Tenesmus is intense desire or feeling to defecate, even with an empty rectum.
If a patient gives history of rectal bleeding, and mucus discharge, it's likely to be an inflammatory process, i.e proctitis.
If a patient gives history of rectal bleeding, with the blood on stool surface, rather than mixed with it, a rectal tumour should be suspected.
If tenesmus is associated with change in bowel habit, usually alternating, a tumour of the descending colon is a possibility.
If the patient is a woman, and there is lower abdominal pain, dysuria, vaginal discharge, and fever, then pelvic inflammatory disease is likely.
If none of the above scenarios exist, and a patient gives history of abdominal pain that is relieved by bowel motion, then further history addressing irritable bowel syndrome should be taken.
If a patient gives history of rectal bleeding, and mucus discharge, it's likely to be an inflammatory process, i.e proctitis.
If a patient gives history of rectal bleeding, with the blood on stool surface, rather than mixed with it, a rectal tumour should be suspected.
If tenesmus is associated with change in bowel habit, usually alternating, a tumour of the descending colon is a possibility.
If the patient is a woman, and there is lower abdominal pain, dysuria, vaginal discharge, and fever, then pelvic inflammatory disease is likely.
If none of the above scenarios exist, and a patient gives history of abdominal pain that is relieved by bowel motion, then further history addressing irritable bowel syndrome should be taken.
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