Defecation is a complex physiological process that is influenced by structural and functional changes in the brain, spinal cord, intestinal tract and surrounding tissues and organs, and any number of factors can lead to abnormal defecation. Constipation is the same. What parents need to do is to look at functional constipation correctly and be alert to abnormal organic constipation. If constipation is very stubborn, persistent, lasting for weeks or months or more, accompanied by abdominal distension, abdominal fecal masses, malnutrition, etc., prompt medical attention is needed. Constipation can be caused by many factors, some of which are functional, that is, related to habits, diet, changes in lifestyle, most of which are temporary or intermittent. Constipation in some young children and children is often related to good movement, mental activities, irregular diet and living, and when there is a sense of bowel movement due to some other factors (such as watching TV, playing or other curious factors), resulting in psychological refusal or forgetting to defecate, the brain consciously hold the stool, so that the accumulated stool stored in the colon, water is excessively absorbed, the intestinal tube to the stimulation of the stool sensitivity is reduced, there will be a weakened sense of stimulation of defecation This can lead to constipation, with a sheep’s stool egg-like consistency. This type of constipation requires the child to develop good bowel habits, regular diet and living, and re-cultivate and restore the child’s sensitivity to the stimulation of defecation. Training can be carried out by the following methods: 1. standardizing the diet and living; 2. opening the laxative first, so that the accumulated stool is completely emptied and the sensitivity of the intestinal canal to stool stimulation is restored; if there is a lot of accumulated stool, it is usually necessary to apply the laxative twice within 24 hours. You can develop a daily habit of defecating in the morning, and on the first day if you do not have a bowel movement, you can assist in defecating once with open cork. On the second day, the same time in the morning after waking up to urge defecation, and from the psychological implication and guidance. On the third day, do the same until a good defecation habit is developed. The above training may not be effective if the diet and living are not regular. Before diagnosing habitual constipation, it is necessary to exclude organic constipation, that is, constipation due to some other cause. These constipations are often very persistent, with abdominal distention, difficult bowel movements, abdominal masses (accumulation of stones) in some children, chronic malnutrition, and developmental delays, most often starting after birth to early childhood or progressively worsening. If a child has chronic constipation, he or she needs to be examined by a hospital qualified in pediatric medicine and pediatric surgery to rule out organic diseases. Constipation caused by diseases commonly associated with pediatric surgery include: congenital megacolon: most of them do not pass fetal stool for 24 hours after birth and take a long time to pass fetal stool, followed by varying degrees of abdominal distension and constipation, most of them have clinical manifestations in the neonatal period and require assisted defecation (corkage and enema), after persistent constipation, if accompanied by thin smelly stool, they need to be alerted to enterocolitis and seek timely medical attention, otherwise it may be life-threatening. Barium enema, rectal manometry and biopsy of the rectal mucosa and lower layers are needed to make a clear diagnosis. Anal stenosis: Some children have congenital anorectal stenosis or anal atresia with a small fistula, which is not noticed by parents after birth, and progressive constipation will worsen after adding supplementary food. Tumor: pelvic and sacral tumor can cause constipation, initially it is not obvious, but when the tumor increases, it will appear as thin strips of stool or flat with angular shape, and it is hard to defecate, this condition is mostly seen in children older than one year old, sometimes the appearance is not abnormal, sometimes a sacrococcygeal mass can be seen. A physical examination and ultrasound and MRI are needed to clarify. Spinal cord embolism: Some children with spinal cord embolism have no obvious abnormalities on physical examination, and the only manifestation is persistent constipation, which is not obvious in infancy and worsens progressively afterwards. Most of these children also have progressive urinary disturbances after infancy, with incomplete or dripping urination. There are other rare factors of constipation: slow-transit constipation, many of these children have bowel movements more than once a week, mostly without significant abdominal distension, physical examination and rectal manometry, rectal mucosa and lower layer biopsy are normal, barium enema except for colonic fecal accumulation does not see obvious abnormalities, colon transit test can be seen in different intestinal segments of the retention time of stool abnormal, the diagnosis and treatment are currently controversial. Excessive rectal protrusion and abnormal anorectal angle. In normal people, the rectum is slightly curved, and if the curvature is too large or the anorectal angle is significantly abnormal it can affect the sensation of defecation or cause straining to defecate, which is rarely diagnosed in children. Some children who do not have dry stools but are prone to anal fissures may sometimes be related to the anorectal angle, which is also controversial and not widely recognized, and treatment is certainly inconclusive, but the general principle is to try not to use invasive methods of treatment as long as the symptoms do not affect the child’s development and quality of life. Colonic stricture, or incomplete obstruction of the digestive tract: these children mostly have abdominal distension, vomiting, and little defecation, and need to be seen promptly for a clear diagnosis.