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词条 Rectal tenesmus
释义

  1. Considerations

  2. Treatment

  3. See also

  4. References

  5. External links

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| field = General surgery
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Rectal tenesmus 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.[1]

Tenesmus is a closely related topic to obstructed defecation. The term is from {{lang-la|tēnesmus}}, from Greek {{lang|grc|τεινεσμός}} {{lang|grc-Latn|teinesmos}}, from {{lang|grc|τείνω}} {{lang|grc-Latn|teínō}} to stretch, strain.

Considerations

Tenesmus is characterized by a sensation of needing to pass stool, accompanied by pain, cramping, and straining. Despite straining, little stool is passed.[2] 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:

  • Amebiasis
  • Coeliac disease
  • Chronic arsenic poisoning
  • Colorectal cancer
    • Anal melanoma[3]
  • Cytomegalovirus (in immunocompromised patients)
  • Cystocele
  • Diverticular disease
  • Hemorrhoid, which are prolapsed
  • Imperforate hymen[4]
  • Inflammatory bowel disease
  • Irritable bowel syndrome
  • Ischemic colitis
  • Kidney stones, when a stone is lodged in the lower ureter [5]
  • Pelvic organ prolapse
  • Radiation proctitis
  • Dysentery
  • Rectal gonorrhoea
  • Rectal lymphogranuloma venereum
  • Rectal lower gastrointestinal parasitic infection, particularly Trichuris trichiura (whipworm)
  • Rectocele
  • Shigellosis
  • Ulcerative colitis

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.

Treatment

Pain relief is administered concomitantly to the treatment of the primary disease causing tenesmus. Methadone has been shown to be an effective pain-reliever.[6]

See also

  • Encopresis
  • Constipation
  • Fecal incontinence

References

1. ^{{cite web |title=Wrong Diagnosis |url=http://www.wrongdiagnosis.com/sym/rectal_tenesmus.htm |accessdate=2007-07-09 }}
2. ^{{cite journal|last1=Sanchiz Soler|first1=V.|last2=MÍnguez Pérez|first2=M.|last3=Herreros Martínez|first3=B.|last4=Benages Martínez|first4=A.|title=Protocolo de actuación ante la disquecia o el tenesmo|journal=Medicine - Programa de Formación Médica Continuada Acreditado|volume=8|issue=7|year=2000|pages=367–369|issn=0304-5412|doi=10.1016/S0304-5412(00)70072-2}}
3. ^{{cite journal|last=Bejarano-García|first=A.|author2=C. Núñez-Sousa |author3=V. Aviñó-Tarazona |author4=R. González-Gutiérrez |title=NEOPLASIA ANAL EN PACIENTE CON TENESMO|journal=Revista de la Sociedad Andaluza de Patología Digestiva|date=24 February 2011|volume=34|issue=1|url=http://www.sapd.es/revista/article.php?file=vol34_n1/08}}
4. ^{{Cite journal|last=Mwenda|first=Aruyaru Stanley|date=2013|title=Imperforate Hymen - a care cause of acute abdominal pain and tenesmus: case report and review of the literature|url=http://www.panafrican-med-journal.com/content/article/15/28/full/|journal=Pan African Medical Journal|language=en|volume=15|pages=|doi=10.11604/pamj.2013.15.28.2251|via=|pmc=3758851}}
5. ^Nephrolithiasis: Acute Renal Colic, Stephen W Leslie. eMedicine.
6. ^{{cite journal|last=SÁNCHEZ POSADA|first=R.|author2=P. VARILLAS LÓPEZ |author3=C. CENTENO CORTÉS |title=Metadona como opioide inicial en pacientes con tenesmo rectal|journal=MED PAL|year=2004|volume=11|issue=4|pages=201–204|url=http://www.orcpex.es/documentos/publicaciones/2004/1.pdf|accessdate=21 May 2012}}

External links

{{Medical resources
| ICD10 = {{ICD10|R|19|8|r|10}}
| ICD9 = {{ICD9|787.99}}
| MedlinePlus = 003131
}}
  • {{MedlinePlusEncyclopedia|003131}}
{{Digestive system and abdomen symptoms and signs}}

2 : Symptoms and signs: Digestive system and abdomen|Defecation

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