直腸しぶり

WordNet

painful spasm of the anal sphincter along with an urgent desire to defecate without the significant production of feces; associated with irritable bowel syndrome
of or involving the rectum; "rectal cancer"

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直腸(rectum)の

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/05/18 10:41:22」(JST)

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Rectal tenesmus (Latin, from Greek teinesmos, from teinein to stretch, strain) is a feeling of incomplete defecation. It is the sensation of inability or difficulty to empty the bowel at defecation, even if the bowel contents have already been excreted. Tenesmus indicates the feeling of a residue, and is not always correlated with the actual presence of residual fecal matter in the rectum. It is frequently painful and may be accompanied by involuntary straining and other gastrointestinal symptoms. Tenesmus has both a nociceptive and a neuropathic component, and is usually accompanied by intense patient anxiety.

Vesical tenesmus is a similar condition, experienced as a feeling of incomplete voiding despite the bladder being empty.

Often, rectal tenesmus is simply called tenesmus. The term rectal tenesmus is a retronym to distinguish defecation-related tenesmus from vesical tenesmus.^[1]

Tenesmus is a closely related topic to obstructed defecation.

Considerations

Tenesmus is characterized by a sensation of needing to pass stool, accompanied by pain, cramping, and straining. Despite straining, little stool is passed.^[2] Tenesmus is generally associated with inflammatory diseases of the bowel, which may be caused by either infectious or noninfectious conditions. Conditions associated with tenesmus include:

Irritable bowel syndrome
Diverticular disease
Cytomegalovirus (in immunocompromised patients)
Inflammatory bowel disease
Coeliac disease
Pelvic floor dysfunction
Prolapsed hemorrhoid
Radiation proctitis
Rectal gonorrhoea
Rectal lymphogranuloma venereum
Ulcerative colitis
Chronic arsenic poisoning
Colorectal cancer
- Anal melanoma^[3]
Rectal lower gastrointestinal parasitic infection, particularly Trichuris trichiura (whipworm)
Shigellosis
Amebiasis
Kidney stones, when a stone is lodged in the lower ureter ^[4]
Ischemic colitis

Tenesmus (rectal) is also associated with the installation of either a reversible or non reversible stoma where rectal disease may or may not be present. Patients who experience tenesmus as a result of stoma installation can experience the symptoms of tenesmus for the duration of the stoma presence. Long term pain management may need to be considered as a result.

Treatment

Pain relief is administered concomitantly to the treatment of the primary disease causing tenesmus. Methadone has been shown to be an effective pain-reliever.^[5]

References

^ "Wrong Diagnosis". Retrieved 2007-07-09.
^ Sanchiz Soler, V; MÍnguez Pérez, M; Herreros Martínez, B; Benages Martínez, A (August 2000). "Protocolo de actuación ante la disquecia o el tenesmo". Medicine 8 (7): 367–9. doi:10.1016/s0304-5412(00)70072-2. Cite uses deprecated parameter |coauthors= (help)
^ Bejarano-García, A.; C. Núñez-Sousa; V. Aviñó-Tarazona; R. González-Gutiérrez (24 February 2011). "NEOPLASIA ANAL EN PACIENTE CON TENESMO". Revista de la Sociedad Andaluza de Patología Digestiva 34 (1).
^ Nephrolithiasis: Acute Renal Colic, Stephen W Leslie. eMedicine.
^ SÁNCHEZ POSADA, R.; P. VARILLAS LÓPEZ; C. CENTENO CORTÉS (2004). "Metadona como opioide inicial en pacientes con tenesmo rectal" (PDF). MED PAL 11 (4): 201–204. Retrieved 21 May 2012.

External links

-181075954 at GPnotebook
MedlinePlus Encyclopedia 003131

UpToDate Contents

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1. 一過性直腸痛 proctalgia fugax
2. 大腸癌の臨床症状、診断、および病期分類 clinical presentation diagnosis and staging of colorectal cancer
3. 孤立性直腸潰瘍症候群 solitary rectal ulcer syndrome
4. 大腸癌長期生存患者へのアプローチ approach to the long term survivor of colorectal cancer
5. 放射線性直腸炎の臨床的特徴、診断、および治療 clinical features diagnosis and treatment of radiation proctitis

English Journal

Orphan symptoms in advanced cancer patients followed at home.

Mercadante S, Porzio G, Valle A, Fusco F, Aielli F, Adile C, Casuccio A; On behalf of “Home Care Italy” group (HOCAI group).SourcePain Relief and Palliative Care Unit, La Maddalena Cancer Center, Via San Lorenzo 312, 90146, Palermo, Italy, terapiadeldolore@lamaddalenanet.it.
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer.Support Care Cancer.2013 Oct 13. [Epub ahead of print]
Orphan symptoms are rarely assessed, particularly at home. The aim of this multicenter prospective study was to assess the prevalence of these symptoms and eventual factors possibly associated in advanced cancer patients at admission of a home care program. A prospective study was performed at three
PMID 24122405

Retrieval of a migrated Axialif lumbosacral screw using fluoroscopic guidance with simultaneous real-time sigmoidoscopy; technical report.

Wilson J, Timothy A, Rao J, Sagar PM.SourceaDepartment of Neurosurgery, General Infirmary at Leeds, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, LS13EX. jrfwilson@doctors.org.uk bDepartment of Orthopaedics, General Infirmary at Leeds, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, LS13EX. cDepartment of General Surgery, St James' University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, LS97TF.
Spine.Spine (Phila Pa 1976).2013 Sep 15;38(20):E1285-7. doi: 10.1097/BRS.0b013e31829fef1b.
: Study design. Technical Report.Objective. This article describes the technique of using intra-operative sigmoidoscopy as an adjunct for retrieval of the Axialif lumbosacral screw after failure of lumbar fusion.Summary of Background Data. Minimally invasive axial lumbar interbody fusion devices hav
PMID 24042713

Retrieval of a Migrated AxiaLIF Lumbosacral Screw Using Fluoroscopic Guidance With Simultaneous Real-time Sigmoidoscopy: Technical Report.

Wilson JR, Timothy J, Rao A, Sagar PM.SourceFrom the Departments of *Neurosurgery and †Orthopaedics, General Infirmary at Leeds, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, England; and ‡Department of General Surgery, St James' University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, West Yorkshire, England.
Spine.Spine (Phila Pa 1976).2013 Sep 15;38(20):E1285-7. doi: 10.1097/BRS.0b013e31829fef1b.
STUDY DESIGN: Technical report.OBJECTIVE: This article describes the technique of using intraoperative sigmoidoscopy as an adjunct for retrieval of the AxiaLIF lumbosacral screw after failure of lumbar fusion.SUMMARY OF BACKGROUND DATA: Minimally invasive axial lumbar interbody fusion devices have e
PMID 23778371

Japanese Journal

直腸テネスムスに対して,くも膜下フェノールブロックが有効であった1症例

波戸章郎,池垣淳一
麻酔 64(3), 325-327, 2015-03
NAID 40020381045

終末期がん患者の直腸テネスムスに対して，アモキサピン内服とリドカイン持続静注が奏効した1例

上元洵子,森雅紀,宮城明実,塩野州平,山田博英
Palliative Care Research 10(3), 543-547, 2015
【背景】悪性腫瘍に伴う直腸テネスムスは，進行がん患者のQOLに大きく影響するが確立した治療はない．【症例】71歳，男性．直腸がん原発切除不能のため人工肛門造設術施行．手術11カ月後よりテネスムス症状が出現，その3カ月後には5-15分間隔の便意を催すようになった．原発巣に対する照射を行うも改善認めず．アモキサピン25mg内服が奏効．内服不能後は，クロミプラミン点滴静注を行うも無効．リドカイン持続静注 …
NAID 130005093295

Argon plasma coagulation（APC）療法が有効であった出血性放射線性腸炎の1例

中下学,大場彬博,関由喜,中嶋緑郎,伊藤高章,松本由華,岡沢啓,水城啓,永田博司
Progress of Digestive Endoscopy 84(1), 158-159, 2014
… The symptoms of CRP include diarrhea, tenesmus, rectal pain and persistent rectal bleeding, rectal bleeding being the most common symptom. … We report the case of a 78-year-old man who presented with rectal bleeding after having undergone radiation therapy for prostatic cancer six months earlier. … Endoscopic examination revealed hemorrhages and multiple rectal telangiectasias, and the patient was diagnosed as having CRP. …
NAID 130004985495