Constipation has clear clinical symptoms: whether it is a change in the morphology of the colon and rectum on imaging or a loosening of the diseased bowel, thinning of the tissues or hyperplasia, these symptoms are sufficient to indicate 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 methods in clinic now? 1, constipation patients have what conditions need surgery? (1) Patients who are ineffective or with unsatisfactory effect after long time dietary adjustment, taking laxatives or enema to assist defecation; (2) Patients who have no or indifferent intention to defecate for a long time, and patients who have difficulty in defecation or defecation effort, feeling of impurity in defecation, etc.; (3) Patients whose markers are retained in the colon for more than 72 hours as shown by the colon transport test; (4) Patients whose barium enema combined with fecal contrast shows that the colon is lengthy and dilated, (4) Barium enema combined with fecography shows that the colon is long, dilated, and the colonic pouch has become shallow or disappeared, and there is no obvious recovery after correcting the constipation of outlet obstruction; (5) Barium enema combined with fecography shows that there is obvious obstruction of rectal passage; (6) Barium enema combined with fecography suggests that there is obvious pelvic floor muscle dysfunction; (7) Fiberoptic colonoscopy shows that there is no organic pathology in the colon; (8) There is no obvious psychiatric disorders. 2, commonly used surgical methods (1) colon subtotal resection or lesion of the colon segment resection for colon constipation at present domestic advocate 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 considerations, 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 is more commonly used by foreign scholars, and a few domestic scholars have also reported the relevant operation, because of its postoperative defecation is not easy to control the domestic has not been commonly used. (3) Rectal channel correction – treatment of outlet obstruction type constipation The operation is designed according to the cause of rectal constipation – rectal channel obstruction deformity and pelvic floor muscle dysfunction. By correcting rectal mucosa, rectal valve deformity, pelvic floor muscle dysfunction, sacral rectal separation, etc., the cure rate of rectal constipation is significantly improved. (4) Acupuncture point burying line for constipation The method of treating constipation by burying intestinal line at acupoints for relief is safe, simple, and medically inexpensive, so it is worth trying. (5) Biofeedback therapy is mainly applicable to patients with pelvic floor dysfunction in exit-obstructive constipation, with good efficacy and high safety, and it is one of the options for patients who are not willing to accept surgical treatment. (6) STARR’s surgery and PPH surgery for outlet-obstructed constipation Both are suitable for outlet-obstructed constipation caused by structural changes in the rectal cavity. Recent efficacy is good, because the operation 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. The pathological 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 test results is becoming mature, the use of constipation test results to guide 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.