1.Why does constipation still occur after congenital megacolon surgery? There are many factors for constipation after megacolon surgery, the most common reason is residual ganglion cell-free lesioned intestinal segment, in a few cases the residual lesioned intestinal segment is due to incomplete surgical excision, this situation has rarely occurred under current technology, most cases are secondary necrosis of the distal rectal ganglion due to infection or ischemia, which leads to secondary ganglion cell deficiency, due to the presence of lesioned The presence of a segment of the intestine affects the function of the anorectum and therefore predisposes to constipation. In addition, if the rectal muscle sheath preserved during surgery is too long or too tight, it is also an important cause of postoperative sphincter spasm and loss of retardation. The sphincter cannot reflexively relax in the defecation state, thus constipation. Finally, many patients with megacolon combine with abnormal power function of the proximal colon, and even though the distal diseased bowel is surgically removed, the power disorder of the proximal bowel is not relieved, so they are also prone to constipation after surgery. Other rare causes include excessive pelvic floor injury, severe perirectal scar tissue, abnormal rectal compliance, abnormal rectal mucosal sensation, and other reasons that may lead to postoperative constipation. 2.Does postoperative constipation require a second surgery? Is it effective to continue with enemas? Not all postoperative constipation requires a second surgery. For postoperative constipation, the cause of constipation should be found first, and if there is a clear residual lesion of the intestinal segment, a second surgery is necessary, while if the constipation is caused by other functional reasons, surgery is not recommended. No matter what the cause of constipation, enema treatment is an effective treatment method, some functional causes of constipation, enema can play a radical role, even for the lesion residual constipation, enema is still the most effective way to relieve the symptoms, especially in cases of total gastrointestinal dysfunction, enema is currently the only effective relief method. 3.Why do some children have diarrhea after surgery? What should be done? Diarrhea in the short term (within 1 year or 3 years) after surgery is mechanical and is related to the removal of the intestinal tube. Since the main function of the colon is to absorb water and store feces, the surgery removes part of the intestinal tube, resulting in reduced absorption of water in the colon and shortening of the intestinal tract, so diarrhea is likely to occur; the treatment is mainly to relieve the symptoms, mainly with some drugs that protect the gastrointestinal mucosa and regulate the intestinal microecology. The main treatment is to relieve the symptoms, mainly with drugs that protect the gastrointestinal mucosa and regulate intestinal microecology. The pathogenesis of giant colon-associated enteritis is not clear, but may be related to the existence of functional obstruction at the distal end or destruction of intestinal mucosal barrier and impaired intestinal immune function. The treatment should include bowel lavage and enemas with metronidazole, as well as systemic nutritional support and intravenous metronidazole. If there is a combination of dehydration or severe anemia and malnutrition, it should be corrected at the same time. For example, blood transfusion, gammaglobulin and total intravenous nutrition, etc. 4.How long does diarrhea last and how long should I be alerted to small bowel colitis? Do I need to see a doctor immediately? If the diarrhea is not relieved by normal treatment and systemic symptoms, such as fever, abdominal distension, foul-smelling bowel movements, etc., are present, regardless of how long the diarrhea lasts, small bowel colitis should be considered and treated according to small bowel colitis, with attention to nutritional support. In the past, the morbidity and mortality rate of small bowel colitis was very high and was the main cause of death from megacolon. With the application of broad-spectrum antibiotics and the development of total intravenous nutrition technology, as well as the progress of other nutritional support therapies, the morbidity and mortality rate of small bowel colitis has been significantly reduced, but it should still not be ignored. 5.What is the cause of postoperative diarrhea and blood in the stool? How to treat it? The majority of diarrhea and bloody stools after megacolon surgery are caused by increased vascular permeability of intestinal mucosa and extravasation of blood cells due to enterocolitis, while a few cases are due to bleeding of skin and mucosa caused by alkaline intestinal fluid eroding the perianal skin after prolonged diarrhea, and a few cases are due to anastomotic bleeding. For bloody stool or mucosal bleeding caused by diarrhea, the main treatment is to treat diarrhea, relieve symptoms, protect intestinal mucosa and protect perianal skin, you can apply various oil creams or light bulb illumination to keep perianal skin dry; for anastomotic bleeding, we should immediately fast water and actively treat diarrhea, if conservative treatment is ineffective, we need proximal colostomy and fecal diversion. 6, postoperative bloating for anal dilation, is it normal to have thin and acidic stools? If postoperative bloating occurs, only the bloating caused by anal spasm will be relieved by anal dilation, and there can be a small amount of loose stool during dilation, but if the stool is watery and accompanied by fever or foul-smelling stool, small bowel colitis should be considered and treated early. For intestinal adhesions or dyspepsia or intestinal dysfunction caused by abdominal distension, anal dilation is not very helpful, occasionally there will be a small amount of loose stool, this situation will have to use a little discretionary gastrointestinal power drugs. 7.What is the problem of postoperative fecal incontinence and frequent staining of underwear with small amounts of stool? What should I do? The cause of this phenomenon is not very clear, but it may be related to the malfunction of the internal sphincter, and other causes such as abnormal sensation of the rectal mucosa and reduced rectal compliance may also lead to the occurrence of fecal contamination. There are a large number of case reports confirming that pelvic floor biofeedback training and sacral nerve electrical stimulation therapy are effective methods for treating defecation disorders. In China, Shengjing Hospital of China Medical University has taken the lead in applying this technology to treat defecation disorders after surgery for megacolon and anorectal malformations, and has achieved satisfactory results, with rich clinical experience and leading treatment level in China. The advantages of this method are that it is simple, non-invasive, and has precise efficacy, which is worth promoting.