Constipation (defecation dysfunction) is a complex etiology, more causative factors, the first should distinguish between functional or organic, drug or psychological factors that cause constipation, and functional constipation can be divided into slow transmission type constipation, exit obstruction type constipation and mixed constipation. Many patients have the following misconceptions about constipation: daily defecation is fine many people feel that constipation is not considered a “disease”, do not go to the hospital for formal treatment, but with a variety of laxatives, lubricants, folk remedies “emergency”, and even by hand to pull out. Although this can temporarily relieve the symptoms, but laid a hidden health risks. In fact, the intestinal tract is like the body’s “sewer”, mainly responsible for the body’s dirty work. Once the blockage occurs, the stool stays in the intestine for a long time, it may cause acute or chronic constipation. At this time, the body’s metabolic waste and toxins will be reabsorbed, mental depression, skin acne, bloating and abdominal pain and other discomfort, toxins stimulate the intestinal wall, may also lead to an increase in the incidence of tumors. Therefore, if you feel that you have significantly less frequent bowel movements, only once in two or three days or longer, with significantly dry and hard stools and difficulty in defecation, you should pay enough attention to it. Some of the causes of chronic constipation are very dangerous, such as anal injury, intestinal obstruction, intestinal embolism or ulcer, intestinal malignant tumor, etc. It is best to go to a specialist clinic in time to avoid delaying the diagnosis and treatment of the disease. Most people generally have one bowel movement per day, while constipation is usually less than three times per week, and in severe cases, only one bowel movement in 2 to 4 weeks. However, the number of bowel movements is not the only criterion. According to international standards, there are six criteria for diagnosing constipation, including the feeling of straining to defecate, the feeling of dry ball-like impurity, the feeling of blockage in the anorectum, the need for manual assistance, and the number of bowel movements per week, which should be considered together. Among them, “dry ball or hard stool” is an important indicator, and if 25% of the bowel movements in a week or a month are in this state, it is defined as constipation. Patients with constipation often present with complaints of difficulty in defecation, reduced frequency of defecation, or a feeling of incomplete defecation. It is very important to have sufficient water for the intestinal tract to flow smoothly, and more water in the intestinal tract will not easily cause dry stools. Therefore, it is necessary to know that drinking water is the first priority to solve the problem of constipation. Inadequate hydration, regardless of the method used, is a half-hearted effort. If you don’t drink more water while supplementing with high fiber foods, it may even backfire and cause more severe constipation. It should be reminded not to wait until you are thirsty and then drink a large amount of water at once, but to drink water regularly in small sips and control the amount of water. In addition, to relieve constipation must improve lifestyle habits, you can properly eat more fruits containing high fiber, such as apricots, plums, as well as bananas and other foods that can promote gastrointestinal motility. For people who have less than 3 bowel movements per week, dry ball-like stools, bloating but lack of bowel movement and other symptoms, it is recommended to seek medical treatment. Finally, it is important to relax, the more nervous you are the worse your symptoms become. Constipation is treated only for gastrointestinal constipation is a very common clinical condition that can be caused by a variety of reasons. When it is caused solely by a decrease in gastrointestinal motility, treatment focuses on adjusting the gastrointestinal tract. There are also many constipations that cannot be treated by allopathic medicine alone, but rather by finding the primary cause. For example: 1. Drug constipation. Can appear after taking analgesics, antacid aluminum preparations, antidepressants, antiepileptic drugs, etc.; 2. Neurological injury. Such as spinal cord injury caused by trauma or tumor compression, can damage the nerves innervating the intestines, and subsequently produce constipation; 3. Anal disease. Hemorrhoids, anal fissures and other diseases, due to severe pain in the anal area, can cause spasm of the anal sphincter, so that defecation is delayed and constipation occurs; 4. Pregnancy. The large amount of progesterone secreted during pregnancy can relax the smooth muscle of the uterus and weaken the peristalsis of the large intestine; 5. Exit obstruction constipation. This refers to problems with the lower rectum and anus leading to poor bowel movements. Such as loss of pelvic floor flaccidity, anterior rectal protrusion, and intra-rectal mucosal overturning. In addition, the pain and harm caused by constipation goes far beyond the inability to pass stool and may lead to a series of health problems over time. In particular, people suffering from cardiovascular disease, prolonged forceful defecation is likely to cause accidents. Detoxification is to help defecate some advertising propaganda of the so-called “defecation is detoxification”, in fact, is wrong. In the view of Chinese medicine, “poison” is generally divided into internal and external, internal poison refers to metabolic products, such as urine and faeces, phlegm, etc., external poison refers to various factors that can damage health, such as bacteria, viruses, etc. For healthy people, internal toxins can be excreted on their own, without special intervention. Therefore, there is no causal connection between detoxification and bowel movement. Only “real evidence” in Chinese medicine, such as actual fire in the gastrointestinal tract, swollen and painful gums, mouth ulcers, facial acne, etc., can be relieved by laxative bowel movements. When treating constipation, on the one hand, we should choose reasonable medication, and try not to use drugs or supplements containing ingredients such as rhubarb, senna, cassia and aloe vera. Even if you want to use, it is best to control the use of time within two weeks. On the other hand, strengthening physical exercise, frequent relaxing baths, and eating more fresh fruits and vegetables can be beneficial in relieving constipation. For example, cherries, dark purple grapes, rape, etc., help to help the liver, intestines, stomach, kidneys and other organs to remove waste from the body, open up the intestinal tract, and can prevent skin roughness and pigmentation. Laxatives as a panacea for people who are often constipated, laxatives can undoubtedly solve the urgent problem. However, constipation is a chronic disease, just like high blood pressure, diabetes, to have to fight a “protracted war”, “multi-armed combat” of the mind ready. Do not imagine that some kind of special drugs, or do a surgery to solve the problem. Some patients find laxatives convenient and painful and treat them as a “panacea”, which is very dangerous. Many laxatives contain anthraquinone, which can cause nerve damage to the intestinal wall and paralysis of intestinal function in excessive use, and may also cause colonic melanosis, or “blackening of the intestines” as they are called, and even cause serious consequences such as menstrual disorders and miscarriage in women. The first four non-surgical treatment recommendations are mainly for patients with functional constipation: 1. life, diet adjustment: drink more water (1 cup of warm water in the morning on an empty stomach, drinking about 2000 ml of water per day), more exercise (at least 2 hours of brisk walking per day), eat more coarse grains (corn, oats, etc.), fresh fruits, vegetables rich in dietary fiber (celery, leeks, etc.), avoid spicy, stimulating diet, avoid smoking and alcohol 2. Develop the habit of regular defecation: go to the toilet 1-2 times a day, 30 minutes after breakfast is the best time to defecate because of the gastrocolonic reflex, or you can adjust it according to your defecation habits. If there is no bowel movement, you can initially apply open-colored anal induction of defecation (10-15 days), each defecation 5-10 minutes (regardless of the amount of defecation and the sense of incomplete defecation), avoid sedentary, squatting forceful defecation (will aggravate the pelvic floor dysfunction), and establish the biological clock of defecation. 3. medication 3.1 Preferred drugs with no or little side effects: probiotics: dietary fiber products: water-soluble dietary fiber pectin Jinling No. 1 (10g of water-soluble dietary fiber = 2.5kg of cabbage = 2.5kg of celery = 2.5kg of grapes = 833g of bananas) probiotics + dietary fiber (prebiotics) taken at the same time, and to ensure that 1 and 2 (especially 2000ml of water per day of water consumption) are completed, 1-3 months after the difficult bowel movement will have different degrees of relief! 3.2 If the above treatment is not effective, add laxative treatment: Lactulose (Dumic) 15-30ml/time 15-45ml/day; When lactulose is not effective: Fosone (polyethylene glycol electrolyte dispersion) 1 bag/time 1-2 times/day (to short-term diarrhea, unblock the intestinal tract for the purpose, not recommended to take a large number of long-term) Prilucapride tablets (Lilo) (colon dynamometer) 1 tablet 1/day; (not recommended for long-term taking) Avoid long-term use of strong stimulant laxatives such as if conductive (phenolphthalein) tablets, senna leaves, aloe capsules and formulae containing rhubarb and mannitol (Chinese medicine preparations). If the above treatment does not work, consider hospitalization for intestinal microecological therapy: 4. Intestinal microecological therapy Fecal microbiota transplantation (FMT) as a long history and can rebuild intestinal flora therapy is back to clinical attention, that is, the healthy human fecal flora, through a certain way to transplant into the patient’s intestine, to regulate the intestinal flora imbalance, to regulate the intestinal flora. It can help to regulate the imbalance of intestinal flora and rebuild the normal function of intestinal micro-ecosystem for the treatment of intestinal and extra-intestinal diseases. The traditional routes of fecal bacteria transplantation are mainly via enema, gastroscopy, enteroscopy, fistula, etc. However, the above invasive routes inevitably bring different degrees of trauma to patients. Many investigators expect treatment through the oral capsule route. In view of this, Prof. Ning Li’s team has successfully prepared live bacteria capsules containing the full spectrum of intestinal bacteria by using vacuum freeze-drying technology to prepare the live bacteria and also using acid-resistant protective film for wrapping. The capsules have been used in some patients and achieved good therapeutic results; the development of this type of capsule makes the clinical application of fecal bacteria transplantation more efficient and less traumatic for patients. Fecal transplantation Conventional hospitalization cycle of about half a month, the cost of 20,000 to 30,000 yuan, discharge from the hospital within half a month to observe the specific efficacy; if the above four conservative treatment effect is still not enough to expect, can consider to perform jinling treatment. 5. Surgical treatment If the above treatment still cannot improve the difficulty in defecation and the defecation cycle is more than 3-5 days, you need to go to the local hospital for enema treatment to avoid the occurrence of fecal stone intestinal obstruction; at the same time, you should actively come to our hospital for a comprehensive assessment (barium enema, fecal imaging, colon transport test, whole gastrointestinal barium meal, abdominal CT, etc.) before considering the treatment of Jinling operation (subtotal resection of colon combined with lateral anastomosis of ascending colon and rectum) .