A 53-year-old woman presented with a one-month history of evacuation difficulty. Although her stool was soft (Bristol Stool Form Scale type 5–6), she was unable to defecate despite straining and was unsure how to strain effectively. Anal sphincter tone and squeeze pressure were normal on digital rectal examination. Given the persistence of evacuation difficulty despite soft stools, defecography was performed, revealing pelvic floor incoordination with absent perineal descent and incomplete evacuation. She was diagnosed with functional defecation disorder and deemed suitable for biofeedback (BF) therapy. Under the supervision of a physical therapist, she underwent five sessions of BF therapy using anal electromyography and rectal balloon expulsion training. Her symptoms improved, and the sensation of evacuation difficulty resolved. Evacuation difficulty is a hallmark of defecation disorder-type constipation. While it can result from hard stools in IBS-C, it may also occur in defecation disorders despite soft stool. Defecography is essential to distinguish between functional and structural causes. BF therapy is indicated for functional disorders such as pelvic floor incoordination or inadequate propulsion. If a patient reports evacuation difficulty, stool consistency should be assessed, and referral for defecography should be considered if symptoms persist with soft stool.