Tenesmus: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Tenesmus?
A gastroenterologist, a doctor who treats the digestive system, usually evaluates tenesmus. It is the feeling of needing to pass stool when the bowels are already empty. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is tenesmus?
Tenesmus is the feeling that you need to pass stool, even though your bowels are already empty. It may involve straining, pain, and cramping. People with tenesmus may push very hard to empty their bowels. They only pass a small amount of stool. Some people feel a constant urge to have a bowel movement.
Symptoms
The main symptom is feeling that you need to pass stool when your bowels are empty.
- Straining, pain, and cramping.
- Pushing hard but passing only a small amount of stool.
- A constant urge to have a bowel movement.
With ulcerative colitis, tenesmus can come with diarrhea and rectal bleeding. It can also come with belly cramps and pain, and mucus or pus in the stool.
Causes and who gets it
Tenesmus most often occurs with inflammatory diseases of the bowels. These diseases may be caused by an infection or other conditions. It can also occur with motility disorders. These are diseases that affect the normal movements of the intestines. Tenesmus may be caused by:
- Colorectal cancer or tumors.
- Crohn disease.
- Infection of the colon.
- Inflammation of the colon or rectum from radiation.
- Ulcerative colitis or ulcerative proctitis.
Ulcerative colitis inflames the lining of the large intestine and rectum.
How doctors diagnose it
Your provider will examine you and ask questions. You may be asked when the problem began and whether you have had it before. You may also be asked if others in your household have similar problems. The exam may include a detailed belly exam, and a rectal exam is done in most cases. Tests that may be done include:
- Colonoscopy, a test that looks at the colon and rectum.
- Complete blood count (CBC).
- Stool cultures.
- A CT scan of the belly, in rare cases.
A colonoscopy with a biopsy is most often used to diagnose ulcerative colitis.
Treatment
For home care, adding more fiber and fluid to your diet can help ease constipation. Tenesmus can be caused by many diseases, so treatment is shown here for one of them, ulcerative colitis, as an example. The treatment goals for ulcerative colitis are to control acute attacks, prevent repeated attacks, and help the colon heal. During a severe episode of ulcerative colitis, you may need to be treated in the hospital. Medicines to quiet the immune system may be part of ulcerative colitis treatment. Surgery to remove the colon will cure ulcerative colitis and removes the threat of colon cancer. You may need surgery if colitis does not respond to intensive medical therapy.
When to see a doctor
Contact your health care provider if you continue to have tenesmus. Also contact your provider if you have belly pain, blood in the stool, chills, fever, nausea, or vomiting. These symptoms could be a sign of a disease that might be causing the problem. Call 911 or go to the emergency room if you have severe belly pain or pressure. Also go if you have bleeding that will not stop, or if you vomit or cough up blood.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can review your symptoms, order first tests, and refer you to a gastroenterologist.
Common questions
What does tenesmus feel like?
It feels like you need to pass stool, even though your bowels are already empty. You may strain, and you may have pain and cramping. Often only a small amount of stool passes.
Is tenesmus a sign of cancer?
It can be, because colorectal cancer or tumors are one possible cause. Other causes include Crohn disease and infection of the colon. Contact your provider if you keep having tenesmus.
Is tenesmus a symptom of ulcerative colitis?
Yes, it is one of the symptoms of ulcerative colitis. It can come with diarrhea, rectal bleeding, and mucus or pus in the stool.
What can I do at home for tenesmus?
At home, you can add more fiber and fluid to your diet, which can help ease constipation. Contact your provider if you continue to have tenesmus.
Sources
- MedlinePlus - Tenesmus
- MedlinePlus - Ulcerative colitis
- National Institute of Diabetes and Digestive and Kidney Diseases - Symptoms & Causes of Ulcerative Colitis
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
