The common manifestations of chronic constipation are the following categories: 1, less bowel movement, less stool: this type of constipation can be seen in the slow passage type and exit obstruction type constipation. The former is due to the slow passage, so the number of stools and stool are less, but at certain intervals can still appear stool, stool is often dry and hard, forceful defecation helps to expel feces. In the latter case, the sensory threshold is often increased, and it is not easy to cause the urge to defecate, thus, the number of stools is small, and the stool is not necessarily dry and hard. For these patients, we can try bulking agents or osmolytes to increase the water content of stool, increase softness and volume, stimulate peristalsis of the colon, and also increase the stimulation of the rectal mucosa. At the same time should be regular defecation. 2, difficult defecation, effort: prominent performance for the abnormal difficult fecal discharge, also seen in two cases, to export obstructive constipation is more common. When the patient force discharge, the external anal sphincter presents paradoxical contraction, so that defecation is difficult. This type of constipation is not necessarily less frequent, but it is time-consuming and labor-intensive. If accompanied by weakness of the abdominal muscle contraction, the difficulty of defecation is aggravated. The second case is due to slow passage, excessive absorption of water in the stool, dry stool, especially for a long time without defecation, making the discharge of dry hard stool abnormally difficult, can occur fecal impaction. This type of constipation can also be tried with bulking agents or osmotic agents to soften the stool and facilitate its discharge, sometimes combined with enema treatment. If the stool is still difficult to pass after softening, it is suggested to be outlet obstructive constipation. Patients in this category need guidance on bowel movements and biofeedback therapy if necessary. 3.Incompetent defecation: there is often a feeling of obstruction in the anorectum, and defecation is not smooth. Although there are frequent bowel movements and a lot of bowel movements, even with great effort, it does not help and it is difficult to have a smooth bowel movement. It may be accompanied by anorectal irritation symptoms, such as cramping and discomfort. These patients often have reduced sensory thresholds and hypersensitivity of rectal sensation, or are associated with endorectal anatomy, such as internal rectal overlap and internal hemorrhoids. Individual cases with elevated rectal sensory thresholds also present with similar symptoms, which may be related to combined anorectal local anatomical changes. Treatment of this group of patients requires raising the sensory threshold, reducing the number of bowel movements, and treating local anorectal lesions, such as local management of hemorrhoid-derived constipation. 4, constipation with abdominal pain or abdominal discomfort: common in IBS constipation type, often relieved after defecation symptoms. The above types of constipation are not only seen in functional constipation, but also in IBS constipation type (which may also have manifestations of each of the above types). The above types of constipation can also be seen in organic diseases such as chronic constipation caused by diabetes mellitus and constipation caused by medications. They should be analyzed with attention. In addition, there are often combinations of the above conditions. Common methods to determine the type of constipation 1, gastrointestinal passage test: it is recommended that at least 48h after stopping the relevant drugs after taking 20 impermeable X-ray markers, take an abdominal film (normal when most markers have arrived in the rectum or have been discharged), the purpose of choosing 48h film is possible to observe the distribution of markers at this time, such as most have been concentrated in the sigmoid colon and rectal area or have not yet reached this area If the majority of the markers have not reached the sigmoid and rectum or are still in the sigmoid and rectum, then this would suggest normal or delayed passage, respectively. If another film is taken at 72h, if most of the markers still have not reached the sigmoid and rectum or are still in the sigmoid and rectum, then this would support slow passage constipation or outlet obstructive constipation, respectively. The gastrointestinal passage test is an easy method that can be extended and applied. Its accuracy may increase if extended to 5-6 days with one film, but feasibility is poor because most patients have difficulty adhering and self-administer laxatives. The sensitivity of the test is reduced, especially the difficulty in determining the type of constipation, unless a series of films is taken. 2, anorectal manometry: can provide the presence or absence of local anorectal mechanisms causing constipation, such as paradoxical contraction of the external anal sphincter during forceful evacuation, suggesting outlet obstructive constipation; after injecting air into the rectal balloon, if the anorectal inhibitory reflex is absent, it suggests Hirschsprung’sdisease; and the mucosal response of the rectal wall to the air balloon After intra-balloon gas injection caused by the sense of bowel movement, the maximum tolerance limit of the volume, etc., can provide whether the threshold of defecation of the rectal wall is normal. 3.Anorectal finger examination: It is emphasized here that anorectal finger examination is not only an important method to check whether there is rectal cancer, but also a common and simple technique to determine whether there is export obstructive constipation. Especially the enhanced sphincter tension, the sphincter can not be relaxed during force discharge, but more contracted and tense, suggesting long-term extreme effort to defecate, resulting in sphincter hypertrophy, and at the same time in paradoxical contraction during force discharge.