Tenesmus

How Chinese medicine differentiates tenesmus (urgent, incomplete evacuation) into the five patterns you'll actually meet in practice, and the points for each. Distinct from this site's Dysentery, Diarrhea and Undigested Food in Stools pages. Acupuncture only — no herbs.

This page is educational, for practitioners and students — it is not a diagnostic tool and does not replace a proper in-person assessment. Persistent tenesmus with blood, mucus, weight loss, fever or a change in bowel habit needs medical investigation (infection, inflammatory bowel disease or a rectal lesion).

General Acupuncture Points

Acupuncture points traditionally used for tenesmus — 3 key points, used across the patterns below rather than tied to just one.

Point	Key action
ST-25	Regulates the Intestines. Regulates Stomach and Spleen. Moves Qi and invigorates Blood.
ST-37	Regulates the Stomach and Intestines and resolves retention of Food. Eliminates Damp-Heat. Subdues rebellious Qi.
ST-36	Benefits Stomach and Spleen. Tonifies Qi and Blood. Tonifies the Original Qi.

The Five Patterns

↑ reinforcing ↓ reducing ⊥ even method.

1. Damp-Heat in the Large Intestine View full pattern →

Clinical manifestations: Burning urgency; foul-smelling mucus or blood in the stools; body heaviness; thirst with scanty dark urine.

Tongue: Red, thick yellow greasy coat. Pulse: Slippery and rapid.

Treatment principle: Clears Heat and dries Dampness.

ST-25 ↓ ST-37 ↓ L.I.-4 ↓

Note: no moxa.

2. Large Intestine Qi Stagnation View full pattern →

Clinical manifestations: Cramping pain that shifts; incomplete evacuation; worse with emotional stress; excessive gas.

Tongue: Normal or light red, thin white coat. Pulse: Wiry, especially at the left middle position.

Treatment principle: Moves Qi and regulates the Liver to relieve stagnation.

ST-25 ⊥ ST-37 ⊥ LIV-3 ↓ REN-6 ⊥

Note: no moxa.

3. Spleen Qi Sinking View full pattern →

Clinical manifestations: Bearing-down, dragging sensation; chronic fatigue; incomplete evacuation without burning; poor appetite.

Tongue: Pale, puffy, tooth-marked, thin white coat. Pulse: Weak, especially at the right middle position.

Treatment principle: Tonifies Spleen Qi and lifts sinking Qi.

DU-20 ↑ ST-36 ↑ REN-6 ↑

Note: moxa is strongly indicated.

4. Cold-Damp Invading the Spleen View full pattern →

Clinical manifestations: Cramping pain that feels cold; white mucus in the stools; heaviness; loose, difficult stools; nausea.

Tongue: Pale, swollen, tooth-marked, thick white greasy coat. Pulse: Soggy or slippery and slow.

Treatment principle: Warms the Middle Burner, disperses Cold and transforms Dampness.

ST-25 ↑ SP-9 ↓ ST-36 ↑

Note: moxa is appropriate.

5. Dryness in the Large Intestine View full pattern →

Clinical manifestations: Hard, dry stools; straining with scanty pellets; very dry mouth and lips; incomplete evacuation.

Tongue: Red, dry, thin, possible central crack. Pulse: Fine, possibly choppy.

Treatment principle: Moistens the intestines and nourishes Yin.

ST-25 ⊥ ST-37 ⊥ T.B.-6 ↓ SP-6 ↑

Note: no moxa.

Related conditions

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