Constantly Feeling Like You Need to Have a Bowel Movement?
Have you ever finished using the bathroom only to feel like you still need to go?
Or maybe you experience a constant sensation of pressure in your rectum, as if there is stool remaining even when there isn’t.
This uncomfortable feeling is known as tenesmus, and it can be frustrating, disruptive, and sometimes even embarrassing to talk about. Many people assume it must be a digestive issue, but what surprises many patients is that the pelvic floor muscles can play a major role in these symptoms.
At Legacy Physical Therapy in St. Louis and Creve Coeur, Missouri, we frequently work with individuals struggling with bowel symptoms, pelvic pain, and pelvic floor dysfunction. For many patients, pelvic floor physical therapy can be an important part of finding relief from tenesmus.
What Is Tenesmus?
Tenesmus is the persistent feeling that you need to have a bowel movement, even when your rectum is empty.
People with tenesmus may experience:
- A constant urge to have a bowel movement
- Feeling like they cannot completely empty their bowels
- Rectal pressure or fullness
- Straining during bowel movements
- Frequent trips to the bathroom with little or no stool passed
- Pelvic discomfort or pain
These symptoms can significantly affect quality of life and may leave people feeling anxious about leaving home or being away from a bathroom.
What Causes Tenesmus?
Tenesmus can be caused by several different conditions, including:
- Inflammatory bowel disease (Crohn’s disease or ulcerative colitis)
- Irritable bowel syndrome (IBS)
- Rectal inflammation or infection
- Hemorrhoids
- Rectal prolapse
- Pelvic organ prolapse
- Previous pelvic surgery
- Chronic constipation
However, one commonly overlooked contributor is pelvic floor dysfunction.
How the Pelvic Floor Can Contribute to Tenesmus
The pelvic floor is a group of muscles that support the bladder, bowel, and reproductive organs.
When functioning normally, these muscles coordinate with the diaphragm, abdominal muscles, and nervous system to allow for comfortable bowel movements.
However, sometimes the pelvic floor muscles become:
- Overactive
- Tight
- Painful
- Uncoordinated
- Unable to relax properly during bowel movements
When this happens, the muscles surrounding the rectum may create sensations that mimic the feeling of needing to pass stool.
In some cases, patients describe:
- Feeling like stool is “stuck”
- A sensation of incomplete emptying
- Constant rectal pressure
- Repeated unsuccessful attempts to have a bowel movement
Even when there is little or no stool present, the nervous system and pelvic floor muscles may continue sending signals that create the urge to go.
Pelvic Floor Dysfunction and Dyssynergic Defecation
One specific pelvic floor condition associated with tenesmus is called dyssynergic defecation.
Normally, the pelvic floor muscles relax during a bowel movement.
With dyssynergic defecation, the muscles may:
- Tighten instead of relax
- Fail to coordinate properly
- Create resistance that makes stool difficult to pass
As a result, individuals often feel like they never completely empty their bowels.
This can lead to:
- Chronic straining
- Constipation
- Bloating
- Rectal discomfort
- Tenesmus
How Pelvic Floor Physical Therapy Can Help
Pelvic floor physical therapy focuses on improving the function and coordination of the muscles involved in bowel movements.
At Legacy Physical Therapy, treatment may include:
Pelvic Floor Muscle Assessment
We evaluate how your pelvic floor muscles are functioning, including their strength, mobility, coordination, and ability to relax.
Down-Training Overactive Muscles
Many people with tenesmus have pelvic floor muscles that are constantly “on.”
Treatment may include techniques to help reduce muscle tension and improve relaxation.
Breathing and Pressure Management
The diaphragm and pelvic floor work together during bowel movements.
Learning proper breathing strategies can help improve pelvic floor function and reduce straining.
Bowel Movement Mechanics
Many people have never been taught the most efficient way to empty their bowels.
We often provide guidance regarding:
- Toilet positioning
- Relaxation strategies
- Proper pushing mechanics
- Bowel habits
Nervous System Regulation
Chronic pelvic symptoms can make the nervous system more sensitive.
Physical therapy may include techniques to help calm the nervous system and reduce the urgency sensations associated with tenesmus.
When Should You Seek Help?
You should always discuss persistent bowel symptoms with your healthcare provider to rule out medical conditions that may require additional treatment.
However, if you’ve been told that everything looks normal and you’re still experiencing:
- A constant urge to have a bowel movement
- Feelings of incomplete emptying
- Rectal pressure
- Chronic constipation
- Straining with bowel movements
- Pelvic pain
A pelvic floor evaluation may be an important next step.
You Don’t Have to Live With Constant Rectal Pressure
Tenesmus can be incredibly frustrating, especially when it feels like no one can explain why it’s happening.
The good news is that pelvic floor dysfunction is often a treatable contributor to these symptoms. By addressing muscle tension, coordination, breathing mechanics, and nervous system involvement, many patients experience significant improvements in comfort and bowel function.
At Legacy Physical Therapy, our team of expert pelvic floor physical therapists helps people throughout St. Louis and Creve Coeur identify the root cause of their symptoms and develop a personalized treatment plan.
If you’re struggling with tenesmus, chronic constipation, or feelings of incomplete bowel emptying, we’d love to help.
Schedule a Free Discovery Visit
Not sure if pelvic floor therapy is right for you?
Schedule a free discovery visit with one of our pelvic floor specialists to discuss your symptoms and learn about your treatment options.
Call Legacy Physical Therapy today at 636-225-3649 or visit LegacyTherapySTL.com to get started.
