Constipation is one of the most common clinical problems, sometimes it is only a symptom or a group of symptoms, mostly due to poor diet, irregular life, side effects of drugs, etc. This kind of constipation is mostly transient or temporary. But most of the constipation is not transient, is long-term, and after a variety of treatment effect is not good, or even ineffective. Therefore, constipation is a seemingly simple but in fact is a more complex problem, but also recognized globally as a more difficult problem. 1.1 Think constipation is a “minor disease”, do not take it seriously. Constipation is a very common symptom in life, many people have happened, occasionally or often happen to be accustomed to, and does not cause patients or doctors to pay attention. We know that constipation is not an independent disease, and many diseases appear in a common symptom, that is to say, many diseases can cause constipation, in addition to general intestinal functional lesions, drug effects, intestinal occupational lesions such as tumors, polyps, non-specific inflammatory diseases, such as UC, Crohn’s disease, the colon itself, such as colon redundancy, colon twisting and megacolon can cause constipation, if you do not go to the regular hospital for timely examination and diagnosis. If you can’t go to the regular hospital in time to confirm the diagnosis, there may be missed diagnosis, misdiagnosis, delayed treatment, or even life-threatening. 1.2 Do not be diagnosed and treated by doctors, see secret and treat constipation. Some patients think that constipation is dry stools, difficult to discharge, take some laxative medicine can be. Therefore, for years and years with fruit guide tablets, senna, rhubarb and so on to maintain defecation, and the amount of more and more with the larger, the results of colonoscopy intestinal mucosa malignant lesions, and even a very small number of patients have cancer. Secondly, some patients are physically weak, Chinese medicine identification when the virtual secret (evidence), the treatment should be used to benefit the gas and nourish yin lubrication of the bowel and laxative medicine, counter-use of three yellow tablets, oxalic detoxification tablets and other cold and precipitous down the medicine, more injuries to the spleen and stomach, the spleen and stomach can not be normal infusion of water and grain essence, resulting in the virtual evidence of the virtual, the more the more diarrhea, as the boat in the ditch, the boat is difficult to water, hard pulling the strong push, both the laboriousness, but also the loss of the boat, the boat can not be line, the use of additional water The way to increase the water can make the boat line, both labor-saving, but also do not damage the boat, the treatment of virtual constipation is also this reason. If the body is strong, plain fire, Chinese medicine identification when the real secret (evidence), hot secret (evidence), the treatment should be applied to clear heat diarrhea and other drugs, should not take the Cistanch, fire Ma Ren and other nourishing Yin laxative medicine. Just like boiling water, the water boiled by uncovering and adding water can only alleviate the moment, the bottom of the kettle to solve the fundamental problem. Treatment of disease is the same, only accurate identification, identification and treatment in order to achieve the purpose of the fundamental cure, many patients recounted the beginning of the medicine is effective, after a few days on the ineffective, this problem is not difficult to understand. 1.3 Thinking that fruits can prevent and cure constipation. Fruit can prevent and control constipation, has been common sense, but it should be noted that not all fruits have the role of preventing and controlling constipation, different fruits play different roles, for example, some people eat pears, bananas, watermelons, oranges and other fruits after the increase in intestinal peristalsis to prevent and control constipation, and eat apples, persimmons, but aggravate constipation. If often afraid of cold, cold hands and feet (Yang deficiency constitution) people, eat pear, persimmon, pineapple will aggravate constipation, eat bananas, oranges to prevent and control constipation; and often dry mouth, upset, hot hands and feet (Yin deficiency constitution) people, eat pear, oranges, pomelo will relieve constipation, while eating oranges is not suitable. 1.4 Poor understanding of the complexity of constipation. Whether it is the etiology, pathogenesis, or the physiology and pathology of the colorectal lack of sufficient knowledge, the causes of constipation is very complex, such as the intestinal tract itself such as tumors, inflammation, tuberculosis, anastomotic stenosis, megacolon, megalorectum, colonic diverticulosis, irritable bowel syndrome, anal canal stenosis, pelvic floor spasms, intramucosal prolapse of the rectum, rectal proptosis, small intestinal hernia, sigmoid colon hernia, and so on, the extracolorectal pathology such as hypothyroidism, hypopituitarism, hypercalcemia, hypokalemia, diabetes mellitus, pregnancy, mental disorders such as depression, psychosis, neuropathy such as central neuropathy, spinal neuropathy, peripheral neuropathy, medication side-effects such as morphine, antidepressant, psycho-psychotherapeutic medication, calcium channel blocker, ganglionic blocker, iron, etc., as well as unscientific diets and habits such as over-refined diet, Too little, too high calorie, insufficient water, inhibit defecation and so on can lead to constipation, so when analyzing the cause of the disease, we can not lose sight of the other. 2, treatment misunderstanding 2.1 only seek temporary effect, lack of fundamental treatment. “Treat the symptoms in an emergency, and treat the root cause in a slow manner.” Is the basic principle of Chinese medicine treatment of disease. To solve the problem of defecation difficulty and exit obstruction is to treat the symptoms urgently, and then to treat the root cause slowly, i.e. to treat the causes of defecation difficulty or obstruction. Although constipation is not an independent disease, but it as a symptom of long-term existence or recurrence, can be due to gas deficiency, blood deficiency, yin deficiency, yang deficiency, or solid heat stagnation and caused by the long-term application of laxatives or mis-treatment, the disease can be secondary to prolapse of rectal mucosa, rectal protrusion or colonic redundancy, or even the formation of small intestinal hernia, sigmoid colon hernia, et al., the cause of the etiology and morphology of the changes in each other, the formation of a vicious circle. Therefore, the treatment should be fast from the fundamental solution, both to regulate the body’s bias bias, but also to correct the morphological changes. 2.2 Wrongly treat constipation as “enteritis”. Clinically, there are many patients who do not have dry stools, one or more times a day, without pus and blood and mucus, but the discharge is difficult, discharge effort, always feel that the feces to the anus can not come out, or after the fecal residual stools, blockage feeling, by anoscopy, enteroscopy, no anomalous findings, by the fecal imaging test suggests that may be a mucosal intramucosal rectum, if treated as a “bowel inflammation” treatment, is bound to be ineffective, and even add to the problem. 2.3 Ignorance of the complexity of constipation and excessive belief in surgery. Due to the lack of understanding or special examination of constipation, constipation is considered to be regulated by medication, and when the treatment is ineffective, it blindly chases after surgical treatment or believes too much in surgical treatment, especially for the principle of external treatment of Chinese medicine or surgical treatment of constipation, in fact, a few grassroots hospitals don’t have the spare parts of the examination of constipation, and even take the risk of surgery for the sake of pursuing economic benefits, which leads to the climax of the operation and deflates the expectations, not only increasing the number of patients, but also the number of patients who are suffering from constipation. Expectations, not only increased the patient’s pain, but also to the confusion caused by the surgical treatment of constipation. 2.4 False negative or false positive examination results. When constipation examination results are not true, its treatment will be biased. Among the current examination methods, colonic transmission test is the main means to diagnose slow transmission constipation, focusing on checking the peristaltic function of the colon, and defecography and anorectal electromyography are the main means used to diagnose defecation disorders, focusing on checking the elasticity of the anterior wall of the rectum, the loosening of the rectal mucosa, and the coordinated function of the muscles of the pelvic floor; however, there is a problem with all of them, namely, that all of them are not in physiological condition However, there is a problem with all the methods, namely that they are not performed under physiological conditions. The thinness of the contrast medium, the location and depth of the insertion of the needle, the degree of cooperation of the patient, and the patient’s position (squatting for defecation and lying on the side for the examination) will all affect the results of the examination. In clinical practice, there is often a situation in which the patient usually defecates once every 7-8 days, or even longer, but empties the bowels on the second day after oral administration of colonic markers, which suggests that the colon transmission test is normal, and that it is often necessary to do the transmission test twice or even three times in order to reflect the true situation, so there is a certain rationale for the requirement of Rome III that the transmission test must be done at least two times. On the contrary, treatment accordingly will inevitably be biased. 3, conditioning misunderstandings Clinical also found in the dietary structure, dietary behavior and other aspects of the misunderstanding, some of the elderly think that eating more fruit will raise blood sugar, thus reducing the amount of fruit intake, resulting in constipation. There are also elderly intake of vegetable varieties monotonous, reducing the dietary fiber intake, so that the bowel movement slowed down and caused constipation. It is also found that milk may have a greater relationship with the occurrence of constipation, it has been suggested that when drinking milk can be appropriate to add honey to prevent constipation. Eating too little can also cause constipation, when the daily diet is significantly lower than their past level, constipation will occur. Such as many diseases in the treatment of fasting for several days or chronic digestive disorders caused by loss of appetite and eat too little, the elderly due to the decline in digestive function and the decline in food intake, in order to maintain body shape, weight loss and excessive dieting. Due to the amount of food is too small, can not produce effective gastrointestinal stimulation and cause gastro-colonic reflex, so that the intestinal contents in the intestinal lumen running slowly, intestinal peristalsis slows down, and its water is over-absorbed and lead to fecal dryness. 4, different opinions in the clinic often hear patients say, before surgery, the effect is not ideal, or recurrence soon after surgery, some experts on the surgical treatment of constipation is inconsistent, and even proposed that the surgical treatment is ineffective, to be cautious and prudent. The author believes that the implementation and development of each method is not perfect, but with the accumulation of experience and awareness of the re-improvement, the efficacy will be more accurate. Such as colon redundancy or slow transmission of patients, colon resection how much appropriate, initially resection of the sigmoid colon, the left half of the colon, the near-term effect can be, the long-term effect is less than ideal, and then changed to the whole colon sub-total cuts, worried about the number of stools will be more, and in fact, after 1 month after the operation, the number of stools is only 3-5 times, individual patients, 7, 8 times, half a year later, more than 2-4 times, the long-term effect will be good. Then for the pubococcygeus rectus muscle hypertrophy, spasm caused by the outlet obstruction type constipation, surgical treatment, is to solve the problem of acute, more importantly, but also regularly expand the anus, to prevent postoperative recurrence, and how to grasp the operation (cut off how much sphincter for the best) degree of the problem. Postoperative recurrence is also an important issue, that is, the judgment of the etiology of outlet obstruction, caused by a variety of causes of outlet obstruction, such as puborectal muscle hypertrophy, puborectal muscle spasm, spasm of the pelvic floor muscles, perineal descent, anterior proclination of the rectum, rectal prolapse within the mucosa, etc., a patient is not caused by a cause, may be two or even a variety of causes of the results of the joint role of the treatment of its treatment of course, the effect of one of them is not good. The effect of treating only one of the causes is certainly not good.