Whether it is a change in the morphology of the colon and rectum on imaging or laxity, thinning of tissue or hyperplasia of the diseased bowel, these symptoms are a strong indication that constipation is a disease rather than a symptom. Patients whose constipation is not relieved by formal conservative treatment such as dietary and lifestyle modification, medication, or even including biofeedback, should be treated surgically. This is the most reasonable and effective treatment for patients with a long medical history, ineffective conservative treatment, and constipation diagnosed through various tests. So under what circumstances is surgery needed? What are the surgical procedures available in the clinic nowadays? Next I will explain to you one by one through this article. 1, constipation patients have what conditions need surgical treatment? (1) by a long time diet and living regulation, taking laxatives or enema to assist defecation ineffective or unsatisfactory results. (2) Patients who have no or indifferent intention to defecate for a long period of time, and who have clinical manifestations such as difficulty in defecation or laborious defecation, or feeling of unclean defecation. (3) Patients whose colonic transport test shows that the marker is retained in the colon for a period of time greater than 72 hours. (4) Barium enema combined with fecal imaging showing colonic redundancy, dilatation, shallow or disappearing colonic pouch, after correction of outlet-obstructive constipation and without significant recovery. (5) Barium enema combined with fecography showing significant rectal passage obstruction. (6) Barium enema combined with fecography suggests significant pelvic floor muscle dysfunction. (7) Fiber colonoscopy of the colon without organic lesions. (8) Those without obvious psychosomatic disorders. 2, commonly used surgical methods ⑴ colon subtotal resection or lesion colon segment resection: for colon type constipation at present the domestic advocates the use of colon subtotal resection, clinical observation of the efficacy of reliable. Some scholars from the perspective of maintaining the patient’s colon function, in the full correction of rectal channel deformity caused by rectal constipation on the basis of only doing the lesion of the colon segment resection, but also achieved ideal results. Its surgical access can be taken as traditional open surgery, and with the improvement and popularization of laparoscopic technology, the proportion of laparoscopic constipation surgery is gradually increasing. (2) Total colectomy: foreign scholars apply more common, a few domestic scholars also have related operation reports, because of its postoperative defecation is not easy to control the domestic has not been commonly used. (3) Rectal channel correction: the treatment of outlet obstruction type constipation the operation is based on the cause of rectal constipation – rectal channel obstruction deformity and pelvic floor muscle dysfunction design. By correcting rectal mucosa, rectal valve deformity, pelvic floor muscle dysfunction, sacral straight separation, etc., the cure rate of rectal constipation is significantly improved. (4) Acupuncture point burying line: treatment of constipation through acupuncture point burying intestinal line relief treatment of constipation, its method is safe, simple, low medical cost, it is worth trying. (5) biofeedback: the treatment is mainly applicable to the exit obstruction type constipation with pelvic floor dysfunction patients, good efficacy, high safety, for patients who are not willing to accept surgical treatment is one of the means that can be chosen. (6) STARR’s surgery, PPH surgery: the treatment of exit-obstructive constipation both applicable to the rectal luminal structural changes caused by exit-obstructive constipation. Recent efficacy is good, because of the surgery is carried out for a short period of time, its long-term efficacy is still under observation. 3, constipation prevention and treatment precautions According to the clinical colon pathology results confirmed that constipation cut colon have colon muscle damage; all colon specimens have intermuscular plexus have degeneration, reduction or even disappearance and so on, and the colon, rectum, long-term chronic obstruction, long-term use of stimulating laxative (rhubarb, senna, aloe vera, cassia seeds, fruit guide tablets and stopping the plugs) are likely to cause these changes. Also if these drugs or preparations containing them are applied for a long period of time, they can cause difficult to manage complications such as colonic melanosis and laxative colonization. Therefore, the above-mentioned drugs should not be used for a long time. Pathologic changes in the constipated diseased intestinal segments are progressive, and in this sense it is better to treat constipation sooner rather than later. With the development of medical science, the understanding of constipation is progressing, the diagnosis and treatment methods of constipation are increasing, the understanding of the significance of constipation examination results is becoming mature, the use of constipation examination results to guide the clinical diagnosis, the standard of treatment program development is improving, and the treatment effect of constipation is also improving. It is reasonable to believe that the research on the diagnosis and treatment of constipation will bring us more confidence and hope.