Chronic Tenesmus: 'Intestinal Inertia' and 'Methane SIBO' Could Be the Real Causes | Incheon Tenesmus

Even after a trip to the bathroom, do you experience a persistent feeling that something is still left behind? Are you constantly bothered by a sensation of incomplete bowel movement that prevents you from feeling truly relieved, leading to preoccupation with your lower abdomen and an inexplicable discomfort throughout the day? Many people distinguish this from 'constipation,' often dismissing it as 'that's just how my bowels are.' However, this daily recurring feeling of incomplete evacuation could be a strong signal that your intestines have lost their 'power to push things out on their own.'

Hello. I am Choi Yeon-seung, a Traditional Korean Medicine doctor who, for the past 15 years, has been identifying and resolving the causes of inexplicable incomplete bowel movements from the perspective of 'intestinal motility' and 'SIBO (Small Intestinal Bacterial Overgrowth),' helping patients regain the 'pleasure of complete evacuation.'

If you read this article to the end today, you will clearly understand the true cause of that persistent and bothersome sensation of incomplete evacuation. You'll be able to take the first step towards a refreshing morning, no longer struggling endlessly on the toilet.

Causes of Incomplete Evacuation

The sensation of incomplete evacuation is by no means a problem arising from 'just a feeling' or 'being overly sensitive.' It is a clear 'physical symptom' indicating an issue with your bowel function.

Cause 1: When stool is truly 'left behind' (Incomplete Evacuation)

This is the most common scenario. The 'propulsive force' that contracts the intestines to push out stool is weak, causing the defecation process to stop halfway. Since not all contents can be pushed out completely, a portion of the stool naturally remains in the rectum, which is then felt as an uncomfortable sensation of incomplete evacuation. It's akin to trying to squeeze toothpaste, but lacking the strength in your hand to get the very last bit out.

Cause 2: When it 'feels like' something is left behind (Rectal Hypersensitivity)

In this case, most of the stool has been evacuated, but the nerves in the rectal mucosa are abnormally hypersensitive. Even small amounts of gas, secretions, or tiny fragments of stool remaining in the rectum are misinterpreted by the brain as a huge signal that 'a large mass is still present.' This causes the sensation to be perceived as much greater than it actually is, similar to 'auditory hypersensitivity,' where small noises are perceived as very loud.

Why Can't the Intestines Push Everything Out Completely? (feat. Methane SIBO)

There is a strong suspect that triggers both the aforementioned 'weakened propulsive force' and 'hypersensitive nerves.' It is 'Methane-dominant SIBO (IMO - Intestinal Methanogen Overgrowth).'

Mechanism 1: Methane gas 'hits the brakes' on the intestines. (→ Induces Incomplete Evacuation)

As explained in previous constipation content, methane gas itself acts as a 'brake' that suppresses peristalsis by affecting the nerves of the intestines. Defecation is completed smoothly only when various parts of the intestines contract harmoniously, and finally, powerfully. However, if methane gas continuously puts the brakes on this process, the intestines lose the strength to push everything out completely. Just like gently squeezing toothpaste without being able to press firmly to get it all out, 'incomplete evacuation' occurs, leaving some contents in the intestines.

Mechanism 2: Inflammation disrupts the rectum's 'sensors.' (→ Induces Rectal Hypersensitivity)

Toxins (LPS) and gases produced by bacteria overgrown due to SIBO cause chronic inflammation in the intestinal lining. When the rectum, the final gateway for defecation, becomes hypersensitive due to this inflammation, it's as if its sensors are malfunctioning. Even very small stimuli, such as a tiny amount of gas or residual mucus, send exaggerated signals to the brain, indicating that 'a lot of stool is still present.' This is the sensation of incomplete evacuation caused by 'rectal hypersensitivity.'

The Source of 'Propulsive Force' (Traditional Korean Medicine Perspective: The Role of Qi)

So, why does Methane SIBO occur, and why does our intestinal motility weaken? Where is the starting point of all these problems?

Traditional Korean Medicine finds the fundamental cause in the human body's most basic driving force, 'Qi (氣).' In Traditional Korean Medicine, 'Qi' goes beyond merely 'mood' or 'energy,' signifying a tangible force that drives and propels all functions in our body. The power of childbirth to push out a baby, the heart's power to circulate blood throughout the body, and the power of defecation to push out stool all originate from this 'Qi.'

1. A state of 'Qi Deficiency (氣虛)' where Qi is absolutely insufficient

It's like a car battery that has run out of charge. After chronic overwork or a serious illness, the body's energy becomes absolutely depleted, leaving no strength to push contents completely out of the intestines. People in this state often experience chronic fatigue, lethargy, and dizziness.

2. A state of 'Qi Stagnation (氣滯)' where Qi is severely blocked

It's like having a full battery, but the wires leading to the engine are cut or tangled. Due to extreme stress or emotional issues, the flow of Qi becomes stagnant, preventing strength from being properly delivered even when it's present. This applies to cases where one feels bloated and uncomfortable due to gas in the abdomen, yet cannot exert proper force during defecation.

To Regain the 'Pleasure of Complete Evacuation'

In conclusion, the persistent and bothersome sensation of incomplete evacuation that plagued you was not merely a phenomenon of residual stool. It was a complex problem where our body's 'propulsive force (Qi)' was insufficient or blocked (Qi Deficiency/Qi Stagnation), and in the resulting environment, 'Methane SIBO' proliferated, further exacerbating the situation.

Therefore, the solution to regaining the 'pleasure of complete evacuation' does not lie solely in removing stool.

• Replenishing and regulating intestinal Qi (補氣/行氣) to build the strength for self-propulsion, and
• Improving the intestinal environment to control SIBO.

These two approaches must occur simultaneously to break the vicious cycle and experience truly 'refreshing bowel movements.' Of course, alongside professional treatment, small efforts in daily life must accumulate to accelerate the pace of recovery.

Today, we explored the fundamental reasons why our 'propulsive force' weakens. So, are there any worst habits we unknowingly practice daily that further weaken this force? Next time, we will delve into a crucial tip that anyone can easily follow but most people overlook: Never use 'this posture' in the bathroom! The worst habit that causes incomplete evacuation.

A refreshing start every morning is not a distant dream. Your intestines can regain the strength to evacuate completely and refreshingly.

#IncompleteEvacuation #SIBO