1.What are the clinical symptoms of constipation? (1) Fewer bowel movements and fewer bowel movements. (2) Difficult and laborious defecation. (3) Not smooth defecation. (4) Dry, hard stools and a feeling of impurity. (5) Constipation accompanied by abdominal pain or abdominal discomfort. (6) Some patients also have insomnia, irritability, dreaminess, depression, anxiety and other mental disorders. 2.How to diagnose functional constipation? The diagnosis of functional constipation is mainly based on symptoms. Based on the exclusion of organic diseases and drug effects, and meet the following diagnostic criteria: (1) must include two or more of the following ① at least 25% of the defecation effort. (2) At least 25% of the bowel movements are dry, bulbous or hard stools. At least 25% of the bowel movements are incomplete. At least 25% of the bowel movements have a feeling of anorectal obstruction and/or blockage. ⑤ At least 25% of the bowel movements require manual assistance (e.g., finger-assisted defecation, pelvic floor support). (6) The number of bowel movements is less than 3 times/week. (2) Rarely have loose stools when laxatives are not used. (3) Does not meet the diagnostic criteria for irritable bowel syndrome. Meanwhile, the symptoms appeared at least 6 months before diagnosis, and the symptoms in the last 3 months meet the above diagnostic criteria. 3.What tests are needed for constipation? What is the significance of the relevant examination? (1) Stool examination: carefully observe the shape, size, hardness, pus, blood and mucus of the stool. Stool routine and occult blood test are routine examinations. (2) Rectal finger examination: it helps to detect rectal cancer, hemorrhoids, stricture, blockage of hard fecal matter and external pressure, spasm or relaxation of anal sphincter. (3) Proctoscopy, sigmoidoscopy, colonoscopy and other endoscopic examination: it can directly observe whether there are lesions in the intestinal mucosa, and biopsy can be done to clarify the nature of lesions. (4) Gastrointestinal X-ray examination: Barium gastrointestinal examination has reference value for understanding the function of gastrointestinal motility. Normally, barium can reach the splenic flexure of the colon in 12 to 18 hours, and all barium should be discharged from the colon in 24 to 72 hours. There may be delayed emptying in case of constipation. Barium enema, especially low-tension double contrast of the colon, may be helpful in discovering the etiology of constipation. (5) Special examination: Experts say that swallowing a certain number of X-ray impermeable fragments of rubber tubes as markers and taking abdominal films at regular intervals to learn about the speed and distribution of the markers running through the gastrointestinal tract in order to differentiate between rectal constipation or colonic constipation. Defecography is an examination method that combines dynamic and static examination of defecation movements, which helps in the diagnosis of functional constipation. 4. What are the diagnostic criteria for functional constipation in children? (1) Diagnostic criteria for newborn/toddler Rome III: Newborn to 4 years old toddler with at least 2 of the following symptoms for 1 month. ① Defecation ≤2 times/week. ② Have at least 1 incontinence episode/week after being able to control defecation on their own. A history of fecal retention. ④History of painful and laborious defecation. ⑤ Presence of large fecal mass in the rectum. ⑥ A history of large fecal matter obstructing the toilet. Accompanying symptoms include irritability, lack of appetite, and/or early satiety. Accompanying symptoms may disappear quickly with the expulsion of large quantities of feces. (2) Child/Adolescent Rome III Diagnostic Criteria: Children older than 4 years of age must meet 2 or more of the following criteria and do not meet the diagnostic criteria for Irritable Bowel Syndrome. ① Defecation ≤2 times/week. ② Have fecal incontinence at least 1 time/week. ③ Have a large amount of fecal retention or a posture associated with fecal retention. ④ Have a history of pain or difficulty in defecation. ⑤ Presence of large fecal mass in the rectum. ⑥ A history of large fecal matter obstructing the toilet. The above criteria have been met for at least 2 months prior to diagnosis; and episodes occur at least 1 time/week. 5. How to diagnose the cause of constipation in patients? (1) Ask the patient in detail about his/her diet, living habits and work. (2) Previous history of illness and surgery, especially the history of hemorrhoids, anal fistula and anal fissure. (3) Whether there is any recent history of taking medication, especially whether there is any history of taking laxatives for a long period of time. (4) The cause of constipation should be clarified as far as possible through corresponding examination. (5) For middle-aged patients or above, if there is a change in bowel habit, and the bowel movement is changed from once a day or once every two days to once every three days or several days, the patients should be alerted to the possibility of left colon cancer.