A constipation that is characterized by difficulty passing bowel movements after they reach the rectum. One experiences difficulty evacuating the stool and often has to strain or press the fingers into the vagina or in front of or into the rectum to help remove the stool. Outlet dysfunction can be caused by inappropriate or abnormal muscle contraction of the pelvic floor (called pelvic floor dyssynergia or dyssynergic defecation) which can respond to biofeedback. It may also be due to a rectocele or other structural changes in the pelvic floor that will require medical or at times, surgical treatment. [ url:https://www.med.unc.edu/ibs/wp-content/uploads/sites/450/2017/10/Constipation.pdf ]