Tenezmas: what are they?

An important symptom indicating health problems is tenesmus. They accompany many diseases and require careful diagnostics. Treatment is prescribed depending on the cause of the disorder, so it is very important to make the correct diagnosis.

Tenesmus is a concept that can be translated from Greek as “an ineffective urge.” This symptom may or may not be accompanied by a painful reaction. It is a specific “response” of the bladder or rectum to some irritant and is the result of reflex excitation of motility. [ 1 ]

Epidemiology

Every fourth person on the planet, regardless of age, suffers from tenesmus and discomfort in the pelvic and abdominal area. Many diseases are accompanied by very painful spasmodic attacks that recur 2-3 times a week.

Gastroenterologists and urologists call tenesmus the second most common symptom after abdominal pain. Doctors of other specialties, such as therapists, pediatricians, and surgeons, encounter such painful symptoms every day.

In the vast majority of patients, tenesmus and abdominal pain are the main symptoms of gastroenterological and urological problems. The causes and development of pathology may differ in different situations. At the same time, the main characteristics of tenesmus of different etiologies (localization, period of occurrence, duration, intensity, etc.) are not specific and often have much in common, which can provoke diagnostic inaccuracies and lead to the appointment of incorrect treatment.

Causes tenesmoving

Since rectal and bladder tenesmus are distinguished, the reasons for their formation may be different. Let's consider them separately from each other.

Rectal tenesmus occurs as a result of the following painful conditions:

• Hemorrhoids (dilation of the venous lumen due to varicose veins, inflammatory reaction or thrombosis). Hemorrhoids, in turn, can have a hereditary etiology, or be the result of obesity, lack of physical activity, excessive physical exertion, stress, etc.
• Proctitis (an inflammatory process affecting the rectal mucosa) is associated with frequent constipation, helminthiasis, prostatitis, hemorrhoids, cystitis, etc.
• Sigmoiditis (an isolated inflammatory process in the sigmoid colon) – its appearance is facilitated by ischemic and infectious diseases of the intestine, radiation sickness, granulomatous enteritis and other intestinal lesions.
• Fecal stones (accumulations of dense fecal matter in the lumen of the rectum, which when palpating the abdomen can imitate a tumor process).
• Fistulas (appear as a complication of a chronic inflammatory reaction in the perirectal tissue, anal pockets or in the space between the sphincters).
• Polyps (numerous or single growths on mucous tissues) – appear in areas of inflammation, hyperplasia, etc.
• Adenoma (a benign growth that, under certain circumstances, may have a tendency to become malignant).
• Adenocarcinoma (a malignant disease arising from the cellular structures of the glandular epithelium).
• Stenosis accompanied by narrowing of the rectal lumen due to inflammation, tumors or congenital anatomical abnormalities.
• Periproctitis (purulent inflammatory reaction in the perirectal tissue) is the result of inflammation of the rectum or hemorrhoids.
• Pararectal lymphadenitis (inflammation of the lymph nodes when an infection penetrates them). [ 2 ]

No less common causes of rectal tenesmus are:

• intestinal tuberculosis, enterocolitis, typhoid fever, dysentery, etc.;
• inflammation of the spinal cord, thyrotoxic crisis;
• perineal crisis syndrome;
• proctospasm of unknown etiology.

Tenesmus is also characteristic of irritable bowel syndrome, which is accompanied by autonomic disorders, dysbacteriosis, and nervous disorders. [ 3 ]

Bladder tenesmus develops due to the following reasons:

• Cystitis (an inflammatory reaction associated with the penetration of an infectious agent into the bladder) can occur against the background of a sharp weakening of the immune system, eating disorders, diabetes, etc.
• Prostatitis (inflammation of the prostate) is often associated with physical inactivity, sexually transmitted infections, prolonged abstinence, etc.
• Increased urethral stone formation is caused by metabolic disorders and insufficient intake of vitamins into the body.
• Neurogenic bladder is a disease associated with improper functioning of the central nervous system and the autonomic nervous system.
• Gynecological pathologies (tumor or inflammatory processes of the reproductive organs, endometrioid growths).
• Tumor processes in the pelvis.
• Bone inflammation in the lower segments of the spinal column. [ 4 ]

Risk factors

A number of factors lead to the appearance of tenesmus:

• disorders of the central nervous system and autonomic nervous system;
• severe disruption of the quality of intestinal microflora (dysbacteriosis);
• metabolic disorders;
• inflammatory processes;
• injuries to the abdominal cavity, pelvic area, perineum;
• poor nutrition;
• alcohol abuse, smoking;
• mental disorders;
• physical inactivity, excessive physical overload;
• stress, social-emotional factors.

In this case, the basic global factors are considered to be nutritional disorders, hypothermia, alcohol and tobacco consumption. Such factors, among other things, increase the risk of chronic pathologies. A major role is played by a reduced level of sanitation and hygiene, unsuitable water for drinking, and poor-quality food. [ 5 ]

Pathogenesis

The process of tenesmus development is closely related to spasms and muscle contractions:

• smooth intestinal muscles (primarily the rectum and sigmoid colon are involved);
• smooth muscle fibers of the urinary bladder.

Irritating factors cause increased contractile activity of the abdominal, perineal and pelvic muscles. Due to the simultaneous spasm of one muscle group and the lack of relaxation of another group (as well as the sphincters), the removal of feces or urine is significantly complicated. In some cases, a “pushing out” of a small amount of feces is observed. [ 6 ]

In some patients, tenesmus may cause mucous, purulent or bloody discharge, which is caused by the underlying disease that provoked the appearance of painful symptoms.

During tenesmus, intramuscular tension increases, which is a consequence of the irritating effect:

• on the nerve plexuses of the muscles;
• on the hypogastric nerves and nerve endings of the pelvic plexus.

One of the main factors that can provoke painful contractions is a functional failure in the central nervous system. Such tenesmus is chaotic and ineffective.

Symptoms tenesmoving

Tenesmus is a "deceptive" urge of the body, during which a person expects to perform an act of urination or defecation, but in fact nothing of the sort happens. Only in some cases is a very small amount of feces or mucus excreted. Unpleasant sensations are often accompanied by pain and spasms. However, the condition returns to normal after the tenesmus ends.

The pain is more disturbing in the perianal area. Symptoms may gradually increase and then suddenly stop.

Tenesmus is characterized by:

• spasms and pain in the lower abdomen;
• intense urge to urinate or defecate;
• lack of result from the urge (urine or feces are not excreted at all, or are excreted in extremely small quantities).

The presence of mucous or purulent discharge may be noticed in the urine or feces (not always). Some patients experience the formation of erosions in the anal area.

The first signs are not always the same, they can be subtle or very pronounced. For example, with severe tenesmus, rectal prolapse occurs, and with mild tenesmus, itching in the perianal and vaginal area is possible. [ 7 ]

Intestinal tenesmus

The most common cause of intestinal tenesmus is inflammatory bowel disease. Sometimes these symptoms are observed with prolonged digestive disorders, with accumulation of feces in the intestinal cavity. Often the "culprits" are helminths, as well as the consumption of hard-to-digest and coarse food (especially against the background of overeating).

The affected area of the intestine can be determined by the type of localization of tenesmus:

• navel area – pathology of the small intestine;
• right iliac region – ileitis;
• lower abdominal segment, mainly on the left side – left-sided pathologies of the large intestine;
• right iliac zone and lateral abdominal walls on the right – right-sided pathologies of the large intestine.

Tenesmus may be permanent, but is more often acute and progressive. The latter usually indicates an acute process requiring emergency medical care. Recurring unexpressed (aching) tenesmus is most often caused by chronic intestinal or retroperitoneal pathologies. [ 8 ]

Tenesmus of the rectum

A special type of clinical manifestations are tenesmus, which are often called rectal colic. Such painful symptoms arise against the background of irritation of the rectum and nearby organs. They are manifested by very frequent and unpleasant urges to remove feces, with sensations of convulsive spasm in the rectal and sphincter zone. Defecation does not occur, since the lumen of the rectum is either empty or filled with only a certain amount of inflammatory secretions.

The most severe course of tenesmus is observed in the acute form of dysentery, when the inflammatory reaction descends into the lower parts of the intestine. Similar symptoms are also observed in other inflammations or ulcerative processes in the rectum.

Tenesmus in hemorrhoids

Tenesmus has different diagnostic value, which depends on the moment of its appearance. Thus, the onset of painful urges before defecation indicates damage to the descending colon or sigmoid colon.

Pulling sensations during defecation when passing feces, as well as subsequent "empty" tenesmus, suggest the presence of a pathological process directly in the rectum. This sometimes happens in patients with hemorrhoids, anal fissures, etc.

Hemorrhoids are a common cause of rectal pain. Moreover, the symptoms largely depend on where exactly the pathological process is localized. Internal damage can occur on the inner surface of the rectum, but can also spread further as the disease worsens. [ 9 ]

Hemorrhoids cause various symptoms, ranging from mild discomfort to severe painful tenesmus and thrombosis. Sharp or pulsating pain appears, which can last for several days. Tenesmus is mainly accompanied by difficulties with the removal of feces, the appearance of perianal edema, and lumps in the anal area.

The pain during tenesmus is usually sudden and severe, lasting less than a minute (sometimes longer). This symptom is caused by muscle spasm in the rectal muscles. [ 10 ]

Mucus in tenesmus

The release of mucus instead of feces during tenesmus usually indicates the presence of an inflammatory process in the small or large intestine. Clots or streaks of blood, pieces of feces may come out along with the mucus.

A patient with such symptoms should undergo a full course of diagnostics, since there are quite a lot of diseases accompanied by this painful symptom.

Treatment is prescribed depending on the pathology identified. As a rule, its main points are:

• normalization of intestinal motility and formation of feces;
• restoration of adequate digestive processes and absorption of nutrients;
• eradication of adverse effects of impaired intestinal function;
• prevention of recurrence of tenesmus and the underlying disease.

The discharge of mucus and other pathological discharges in combination with tenesmus is a sign that cannot be ignored. It is necessary to contact a doctor, without wasting precious time on attempts at self-medication.

Blood in tenesmus

Bloody discharge during tenesmus is often caused by hemorrhoids, rectal fissures, ulcerative processes in the intestinal wall - for example, with a duodenal ulcer or ulcerative enterocolitis. Often this symptom occurs against the background of varicose veins of the rectum.

The most common cause is hemorrhoids in patients with long-standing hemorrhoids, or anal fissures.

If there is intestinal bleeding, then bloody stools are usually observed.

If feces are dark (almost black) in color, this means that there is bleeding in the upper intestinal sections. The release of scarlet blood during tenesmus indicates damage to the lower intestinal segment.

In case of heavy or prolonged bleeding, the following signs are detected:

• headache, dizziness;
• noise in the head, in the ears;
• feeling of fatigue, weakness;
• pale skin, dark circles under the eyes;
• weakness of cardiac function;
• less often – impaired consciousness, even fainting.

If there are signs of intestinal bleeding, it is necessary to seek medical help. In case of large blood loss, the patient must be hospitalized.

Diarrhea with tenesmus

It is considered normal if a person defecates 1-2 times a day. If trips to the toilet occur more often - more than 4 times a day - and the feces have a liquid consistency, then they talk about the development of diarrhea, or loose stools. Such a pathological condition, combined with tenesmus, indicates accelerated intestinal motility and increased passage of food and fecal matter through the intestines.

The appearance of diarrhea is always associated with disturbances in the motor and secretory functions of the large intestine. If everything is normal in this section of the digestive tract, then there should be no diarrhea. As disturbances develop, motility increases, feces become liquefied and begin to move quickly through the large intestine. [ 11 ]

In this case, intestinal secretion increases and its absorption capacity decreases. Diarrhea can be accompanied not only by tenesmus, but also by flatulence, "rumbling" sounds and abdominal pain. First of all, the disease should be distinguished from poisoning or intestinal infection.

Painful tenesmus

If tenesmus is not accompanied by pain, then they simply speak of "empty" urges. But quite often urges appear simultaneously with painful sensations, sometimes very strong. Such a symptom complex in many cases is a sign of pathology of the colon, rectum or sigmoid colon - for example, we can talk about inflammatory processes, neoplasms, polyps, etc. In addition, patients are often diagnosed with:

• proctitis and paraproctitis;
• Crohn's disease;
• haemorrhoids;
• infectious processes ( salmonellosis, dysentery, etc.);
• irritable bowel syndrome.

In some situations, false tenesmus is neurogenic in nature and is a separate manifestation of neuroses and other similar conditions. In rare cases, it becomes a sign of CNS diseases.

Tenesmus of the bladder

The signs and manifestations of bladder tenesmus may vary in each patient. The characteristics change during the course of the pathology - for example, they increase with PMS in women, appear during stress or sexual intercourse.

Additional signs of bladder tenesmus often include the following:

• pain in the pelvic area, or between the anus and vagina in women and between the anus and scrotum in men;
• frequent urination in extremely small amounts;
• a feeling of distension in the pelvic area;
• anxiety, irritability.

Such painful sensations always indicate a serious health problem. It is important to consult a doctor in a timely manner for diagnosis and prescription of complex treatment. It may take some time before the doctor selects an individual effective therapy. It is possible to prescribe physiotherapy, which helps reduce the frequency and intensity of attacks if they are caused by spasm of the pelvic floor muscles. One of the options for such treatment is the Urostim device, which is a biofeedback device with electrical stimulation of the pelvic floor muscles. [ 12 ]

Tenesmus in children

Tenesmus in infants may occur due to developmental defects, such as narrowing or lengthening of a segment of the intestine. Such defects are often caused by:

• Down syndrome;
• polyhydramnios in a woman during pregnancy;
• diabetes in women.

Frequent tenesmus causes pain in the child, so he cries, shows great anxiety, strains unsuccessfully, and fidgets.

In older children, tenesmus is caused by inflammatory and infectious processes in the body, dysbacteriosis, and psychoemotional disorders. When making a diagnosis, the doctor must exclude polyposis, diverticulosis, intestinal and parasitic infections, Crohn's disease, tuberculosis, and dolichosigma. In some cases, painful attacks occur with neuroendocrine tumors, thyrotoxicosis, and diabetes mellitus with autonomous diabetic enteropathy.

Against the background of tenesmus, children often experience symptoms such as intense abdominal pain, rectal bleeding, lactose, gluten and fructose intolerance, and fever. If these symptoms appear, a visit to a doctor should be mandatory and immediate.

Forms

Tenesmus is divided into two categories depending on its location:

• bladder;
• intestinal.
• There is also a clinical classification according to the variants of the course of tenesmus:
• with bloating and abdominal pain;
• with frequent loose stools;
• with constipation.

This division is conditional, since many patients have a combination of painful symptoms, or their transformation from one form to another (for example, the absence of defecation is replaced by diarrhea, or vice versa).

Complications and consequences

Lack of medical care or incorrectly prescribed therapy are the factors that can lead to complications such as:

• anal or vulvar varicose veins;
• rectal fissures;
• intestinal obstruction;
• impaired absorption and assimilation of food (as a result - anemia, hypovitaminosis, metabolic disorders);
• pathologies of the upper digestive system (for example, gastroduodenitis).

Attempts at self-medication for tenesmus – in particular, taking painkillers – can lead to various complications, including those that pose a danger to the patient’s life. At the same time, attempts to “endure” the painful condition without therapy contribute to the chronic transformation of the existing pathology, the development of severe forms of the disease, and a deterioration in the quality of life. Therefore, if you care about your health, when suspicious painful symptoms appear, you need to contact a doctor without delay, preferably at the initial stage of the pathology.

Diagnostics tenesmoving

To determine the cause of the unpleasant symptoms, you must first make a diagnosis - that is, find the disease that provoked the tenesmus.

Laboratory tests include the following analyses:

• general clinical blood test – shows inflammatory changes, presence of anemia;
• blood biochemistry – allows you to evaluate the function of internal organs, helps to determine the presence of an inflammatory process and metabolic disorders;
• coprogram (microscopic examination of feces) – allows to identify failures in the food digestion mechanism;
• stool test for occult blood – helps detect hidden bleeding in the intestines;
• fecal culture in cases of suspected acute infectious intestinal lesions. [ 13 ]

Instrumental diagnostics are also mandatory and include the following studies:

• Irrigoscopy is one of the many options for X-ray diagnostics. The examination process is as follows: through the anus into the rectal cavity, a contrast agent is introduced - a special substance that has the ability to be clearly visualized on the monitor of an X-ray device. The procedure allows you to consider the presence of an inflammatory reaction, tumor processes and other factors causing tenesmus in a patient.
• Colonoscopy is one of the basic types of diagnostics of intestinal pathologies. It helps to visually assess the condition of the intestinal mucosa, since a special camera is used for diagnostics. During the procedure, it is possible to perform a biopsy - removal of a tissue particle for further laboratory testing. This point is very important if there is a suspicion of benign or malignant tumor processes.
• Magnetic resonance imaging and computed tomography are considered additional methods for establishing and refining the diagnosis. These diagnostic procedures allow for a step-by-step examination of the necessary structures, determining the depth, extent and exact location of the disease process. [ 14 ]

Differential diagnosis

Differential diagnostics are carried out with tumor processes, acute intestinal infections, inflammatory diseases of the urological or digestive tract. In patients, it is necessary to exclude diverticulosis, colorectal cancer, ischemic colitis, polyposis and other organic lesions. [ 15 ]

Treatment tenesmoving

The treatment plan for the disease that caused the tenesmus is developed by the attending physician after the final diagnosis has been made. Timely initiation of treatment is important, as this will prevent the development of complications and speed up healing.

In almost all cases of bladder and digestive tract diseases, the doctor prescribes a diet. If tenesmus accompanies an acute form of pathology, then for some time nutritional components can be administered parenterally, bypassing the digestive tract. Gradually, the patient is returned to normal food intake, with the exclusion from the diet of foods that can provoke a relapse of the disease. [ 16 ]

Treatment of the underlying disease can be carried out in stages. For example, in acute gastroenteritis, excretory function is first normalized, then antibiotics are prescribed, and after them - drugs that restore the composition of intestinal microflora, regenerate mucous tissues, and improve metabolism in the body.

The duration of treatment may vary. While some pathologies can be cured in 1-2 weeks, others may require longer therapy. And chronic pathologies may "stay" with the patient for life.

In some cases, including urgent acute conditions, as well as when drug treatment is ineffective and the disease progresses further, surgical care is indicated. Interventions can be abdominal or minimally invasive (laparoscopic), depending on the extent of the pathology. [ 17 ]

Medicines

Symptomatic treatment is aimed directly at relieving the patient of painful attacks - tenesmus. As a rule, the doctor prescribes antispasmodics - medications that eliminate spasms of the smooth muscles of the intestine, which leads to relief of pain and restoration of intestinal motility.

The most frequently prescribed drugs from this group are:

Drotaverine (No-shpa)	It is effective in tenesmus of muscular and nervous origin. It acts on the smooth muscles of the digestive, biliary, and genitourinary systems. The average daily dosage for adults is 3-6 tablets (in 2-3 doses). The duration of therapy is determined individually.
Peppermint tablets	A drug with moderate antispasmodic, sedative, choleretic action. Take 1-2 tablets sublingually (for adults - up to 10 tablets per day). The duration of treatment may vary, depending on the effectiveness of the drug.
Papaverine	Myotropic, antispasmodic and hypotensive drug that reduces the contractile activity of smooth muscles. Effective in cholecystitis, pylorospasm, spastic colitis, renal colic, etc. Can be prescribed in the form of tablets or intramuscular injections, at the discretion of the doctor.
Mebeverine	An antispasmodic drug with myotropic action. Directly affects the smooth muscles of the digestive tract without affecting normal intestinal motility. Particularly effective for tenesmus caused by irritable bowel syndrome. The standard dosage of the drug is 200 mg twice a day, with water. The course of treatment is continued until a stable improvement in the condition.

Antispasmodics, which directly affect the smooth muscles of the digestive and genitourinary systems, "force" them to relax, which simultaneously affects the disappearance of tenesmus and spasms. Most of these drugs are available in pharmacies without a prescription, but they should not be taken without a doctor's recommendation.

Some antispasmodics may also contain substances that increase the volume of stool. If you plan to take these medications, you must ensure that you have sufficient fluid in your digestive system. Otherwise, the risk of intestinal obstruction increases. [ 18 ]

As for peppermint-based preparations, they are believed to reduce the penetration of calcium into muscles, which leads to their relaxation. However, one should not expect instant action from mint: the remedy acts softly and gradually. However, in case of severe lesions and acute conditions, mint preparations may not be enough. They are usually used in mild cases.

Side effects of antispasmodics often include headaches, constipation, thirst, and transient visual impairment. Most often, such undesirable symptoms appear in case of overdose, as well as in children and the elderly.

In addition to antispasmodics, the doctor may prescribe the following medications:

• antidiarrheal drugs (Loperamide) help with frequent loose stools;
• laxatives are used for constipation (Metamucil, methylcellulose, calcium polycarbophil);
• tricyclic antidepressants (Amitriptyline, Desipramine, Nortriptyline) are prescribed for severe pain, as these drugs inhibit the transmission of pain signals between the brain and the intestines;
• sedatives (Diazepam, Lorazepam, etc.) help eliminate anxiety, which can increase the symptoms of tenesmus;
• Antibiotics are prescribed for intestinal and urological infections;
• Probiotics are used to restore normal microflora. [ 19 ]

Allohol for intestinal tenesmus

Allochol is a combined choleretic agent, which contains natural components such as garlic, nettle, dry bile and activated carbon. The action of the drug is based on the properties of its composition:

• garlic improves intestinal peristalsis, suppresses fermentation reactions, eliminates flatulence and inhibits the development of pathogenic flora;
• nettle has choleretic, hemostatic and anti-inflammatory properties, activates digestive processes, improves renal function;
• dry bile stimulates the enzymatic activity of the pancreas and intestines, emulsifies fats and improves their digestion, improves motility, and inhibits putrefactive reactions;
• Activated carbon is a well-known adsorbent with antidiarrheal and detoxifying properties.

In general, Allochol has the following effect:

• increases bile secretion by stimulating the secretory activity of the liver parenchyma;
• stimulates receptors of the small intestinal mucosa;
• increases the osmotic gradient between blood and bile, which explains the osmotic filtration of moisture and electrolytes into the bile system;
• increases bile flow, preventing the ascending movement of infection;
• prevents the precipitation of bile cholesterol.

In addition, Allochol activates bile secretion, improves gallbladder tone, and optimizes the production of cholecystokinin.

However, Allochol should not be used in case of exacerbation of cholecystitis: in such situations, antibiotic therapy is indicated, and antispasmodics are prescribed for pain and tenesmus.

For tenesmus of intestinal or bladder origin, the drug is taken 1-2 tablets up to 3-4 times a day after meals for a month. Then switch to a regimen of 1 tablet 2-3 times a day for 4-6 weeks. A positive result from treatment is usually detected within a week after the start of treatment.

Since the drug contains bile acids and has a choleretic effect, it can be used if tenesmus is associated with constipation or pancreatitis.

During treatment with Allochol, one must not forget about the need to normalize nutrition: the patient is prescribed a diet and an individual meal plan is determined.

Herbal treatment

Medicinal plants for the digestive tract and bladder can significantly relieve pain and tenesmus in the case of many diseases, and also serve as a preventative measure for such pathologies as ulcers, enterocolitis, cystitis, etc.

It is important to understand that the positive effect of herbal treatment is observed only with the correct prescription of certain herbal preparations, which are taken only under the supervision of a doctor.

The simplest recipes for decoctions or infusions are considered the most popular, as they are accessible and easy to prepare. As a rule, decoctions are made from the bark and rhizomes of plants, and infusions are made from inflorescences, foliage and soft shoots.

To prepare the infusion, collect the necessary proportions of plants and boiling water in advance. The raw materials are poured with water and kept under the lid for about 45-60 minutes. Then the product is filtered and taken according to the recipe.

The decoction takes longer to prepare: the raw material is poured with hot water and kept on low heat for 10-20 minutes, then removed from heat and infused for another 10 minutes.

The proportions below are given as 1 tbsp of herbal mixture per 200 ml of boiling water.

For tenesmus, you can use the following herbal mixtures:

• Calamus root, bogbean, wormwood, caraway seeds (in equal parts). Take 1 tbsp of infusion half an hour before meals.
• Dandelion root, wormwood, yarrow herb (20:60:20). Take 1 tbsp of infusion 15-20 minutes before meals.
• Heather, St. John's wort, centaury, buckthorn bark, mint leaves (25:25:20:15:15). The infusion is taken 50 ml up to 4 times a day between meals.
• Centaury, mint leaves (20:80). Take the infusion 100-150 ml of trida per day half an hour before meals.
• St. John's wort, centaury herb, mint leaves, chamomile flowers, immortelle (in equal parts). The infusion is taken 50 ml up to 4 times a day between meals.
• Leaves of bogbean, St. John's wort, mint leaves, yarrow, dill seeds (25:30:15:15:15). Prepare an infusion, which is taken 50 ml 4 times a day.

If after taking a herbal remedy the condition does not improve or even worsens, you should definitely consult a doctor.

Prevention

Prevention of tenesmus, as clinical manifestations of digestive or bladder pathologies, consists of preventing the influence of negative factors and background diseases. Preventive methods consist of the following steps:

• eradication of bad habits;
• regular physical activity;
• creating a balanced work and rest schedule;
• complete and high-quality nutrition;
• control of your own weight, prevention of obesity;
• annual preventive examinations.

The quality of nutrition is of great importance in the prevention of tenesmus. Nutritionists advise following the following dietary rules:

• reduce, or better yet, eliminate, the consumption of alcoholic beverages (it is permissible to drink no more than 150 ml of light alcohol per week to prevent damage to the mucous membrane of internal organs);
• avoid drinking carbonated drinks;
• forget about snacking on the run and dry food, chew your food well;
• minimize the amount of fried foods in your diet, as well as smoked foods, pickles, marinades, and preservatives;
• carefully read the composition of dishes and products, avoid foods with chemical dyes, preservatives, synthetic flavors and aromatic additives;
• eat more plant foods, whole grains;
• cook food using vegetable oils rather than animal oils;
• avoid eating foods that are too hot or too cold (optimally warm foods, with a temperature of about 40°C);
• establish a drinking regimen, consuming about 1.5 liters of clean water daily;
• do not overeat, eat little by little every 2-3 hours;
• try to eat at the same time every day;
• treat dental and gum diseases in a timely manner.

There is no need to treat nutrition with disdain: quality products and adherence to a dietary regimen are a kind of preventive basis for a person’s digestive and urological health.

Stress has a significant impact on the functionality of the gastrointestinal tract and bladder. Therefore, it is important to learn to avoid conflicts, or, as they say, "save your nerves." Sometimes meditation practices, autogenic training, and psychotherapist consultations come to the rescue. The following methods also increase stress resistance:

• high-quality nutrition with sufficient intake of vitamin D;
• ultraviolet and air baths;
• physical activity, swimming, aerobics, pilates;
• training in psychology, acquisition of self-analysis skills.

In addition, it is important to consider that the overwhelming majority of medications have side effects. Therefore, it is not recommended to practice self-medication, as well as independently adjust and extend the doctor's prescriptions.

For example, one of the factors causing tenesmus – dysbacteriosis – is the result of uncontrolled antibiotic therapy, taking laxatives or enterosorbent drugs. And non-steroidal anti-inflammatory drugs (in particular, acetylsalicylic acid) have a negative effect on the mucous membrane of the digestive tract.

Taking care of your own health and following simple recommendations will help prevent the occurrence of tenesmus, as well as other serious pathologies.

Forecast

Depending on the underlying pathology, tenesmus often takes on a complicated course, which negatively affects the duration of the disease and significantly worsens the prognosis, increasing the risk of developing adverse effects. The likelihood of complications is increased among patients who receive inadequate and ineffective initial treatment, or who do not receive therapy at all. [ 20 ]

The basic mechanism for preventing complicated course of the disease, in which tenesmus is observed, is considered to be the use of a comprehensive therapeutic approach. Treatment should include the use of enterosorbents, rehydration preparations, probiotics, and, if indicated, antibiotics or antiviral medications. If there is no effectiveness, the treatment regimen is urgently reviewed and adjusted, constantly monitoring the patient's condition in hospital.