Stuhldrang

Stuhldrang is the medical term for the urge to have a bowel movement. It describes the sensation that defecation is imminent and can occur as part of normal bowel function or as a symptom of a health issue. When the urge is frequent, persistent, or accompanied by pain, bleeding, or changes in stool, it may indicate an underlying condition.

Common benign causes include temporary constipation with rectal stool loading, dietary changes, caffeine or alcohol use, and stress. Less frequently, stuhldrang can result from anorectal problems such as hemorrhoids or anal fissures, or from infections. Chronic or more concerning causes include irritable bowel syndrome with constipation or diarrhea, inflammatory bowel diseases (such as Crohn's disease or ulcerative colitis), fecal impaction, rectal prolapse, and less commonly colorectal cancer or other serious disorders. Neurologic conditions and certain medications can also alter defecation reflexes and contribute to urgency.

Evaluation typically involves a medical history and physical examination, including a digital rectal exam. Alarm features prompting further testing include blood in the stool, unintended weight loss, fever, severe or persistent abdominal pain, or onset of symptoms after age 50. Depending on findings, investigations may include stool tests, blood tests, and endoscopic or imaging studies to establish a diagnosis.

Management focuses on treating the underlying cause and relieving symptoms. This may involve dietary adjustments and adequate fluids, fiber supplementation, and bowel regimens for constipation or diarrhea. Pelvic floor exercises or biofeedback can help with certain pelvic disorders. Infections, inflammatory conditions, or other pathologies require condition-specific therapy. Patients are advised to seek medical care if stuhldrang is persistent, worsening, or accompanied by red flags.