Why do I have urgency and tenesmus with ulcerative colitis?

Question

Hi doctor,

I am a 24-year-old female. I was diagnosed with ulcerative colitis six months ago. My symptoms are not limited to diarrhea; I also experience constant urgency and tenesmus, a term my doctor used to describe my condition.

Even when there is no stool present, I feel pressure and pain in the rectal area, which is very uncomfortable and is affecting my work. While I don't have much blood in my stools now, I do go to the bathroom 5 to 6 times daily.

Currently, I am taking Budesonide 9 mg daily and Mesalamine 1.2 g twice daily. Should I continue taking both medications together? Additionally, can sitting for long hours worsen my condition?

My family has suggested trying homeopathy and aloe vera juice. Do these treatments really work? I am feeling a bit confused about which path to follow.

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I am deeply concerned about your worries.

Your symptoms are typical of active rectal inflammation associated with ulcerative colitis. The constant urge to pass stool, rectal pressure, and the feeling of incomplete evacuation are known as tenesmus. This sensation often occurs when the rectum is inflamed (proctitis), leading to a feeling of urgency even when no stool is present.

You are currently taking Mesalamine and Budesonide, which are commonly used together during flare-ups. Mesalamine helps control inflammation in the long term, while Budesonide is often used for short-term relief of active symptoms.

You should continue taking these medications as prescribed unless your gastroenterologist recommends any changes. In some cases, if tenesmus is particularly severe, doctors may also prescribe rectal mesalamine suppositories or enemas. These treatments target rectal inflammation directly and can help alleviate urgency.

While sitting for long hours does not cause ulcerative colitis, prolonged sitting may heighten awareness of rectal discomfort. Gentle movement and taking short breaks during work may help ease pressure.

When it comes to homeopathy or aloe vera, there is no strong scientific evidence supporting their effectiveness in curing ulcerative colitis. Although some natural products may provide mild relief for certain individuals, they should never replace proven medical treatments, as untreated inflammation can worsen the disease.

The best strategy is to continue with evidence-based therapies, maintain regular follow-ups with your gastroenterologist, manage stress effectively, and eat simple, balanced meals during flare-ups. With the right treatment plan, most patients can achieve good symptom control and enjoy prolonged periods of remission.

I hope this helps address your query.

Thank you.