Once diagnosed, congenital megacolon often requires surgical treatment, either a one-time radical surgery or a fistula followed by radical treatment. However, the surgery is not a worry-free experience, and some problems may remain after the surgery, among which constipation and fecal matter are the two most common and annoying complications. Today, experts will teach you how to deal with the two most common complications after congenital megacolon surgery. Constipation after congenital megacolon There are many reasons for constipation after congenital megacolon surgery, including anal stenosis, surgery without cutting in place, incomplete opening of the muscle sheath or postoperative adhesions, and problems with blood supply to the intestine due to high vascular tone in the towed-out segment, resulting in degeneration of ganglion cells in the towed-out segment of the intestine, etc. The treatment of constipation due to different causes is also different: 1) for constipation caused by anal stenosis, anal dilation is required; 2) for constipation caused by surgical failure to cut in place, reoperation is required; 3) for constipation caused by ganglion cell degeneration, reoperation is required. From this we can see that the most important thing is to identify the cause of constipation after congenital megacolon surgery, and in general, most of them require reoperation for treatment. Only constipation caused by anal scar stenosis can be treated with anal dilation. Usually dilation can relieve this type of constipation. When the constipation is relieved, the frequency of dilation can be gradually reduced and eventually stopped. Stopping dilation is a gradual process. Because dilation over a longer period of time creates a dependency that needs to be broken by gradually reducing the frequency of dilation until it is finally stopped. In general, if the constipation is postoperative due to anal stenosis, you will need to start dilation 1-2 times a day. In the case of very severe anal stenosis, additional physical therapy is required. After the constipation is relieved, the frequency of dilation can be changed to once every 2 days, and after a period of time, to once every 3 days, and so on, gradually lengthening the interval of dilation, so that the child can gradually get rid of the stimulation of dilation and establish normal bowel habits by himself. If the child is still constipated after dilation, it means that dilation is ineffective and other treatments, such as bowel cleansing, may be needed. Congenital megacolon postoperative fecal soiling Congenital megacolon postoperative fecal soiling occurs in about 12% of cases and is characterized by normal bowel movements and control, but often small amounts of stool and fecal juice stain the underwear. This fecal soiling is likely to remain with the child for the rest of his or her life. For the management of this complication, tests such as barium enema and rectal and anal canal manometry are needed to analyze the cause of postoperative fecal soiling by combining previous surgical records and examination reports to understand the baby’s bowel emptying function, intestinal peristaltic function, anal canal resting pressure, and the ability of the anal canal to contract on its own. If feces appear soon after surgery, it may be related to the fact that the anal function is affected by the surgery to some extent in the short term after surgery, and mostly recovers gradually after several months. However, in most cases, the fecal matter may improve significantly and eventually disappear through the postoperative recovery process, dietary modification, and bowel habit training. However, if the fecal matter persists and sometimes tends to worsen, some cases still need to be handled by a doctor, and further comprehensive examinations, including MRI and other imaging tests, are needed to clarify the cause and make further treatment decisions based on the cause, or even require surgery again, which would be very complicated. Of course, surgery is not the only way to solve the fecal problem, and the surgery itself may bring other complications or sequelae, and there is a certain uncertainty about the effect of the surgery itself, so the second surgery needs to be done very carefully. Therefore, if the fecal matter is not very serious, the principle of treatment is to avoid surgery as much as possible.