I always want to defecate, I go to the toilet, but I can’t pull it out. When I get out of the toilet, I want to defecate immediately. This symptom has a special term in medicine, called tenesmus.
“tenesmus” refers to the rush to go to the toilet, and “post-heavy” refers to the feeling of the anus sinking and the feeling of being unable to defecate. Don’t ignore it, this is your rectum warning you, the main reasons are:
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1) Proctitis. Proctitis may last for three to five days, some for several months, or even have tenesmus symptoms all year round. Acute proctitis is mostly caused by sharp undigested foreign bodies; patients with frequent constipation are also related to excessively dry stools.
2) Chronic proctitis. It is mainly related to the patient’s immune dysfunction or long-term hemorrhoids, and the anal sinusitis is also related to chronic proctitis.
Patients with proctitis should be given corresponding treatment according to the cause. At the same time, it is very important to pay attention to the adjustment of diet and living habits. Eat less spicy food, cold and greasy food, and pay attention to three meals. Regular, regular work and rest, appropriate activities, and at the same time pay attention to emotional problems. Tension, anxiety, hypochondriasis, depression, etc. have a greater impact on the symptoms of proctitis.
3) Rectal polyps. Most rectal polyps are asymptomatic, sometimes tenesmus, and some patients may have blood in the stool, similar to a hemorrhoid attack. When tenesmus is accompanied by symptoms of blood in the stool, colonoscopy should be done to rule out the existence of rectal polyps. After the diagnosis of rectal polyps, colonoscopy should be done to remove the polyps.
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4) Rectal tumor. For patients over the age of 45 who have tenesmus symptoms, if the symptoms are not relieved after treatment, colonoscopy is strongly recommended to exclude rectal space-occupying lesions. At the same time, rectal tumors are often accompanied by bloody stools, mucus and bloody stools, and rectal tumors can be found by digital rectal examination. In colorectal cancer, the incidence of rectal cancer is the highest, and those with the above symptoms should pay close attention.
5) Extra-intestinal diseases. Except for the intestinal diseases mentioned above, gynecological problems are the most common cause of tenesmus symptoms. Including pelvic inflammatory disease, pelvic abscess, bleeding caused by various gynecological diseases.
This is the main reason why I always want to go to the toilet, but I can’t pull it out. If you have related symptoms, you can go to the hospital for a blood routine, digital rectal examination, and lower abdominal ultrasound. Clear the disease, symptomatic treatment.
Author: Liu Bing, Department of Gastroenterology, Attending Physician, PLA General Hospital (301 Hospital)
Editor: Chun Yujun