Medical Term for Painful Bowel Movements
The medical term for painful bowel movements is "dyschezia." 1
Definition and Clinical Context
Dyschezia refers to difficulty or pain during defecation and is a recognized symptom within the spectrum of defecatory disorders. 1 The term encompasses:
- Pain or discomfort during the act of defecation 1
- A sense of anorectal obstruction or blockage during bowel movements 1
- Excessive straining required to pass stool 1
- Need for manual maneuvers to facilitate defecation (such as digital evacuation or perineal support) 1
Related Terminology
While dyschezia is the primary term, several related conditions may present with painful defecation:
Dyssynergic defecation (also called pelvic floor dyssynergia or anismus): This involves incoordination between abdominal and pelvic floor muscles, where there is incomplete relaxation or paradoxical contraction of the pelvic floor and external anal sphincters during defecation. 1, 2, 3
Obstructed defecation: A broader term that includes structural and functional causes of difficult evacuation. 1
Defecatory disorders: The umbrella category that encompasses dyschezia and related evacuation problems characterized by impaired rectal evacuation from inadequate propulsive forces and/or increased resistance. 1
Important Clinical Distinctions
It is critical to distinguish dyschezia from simple constipation, as they represent different pathophysiologic processes. 4 Key differentiating features include:
- Dyschezia may occur even with soft stools, whereas constipation typically involves hard stools 1
- Difficulty passing soft stools or enema fluid strongly suggests a defecatory disorder rather than simple constipation 5
- Need for perineal or vaginal pressure to allow stool passage indicates pronounced evacuatory defects 5
Underlying Causes to Consider
When evaluating painful bowel movements, consider:
- Structural anorectal pathology: anal fissure, proctitis, hemorrhoids 1
- Functional defecatory disorders: dyssynergic defecation, inadequate defecatory propulsion 6
- Secondary causes: opioid-induced bowel dysfunction, neurologic disorders 1
A careful digital rectal examination is essential to assess for tenderness, masses, anal tone, and the ability to coordinate pelvic floor muscles during simulated defecation. 2, 3