The 3 tests necessary to check constipation are, in our opinion, missing, because the etiology of constipation is extremely complex and conservative treatment is sufficient for a considerable number of children with constipation. In contrast, surgery for megacolon requires an extremely high level of experience from the surgeon. The principle of surgery is to remove the diseased colon with constipation causing lesions, first destroying and then reconstructing the mechanism of bowel control, and it is a contaminated surgery, which may result in many complications, some of which are irreversible and even lifelong fistulas. In some cases, the quality of life of the child is better than not having the surgery. Therefore, it is truly recommended that families of children choose one of the larger specialized pediatric surgeries in the country and stay away from places that may only perform less than 5 constipation surgeries a year. For many children who are not fully evaluated, the following is a report of rectoanal manometry and histochemistry.