Does anyone else have chronic rectal tenesmus?

@logsdon Oh my gosh. It sounds like my very journey!
First and foremost, do not let a surgeon remove any part of her colon. As my GI doctor said, there is no guarantee that the tenesmus will go away. And then what? It is much more likely that it’s being caused by nerves from a lower spine issue, and not a GI issue at all. That needs to be ruled out.
Also, there’s a test called an MRI Defecography, to rule out a prolapse blocking the anorectal canal. If so, there is a surgical remedy.
I also went through a year of pelvic floor therapy, which was of no help.
I tried every prescription laxative available, eg, Linzess. There’s lots of them, all made for slow motility. They didn’t help, and in fact seemed to exasperate the sense of urgency.
There are studies showing that 3 particular antidepressants, taken in very low doses can help with tenesmus, in the amitriptylin family.
I am happy to share any information I’ve learned from this experience.
I’m not done searching for answers, but I have stopped obsessing over my bowel movements.
I now know that the sensation is there regardless of whether it happens or not.
I hope that we can have an ongoing discussion about this, and help each other.
I look forward to your response.

Yes I deal with this issue along with spinal stenosis which is the driving cause of it. along with pelvic floor dysfuction. My muscles in my pelvis are literally locking up trying to keep me upright with all my spinal conditions. I have done many nerve blocks. Had back surgery a laminectomy in 2024 and not a thing has helped. I also did all the laxatives you are referring to and pelvic floor therapy. The pain is from my rib cage down on the left into my rectum. I have basically done my own research. The ortho the GI docs only concentrated on spine and the severe constipation I endure from this condition. I take amitryptilene ( elavil) 10 mg at nite which does help the pain. Next I am trying dry needling with a pelvic floor therapist with advanced experience. i will let you know how it goes. My ortho doc only wants to do blocks . IDK whether to have the sacral block or not. It is very discouraging and difficult to be in chronic pain every single day. It is also hard to explain this type pain to anyone. Appreciate any and all help and comments. I'm still researching. The area I live in is not the best as far as any progressive medicine. I would like to go to a place called PRM in Nashville. TN for pelvic rehab medicine where they inject your pelvic nerves however, not covered by insurance. ....... I look forward to more information from yall.