TENESMUS (Greek teinesmos, from teino to pull, strain) — a painful desire on defecation of a pla an urination without allocation of a pla with allocation of a small amount a calla or urine. Now in relation to an urination this term is practically not used.
Reason of T. hypersensitivity of a rectum to internal pressure is owing to what receipt even of insignificant quantity of contents (a calla, slime, blood) in a gut causes the speeded-up desires on defecation (see). The expressed spastic reductions of unstriated muscles of direct and sigmoid guts, and also cross-striped muscles of a bottom of a basin, a crotch, a prelum abdominale do these desires painful. Lack of the accompanying relaxation of proctal sphincters complicates rectum emptying or leads to tolchkoobrazny ejection of small portions of intestinal contents. The mechanism of painful desires is similar on urination (see). Increase in a tone of muscles of direct and sigmoid guts, bladder, etc. depends on irritation of the autonomous neuroplexes which are in their wall, irritations of c. N of page, and also from reflex influence from the next bodies.
T. are characteristic of inflammatory diseases and tumors of distal departments of a large intestine. They meet at all forms of dysentery, inf. colitis of other etiology, it is very frequent at nespetspfichesky ulcer colitis, at proctites, sigmoidites of any etiology, at patients with hemorrhoids, polyps, cracks, fistulas, rectostenoses, at invagination of a large intestine or ileocecal department of intestines, at a trichuriasis (at children), diseases of a bladder and. an urethra (cystitis, uretrita, an urolithiasis, tumors), at ginekol. pathologies.
Quite often T. are followed by loss of a mucous membrane of a rectum, an itch in the field of an anal orifice, a delay a calla.
T. differentiate with various pain in a rectum and a tailbone. At a proctalgia (see. Rectum ) rectum pains are not connected with desires on defecation and usually arise in the form of attacks, most often at night. At the coccyalgia (see) meeting more often at women, pains are localized in the field of a tailbone, are also not connected with the act of defecation, amplify in a sitting position, sometimes are followed by the next muscle pains, a hip joint. At a proctospasm patients sometimes feel feeling of compression in the field of proctal sphincters or feel the pains irradiating in a waist or in a hip, which are not followed by desires on defecation; at a rectal research (see) the palpating finger or rektoskop encounters considerable resistance. The hyperesthesia and paresthesias in a rectum meet at back to tabes (see).
Treatment is directed to a basic disease. As a symptomatic treatment use microclysters with antispasmodics.
Bibliography: Levitan M. H., Fedorov V. D. and To and p at l of l of e r L. L. Nonspecific colitis, M., 1980; Cancer of a rectum, under the editorship of V. D. Fedorov, M., 1979.
A. V. Frolkis.