Painful feelings during defecation may appear due to many reasons and as a symptom of many diseases. One of the common causes of painful defecation is the constipation. Constipation is defined by a reduced number of bowel movements and/or an abnormal defecation act. It may be a result of inadequate alimentation habits (such as insufficient fibre or liquid intake) or as side effect of medications. 

On the other hand, it may appear also as a symptom of many diseases or body dysfunctions, such cancerous diseases or hypothyroidism (reduced function of thyroid gland). Irritable bowel syndrome is also connected with painful feelings, although primary pain is felt in the abdominal area, it may also appear during defecation due to constipation typical for this disease. Obstructed defecation is a condition characterized as difficulty in evacuation or emptying the rectum and it is connected with rectal pain. Pelvic floor dysfunction syndromes include voiding, sexual, and anorectal disturbances characterized by urinary and fecal incontinence, pelvic pain, and/or constipation/anismus (the failure of the normal relaxation of pelvic floor muscles during attempted defecation). 

Among the diseases connected with painful defecation, endometriosis should be mentioned as a reproduction related disorder that often goes accompanied by dyschezia. 

Endometriosis

Endometriosis is the growth of fragments from uterine inner layer called endometrium outside the uterus. It is relatively common gynaecologic disorder with estimated frequency 5%–10% among women of reproductive age. There are various symptoms to this disease such as dysmenorrhoea (painful menstruation), disorders of menstruation, dyspareunia (painful sexual intercourse) and also painful defecation.

Uterine Fibroids

Uterine fibroids are the most common benign smooth muscle tumours of the uterus encountered in women of reproductive age. Uterine fibroids are a major cause of morbidity in women of a reproductive age. About 20% to 80% of women develop fibroids by the age of 50. Typically, fibroids appear as well-defined, solid masses with a whorled appearance. This problem is often connected with constipation which may also induce dyschezia.

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Sources

Constipation ―sourced from Wikipedia licensed under CC BY-SA 3.0
Rectal tenesmus ―sourced from Wikipedia licensed under CC BY-SA 3.0
Obstructed defecation ―sourced from Wikipedia licensed under CC BY-SA 3.0
Endometriosis-Related Pain, the Forgotten ―by Garcia-Pascual licensed under CC BY 4.0
Endometriosis: Symptoms ―by Feizalan licensed under CC BY-SA 3.0
Defecografía para diagnosticar afecciones del suelo pélvico ―by Barbosa López et al. licensed under CC BY-NC 4.0
Painful constipation: a neglected entity? ―by Bassotti et al. licensed under CC BY-NC 4.0
Anismus ―sourced from World Heritage Encyclopedia licensed under CC BY-SA 3.0
UTERINE FIBROIDS ―sourced from Fertilitypedia.org licensed under CC BY-SA 4.0
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