Word for the Day: Tenesmus

Today, ladies and gents, I thought we'd expand your vocabulary by introducing you to a word I'd never heard before developing ulcerative colitis: tenesmus.  No, I'm not talking about that disease you can get if you step on a rusty nail (that's tetanus), nor am I referring to something related to my favorite racquet sport, tennis.  Tenesmus is defined by Merriam-Webster as "a distressing but ineffectual urge to evacuate the rectum or bladder."

That's all well and good, but I can tell you, friends, that when the rubber hits the road, the neutral language of a dictionary definition cannot begin to explain the frustration caused by the condition known as tenesmus.  All y'all who have healthy poopers take something very important for granted: the ability to judge when you need to have a bowel movement.  I bet it has never even occurred to you to second-guess your body when it tells you, "Hey!  I think I need to poop.  And it would be a good idea if you could get to a bathroom so I can do that soon.  Thanks!" 

But the most persistent and distressing effect of having an inflammatory bowel disease is the inability to trust your body's impulses on this front.  On one hand, I can be cruising along, having a terrific day, when all of a sudden (and I do mean "sudden") I feel a little cramp in my belly that tells me it's time to get to a bathroom, and I mean NOW.  Depending on the situation, I may have 15 seconds to get to the bathroom, or, if I'm really lucky, I can wait 15 minutes.  For grins, how about the next time you become even remotely aware that you have to go to the bathroom, you set the timer on your watch to see how long it takes to become an urgent need.  I will bet you real money that it's A LOT longer than 15 minutes.  In fact, I bet it takes longer than 15 minutes for you to even become aware of the need in the first place.  But I digress....

After dealing with this urgency symptom for a while, I started to notice something a little different going on: I would feel the urge, race to the bathroom, and then.....nothing.  Or maybe pass just a little bit of stool and some gas.  But not anything close to the poop-storm that it felt like was brewing, due to the urgency feeling.  So I'd sit on the toilet, straining, for a few minutes, and still....nothing.  Afraid to leave the bathroom, due to past experiences with walking away from the toilet only to run right back again, I would stay in the bathroom for extended periods but never seem to "produce."

Finally, I asked my doc, "What gives?"  "Tenesmus," he said.  "What we have here is a rectum that can no longer properly detect the urgency of need of removal.  The inflammation has become so intractable that when any bit of matter reaches the rectum, it sends a signal that the load is too much and must be evacuated immediately.  It's called tenesmus."

Great.  So it has a name, but what do we do about it?  "Not much you can do about it, except get the inflammation down in general and hope that the rectum recovers once you achieve remission."  Because the rectum is pretty much the last stop of your digestive tract, sometimes you can treat it with topical medications to help with the inflammation.  This is where you get into the territory of the most glamorous of UC treatments, the enema and the suppository.  As you can imagine, it can be much more effective to treat this area via the anus rather than sending an oral medication all the way through your digestive tract and hope that it is still viable once it reaches the end of the line.

You may have already noticed, intrepid reader, that one of the most frustrating things about having UC is that my symptoms are a moving target.  No two days are ever alike, and things always seem to be in a state of flux, depending on who knows what variables.  So, fortunately, I don't always have to deal with tenesmus, but it's what I've got going on in spades right now.  I am spending a lot of quality time with my toilet, kinda just waiting for things to happen.  It's not like constipation, because I don't feel any kind of bloating or discomfort in my belly, just this kind of spastic feeling in my rectum. 

But the other thing is, I am spending even more time trying to second guess that urgency feeling.  Because it happens so frequently, and so often going to the bathroom is so ineffective, I have taken to trying to judge whether my rectum is just freaking out or whether this time is the real deal.  And as you can imagine, I don't always guess correctly.  You know what this is like, if you can remember back to when you were very young and trying to learn how urgent nature's call really was.  As a 4 or 5 year old, everyone understands if you haven't quite mastered this skill and end up soiling your underroos at pre-school.  Once you're 8 or 9, having an accident while sleeping over at a friend's house could ruin your social life for years.  And here I am, staring down my 42nd birthday, and having the same issues. God, I hate this disease.

So there you go, gang.  Tenesmus.  Now that you know it, try to using it in a sentence just once today.  Something like, "Thank God I've never known what it is to have chronic tenesmus," would be a good start.