image of Tenesmus
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Tenesmus is ineffectual and/or painful straining to urinate or defecate. Tenesmus is often associated with other signs of colonic disease, such as large intestinal diarrhoea or mucus, or both. This chapter discusses relevant history, physical examination and diagnostic tests, and provides an algorithm for approaching the patient with tenesmus.

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23.1 Algorithm showing an approach to the patient with tenesmus.
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23.2 Narrow ‘ribbon-like’ faeces can be suggestive of an anorectal stricture.
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23.4 A small mass of mucosa protruding from the anus of a dog. This mass is a rectal polyp, but digital rectal examination is necessary to be sure that it is not a rectal prolapse or an intussusception.
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