It can be frustrating — and sometimes concerning — to finish a bowel movement but still feel like you need to go again. This sensation is known as tenesmus, a feeling of incomplete evacuation or persistent rectal pressure even after using the bathroom.
While occasional incomplete evacuation may happen from constipation or dietary changes, ongoing symptoms can sometimes point to underlying colorectal conditions that should be evaluated by a specialist (Mayo Clinic, 2024).
At Colorectal Clinic of Tampa Bay, patients are evaluated for a wide range of colorectal symptoms, including persistent pressure, incomplete bowel movements, rectal discomfort, and chronic constipation.
What Is Tenesmus?
Tenesmus is the persistent urge to have a bowel movement even when the rectum is empty. People often describe it as:
Feeling like stool is still “stuck”
Ongoing rectal pressure
Straining without relief
Frequent urges to go
Incomplete emptying after bowel movements
Tenesmus itself is not a disease — it is a symptom that may occur with several colorectal or pelvic floor conditions (Cleveland Clinic, 2023).
Common Causes of Incomplete Evacuation
Constipation
One of the most common causes is chronic constipation. Hard stool may remain in the rectum, creating the sensation that the bowel movement is unfinished (National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK], 2023).
Constipation may be related to:
Low fiber intake
Dehydration
Medications
Pelvic floor dysfunction
Slow colon transit
Pelvic Floor Dysfunction
Sometimes the muscles responsible for bowel movements do not coordinate properly. This condition, known as pelvic floor dyssynergia, can make it difficult to fully empty the rectum (Rao & Patcharatrakul, 2016).
Patients may feel:
Excessive straining
Rectal pressure
The need to return to the bathroom shortly afterward
Hemorrhoids or Rectal Inflammation
Internal hemorrhoids, inflammation, or irritation of the rectal lining may also create feelings of fullness or incomplete evacuation (Cleveland Clinic, 2023).
Irritable Bowel Syndrome (IBS)
IBS — particularly IBS with constipation — may cause altered bowel habits, bloating, and sensations of incomplete emptying (American College of Gastroenterology, 2021).
More Serious Causes
Less commonly, persistent tenesmus may be associated with:
Rectal prolapse
Inflammatory bowel disease (IBD)
Rectal masses or tumors
Colon or rectal cancer
This is why ongoing symptoms should not be ignored, especially if they occur alongside bleeding, unexplained weight loss, or major changes in bowel habits (American Cancer Society, 2024).
When Should You See a Specialist?
You should consider seeing a colorectal specialist if symptoms:
Persist for several weeks
Interfere with daily life
Occur with rectal bleeding
Include abdominal pain or bloating
Cause significant straining
Are associated with unexplained weight loss
At Colorectal Clinic of Tampa Bay, evaluation may include a physical exam, colonoscopy, imaging, or pelvic floor testing depending on symptoms and medical history.
How Is Tenesmus Treated?
Treatment depends on the underlying cause.
Management may include:
Dietary and fiber adjustments
Hydration support
Pelvic floor physical therapy
Hemorrhoid treatment
IBS management
Colonoscopy or further diagnostic evaluation when needed
Addressing the underlying condition is the key to improving symptoms.
Feeling like you still need to poop after a bowel movement can be uncomfortable and frustrating, but it is also a symptom worth paying attention to.
Occasional incomplete evacuation may be harmless, but persistent tenesmus can sometimes signal constipation, pelvic floor dysfunction, hemorrhoids, IBS, or more serious colorectal conditions.
If symptoms continue or worsen, evaluation by a colorectal specialist can help identify the cause and guide appropriate treatment.
Works Cited
American Cancer Society. (2024). Colorectal cancer signs and symptoms. https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/signs-and-symptoms.html
American College of Gastroenterology. (2021). Irritable bowel syndrome guidelines. https://gi.org/topics/irritable-bowel-syndrome/
Cleveland Clinic. (2023). Tenesmus. https://my.clevelandclinic.org/health/symptoms/24107-tenesmus
Mayo Clinic. (2024). Constipation. https://www.mayoclinic.org/diseases-conditions/constipation/symptoms-causes/syc-20354253
National Institute of Diabetes and Digestive and Kidney Diseases. (2023). Symptoms and causes of constipation. https://www.niddk.nih.gov/health-information/digestive-diseases/constipation/symptoms-causes
Rao, S. S. C., & Patcharatrakul, T. (2016). Diagnosis and treatment of dyssynergic defecation. Journal of Neurogastroenterology and Motility, 22(3), 423–435. https://doi.org/10.5056/jnm16060