothing produced. So is tenesmus part of IBS or not - it seems like a very vaguely defined word.


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## Kathleen M. (Nov 16, 1999)

No good answer for that, I'm not sure how it is defined (or if there is a single definition for it)Sometimes you get straining in IBS when stool is hard to pass, but that is normal straining.You can also see people here with pelvic floor disorders where the sphincter tightens up rather than relaxes when you try to have a BM that can cause extended periods of straining. That isn't IBS but it can be seen in some people either with IBS or who are told they have IBS.Pelvic floor disorders should be tested for and usually need different treatment than IBS if you think you might have one.K.


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## Patrick70 (Oct 15, 2007)

I was referring more to straining due to feelings of rectal hypersensitivity (such as incomplete evacuation) - which as I have read is fairly common for IBS folk. On one reading of Tenesmus - it would include this. But then it cannot be a red flag - since it is very common to IBS people.


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## Kathleen M. (Nov 16, 1999)

I guessing it is referring to straining that is not common to IBS if they say it is a red flag.I haven't researched it and do not know where the line between abnormal amounts of straining and normal amount of straining you would expect in anyone who is constipated IBS or not.These words "Tenesmus: Straining, especially long-continued, ineffectual and painful straining" does not sound like the run of the mill straining you see in IBS.http://www.nlm.nih.gov/medlineplus/ency/article/003131.htm has some info that this is what is seen in people with INFLAMMATORY problems which would be a red flag what you have is NOT IBS.I'm not sure exactly where the line would be between IBS straining and Inflammatory Straining as most things like this are a continuum and a lot of people may be in that gray area in the middle where things are not clearly 100% one thing or the other.It sounds like a symptom you should report to the doctor and let them decide where along the continuum you lie.


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## Patrick70 (Oct 15, 2007)

Good idea to mention it too the doc.I am doubtful I have IDB (normal BE 4 years ago - normal blood tests) - plus don't really suffer from D that much - do alternate D/C.I am wondering if the distinction is that tenesmus is violent painful urge to go - and nothing comes. I don't get that - but I do get the feel sometimes that something is stuck there and would be nice if it came out. I think that is more along the lines of rectal hypersensitivity/incomplete evacuation than what is described by one definition of tenesmus.Although sometimes tenesmus is defined just as ineffectual straining - and the meaning in that case seems to be the same as rectal hypersensitivity/incomplete evacuation. On that meaning of tenesmus I would say I suffer from it - though so do a lot of IBS people.


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## Nikki (Jul 11, 2000)

Tenesmus is violent urge.At least, that is as I understand it.Think having gastroenteritis type urges- only nothing comes out. Like that.


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