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Tenesmus and constipation

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Posted 9/25/2015 5:43 PM (GMT 0)
How can you tell the difference?
Posted 9/25/2015 5:49 PM (GMT 0)
The two went hand in hand for me - but the tenesmus presents with horrible urgency, and nothing really coming out. It's not a good time.
Posted 9/25/2015 6:21 PM (GMT 0)
If I'm constipated then I do not have any feeling like I need to poop at all. I'll miss the occasional day, and not poop at all, nor do I feel like I have to poop either. My gut feels a little heavy and I'm a little flatulent but no urge.

Tenesmus is pure evil, it feels like you have to poop urgently right now, and either nothing comes out when you try or just a crumble or bit of mucus might come out. Usually when I have Tenesmus, I have that feeling repeatedly and sometimes I actually have to poop other times it is entirely a false alarm. It's very frustrating because you never know, so I go to the toilet anyways. Tenesmus is related to rectal inflammation.

To me, they are two very different sensations.
Posted 9/25/2015 6:22 PM (GMT 0)
It's like there's a fine line between the two, since I've experienced both I can tell right away which is which for me at least...

When I suffer with proctitis and I have tenesmus my rectum always feels gross, on or off the toilet I can feel the awful twinge of discomfort (incomplete feeling) in my rectum and even after having a BM, the feeling pretty much stays all day and night long....even after I've passed many bowel movements all day.

With constipation, once I pass the BM finally, then the feeling goes away unlike with proctitis causing me tenesmus and I no longer have the "feeling" "to go", with constipation, you can sense the feeling to "go" then you try and often nothing comes out, then after some time the "feeling" will go away but often come back again, but doesn't stay all day and night like it does with tenesmus, that's the way it is for me at least...my brain can just sense which one it is that I'm dealing with....they both suck!!
Posted 9/25/2015 6:25 PM (GMT 0)
I have feelings of needing to poop like now but very little comes out.
I also was having a little more abdominal pain the last few days but that can be from constipation too
I did have a minuscule Bm after a lot of straining and it was very painful
I'm not sure if I'm still constipated and have to have another Bm or its just a false alarm
I have some cortifoam but I hate using steroids and especially if it's not inflammation but Cs
I think I will try to drink tons extra and eat some more fiber and if it doesn't go away than I'll use the foam
What do you think of that plan?
Thanks
Posted 9/25/2015 6:35 PM (GMT 0)
When it feels like a false alarm, it's likely tenesmus for me at least. I would try the cortifoam and see if it gets any better or you could try products for constipation (if that's what you think it likely is) like stool softener, glycerin suppositories or laxatives.
Posted 9/25/2015 8:22 PM (GMT 0)
I have had tenesmus, but only once, and I have never forgotten it, it feels like you want to go to the toilet over and over and over again, and it is dreadful, and just the worst feeling in the world, I actually thought I was going to have to go to the hospital to get it to stop (I was very clueless in those days) In the end, out of desperation I took a laxative pill, with a small glass of water with a little apple cider vinegar in it, followed by a mug of strong coffee, which got things moving real fast, and then I collapsed on my bed exhausted..I hope you feel better soon, I feel bad for you.
Posted 9/25/2015 10:07 PM (GMT 0)
Thanks for all your advice
I had it before and it was much much worse
However I am just trying to convince to myself when I say it might be constipation. I think it's tenesmus.
I gave up on it getting better with fiber and water do I just took some cortifoam
Hoping it works quickly
Posted 9/25/2015 11:15 PM (GMT 0)
Tenesmus is the worst part of IBD for me, it reduces me to tears!!!! Good luck
Posted 9/26/2015 4:36 AM (GMT 0)
I would rather have D and cramping any day than tenesmus.
Posted 9/26/2015 2:13 PM (GMT 0)
I find tenesmus to be the most painful thing in the whole world. It feels like a burning cramp and gives me the shakes and has been known to make me cry as well. If I am constipated I can feel bloated but I don't have any urgency or feel like I need to go or keep pushing. If I have tenesmus, I am usually bleeding as well.
Posted 9/26/2015 5:18 PM (GMT 0)
It's white knuckling, whimpering, groaning and sometimes crying through those episodes. The spasming and extreme nausea continues afterward throughout the day/night. I HATE IT!!!

If you cannot use mesalamine, get on the steroid enemas now.

I rarely have bleeding, but that symptom is the clincher for absolutely flaring...and for me, it happens with minimal inflammation. I treat by increasing rectals to nightly.

Antispasmodics do help to calm the spasming...I take them about every 4 hours when I'm at my worst.

q
Posted 9/27/2015 2:01 AM (GMT 0)
thanks guys
i ended up taking the cortifoam but it still got worse
I will be calling my GI during hours if it doesnt improve by than
maybe ill take some librax
Posted 9/27/2015 10:12 AM (GMT 0)
As somebody relatively new to tenesmus, I would say it's nothing like constipation. With constipation, I never had extreme urges to go, unless - too much information alert - I hadn't been for several days and an impaction had begun in my rectum. With constipation, I felt bilious, bloated, and gassy. Urges to go were few and far between, unless the constipation was at an advanced stage.

Tenesmus is equally grim, but in a different way. I will get hit with an immediate need to evacuate my bowels out of the blue - I mean, I did have urgency with the Crohn's, but not like this. I've already had a couple of accidents at home, and am much more nervous when I go out. Feel like I owe an apology to the UC board for not knowing how awful this was before; sorry UC board.

Edit: Oh yeah, and my rectum is also sore a lot of the time. Not quite constantly, or at least it's much worse at some times than it is at others. Then when I do go to the toilet, my rectum feels like it is trying to get out of my body. I got these spasms of death with Crohn's all the time, but they affected my intestines rather than my rectum - now it's usually just my rectum.

Post Edited (NiceCupOfTea) : 9/27/2015 4:15:18 AM (GMT-6)

Posted 9/27/2015 11:51 AM (GMT 0)
I once had to poop in the kitchen trashcan, because my DW was almost done using our only bathroom, asked me to wait a sec, but I had to go NOW. Boy was she horrified when she walked out of the bathroom and catch me mid-act. I even took the trash outside immediately after I was done ha ha. That's Tenesmus.

When I had Tenesmus, I was a serious contender for the gold in the Olympic 5 meter bathroom sprint and obstacle course, adeptly dodging around and jumping over small obstacles in my path (a small dog, ottoman, etc.).

The way I figure, you got to have a sense of humor to survive this horrible disease...
Posted 9/27/2015 12:03 PM (GMT 0)
Sorry to hear you're still struggling after your takedown NCOT. I was hoping that getting rid of your stoma would've improved things for you. As I know you really didn't like having a stoma.
Posted 9/27/2015 1:13 PM (GMT 0)
Thanks, iPoop - so was I :-/ I'm just clinging onto the hope it's still relatively early days yet for this type of surgery, and that things will improve. I can't help thinking I must surely have rectal inflammation though - Crohn's or otherwise. (I had diversion proctitis in my rectum before surgery but I was assured the biopsies showed no signs of Crohn's.)
Posted 9/27/2015 1:17 PM (GMT 0)
NCOT
Have rectals helped with your tenesmus?
I have used cortifoam but didn't see improvement yet. But no surprise as I only did on Friday and today is Sunday.
I am wearing depends so that I don't kill myself running to the bathroom cuz worse case scenario I'm safe.
We had a guest and mid sentence I'm dashing out of the room
And funny thing is that right now I could care less
Posted 9/27/2015 1:44 PM (GMT 0)
Dikid, I haven't tried any yet. I'll be having further tests, depending on the results of blood/stool tests I had done recently. Trouble is, if the blood/stool tests come back negative, I still have the same symptoms in the meantime and don't get to see my GI until January. I'm not terribly happy with that arrangement, but I may be able to get some rectal meds from my GP or surgeon.

Admittedly I'm scared to try rectal mesalazine meds in case I can't tolerate them (bad history with oral mesalazine, although that was a long time ago now). And I don't really want to take steroid enemas either, again because of my history with steroids.
Posted 9/27/2015 1:48 PM (GMT 0)
The steroid enemas are nothing like the oral.
They are topical and don't give the same side effects.
The problem is that they may thin your skin and that's not good. But it sure beats tenesmus
Posted 9/27/2015 1:58 PM (GMT 0)
I guess my main quibble is that there is little point in taking any form of steroids, if they are going to stop working 2 seconds after you finish them. Which was my usual experience with oral steroids.
Posted 9/27/2015 2:39 PM (GMT 0)
True but I find that it helps bring down the inflammation and since I'm on pretty good maintnence I figured by the time I get to remicade I'll be ok and I can get off the cortifoam safety

I see you don't really have much of maintnence meds so steroids will probably only help temporarily. But anything to get rid of tenesmus.
It's pretty uncomfortable.
Last night I took some tramadol and librax and it helped with the pain
Posted 9/27/2015 2:47 PM (GMT 0)
Huh? Oh yeah, your sig. So Remicade makes the tenesmus go away for a while, but it comes back before your next infusion?

I find rectal/abdominal pain the hardest pain of all to tackle, but on a few nights where it has got really quite bad I have taken some codeine or tramadol - I think it helps a bit. Imodium was sadly disappointing, but I still take it occasionally.
Posted 9/27/2015 2:50 PM (GMT 0)
Well I haven't had tenesmus since May but i got it again this week so I'm hoping I will get better after my infusion this Friday
I would ask them to move up my infusion bit I'm so busy I honesty don't think I can make it until than
Posted 9/27/2015 2:52 PM (GMT 0)
Try canasa if u can.
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