Constipation is one of the most common clinical problems, sometimes only a symptom or a group of symptoms, mostly due to dietary irregularities, irregular life, side effects of drugs, etc. Such constipation is mostly transient or temporary. However, most constipation is not transient, is long-term, and after a variety of treatment effect is poor, or even ineffective. Therefore, constipation is a seemingly simple but actually complex problem, which is also recognized as a more difficult problem worldwide. It has a high incidence especially in the elderly, pregnant women, children and dieters, and is often the only reason why some patients visit hospitals. There are still many misconceptions in the prevention and treatment of constipation. Myths 1, constipation is considered a “minor disease”, do not take it seriously. Constipation is a very common symptom in life, many people have happened before, occasionally or often occurring as a matter of course, and does not attract the attention of patients or doctors. We know that constipation is not an independent disease, but a common symptom in many diseases, 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, colon lesions such as colonic redundancy, colon distortion and megacolon, etc. can cause constipation, if If you can’t go to the regular hospital in time to check and confirm the diagnosis, there may be missed diagnosis, misdiagnosis, delayed treatment, and even life-threatening. 2, without the doctor’s consultation, see constipation treatment constipation. Some patients think constipation is dry stool, discharge difficulties, take some laxative can. Therefore, years and years with fruit guide tablets, senna, rhubarb and so on to maintain defecation, and the amount of the larger the use, the result of intestinal mucosa intestinal microscopy malignant color lesions, and even a very small number of patients have cancer. Secondly, some patients are physically weak, Chinese medicine identification when it is a false secret (card), treatment should be used to benefit qi nourishing yin laxative medicine, anti with three yellow tablets, niuhuang detoxification tablets and other cold and steep down the medicine, more injury to the spleen and stomach, the spleen and stomach can not be normal transmission of water and grain essence, resulting in false evidence more false, more diarrhea more secret, like a boat in the river ditch, less water boat difficult to travel, hard pull strong push, both laborious, but also damage the boat, the boat can not travel, using the water increase The method can make the boat line, both save effort, and not damage the boat, treatment of false secret is also this reason. If the body is strong, there is fire, Chinese medicine identification when the real secret (card), hot secret (card), the treatment should be applied to clear the heat and diarrhea and other drugs, should not take cistanches, fire marijuana and other nourishing Yin laxative medicine. Just like boiling water, the water is boiling using the method of uncovering and adding water can only relieve the moment, the bottom of the kettle to solve the fundamental problem. Cure is also the same, only accurate identification, diagnosis and treatment to achieve the purpose of the fundamental cure, many patients described at the beginning of the medicine effective, after a few days no effect, the problem is not difficult to understand. 3, think that fruit can prevent and control constipation. Fruit can prevent and control constipation, is common knowledge, but it should be noted that not all fruits have the role of prevention and control of constipation, the role of different fruits are different, for example, some people eat pears, bananas, watermelon, oranges and other fruits after the increase in intestinal peristalsis, prevention and control of constipation, but after eating apples, persimmons aggravate constipation. If often afraid of cold, cold hands and feet (Yang deficiency body) people, eat pears, persimmons, pineapples will aggravate constipation, eat bananas, oranges to prevent and control constipation; and often dry mouth, heartburn, hot hands and feet (Yin deficiency body) people, eat pears, oranges, grapefruit will relieve constipation, and eat oranges are not suitable. 4, poor understanding of the complexity of constipation. Whether it is the cause, pathogenesis, or the physiology and pathology of the colon and rectum are lack of sufficient understanding of the causes of constipation is very complex, such as intestinal lesions themselves such as tumors, inflammation, tuberculosis, anastomotic stenosis, giant colon, giant rectum, colonic diverticulosis, intestinal irritable syndrome, anal canal stenosis, pelvic floor spasm, rectal mucosal prolapse, rectal prolapse, small bowel hernia, sigmoid hernia, etc., extra-colonic lesions such as hypothyroidism, hypopituitarism, hypercalcemia, hypokalemia, diabetes mellitus, pregnancy, psychiatric disorders such as depression, psychosis, neuropathy such as central neuropathy, spinal neuropathy, peripheral neuropathy, drug side effects such as morphine, antidepressants, psycho-psychotherapeutic drugs, calcium channel blockers, ganglion blockers, iron, etc., and unscientific diet and habits such as over-refined diet, under-refined diet, over-calorie diet, over-drinking, and over-hypoglycemia, Too little, too much calories, not enough water, inhibit bowel movement, etc. can lead to constipation, so in the analysis of the cause of the disease can not lose sight of one thing. Treatment misconceptions 1, only for the momentary effect, the lack of fundamental treatment. “Urgent is to treat the symptoms, slow is to treat the root.” Is the basic principle of Chinese medicine treatment of disease. To solve the problem of difficult defecation and outlet obstruction is urgent to treat its symptoms, after which it should be slow to treat its root, that is, to treat the causes of difficult defecation or obstruction. Constipation is not an independent disease, but it exists as a symptom for a long time or occurs repeatedly, and can be caused by Qi deficiency, blood deficiency, Yin deficiency, Yang deficiency, or real heat stagnation, coupled with the long-term application of laxative drugs or misuse of treatment, the disease can be followed by prolapse of rectal mucosa, rectal protrusion or colonic redundancy, and even the formation of small intestinal hernia, sigmoid hernia, etc. The etiology and morphological changes affect each other, forming a vicious circle. Therefore, the treatment should be solved quickly from the root, not only to regulate the body’s bias, but also to correct the morphological changes. 2, the wrong constipation as “enteritis” treatment. Clinically, there are many patients do not dry stool, 1 or more times a day, no pus and blood and mucus, but the discharge difficulties, discharge effort, always feel that the stool to the anus can not get out, or after the stool still have a sense of residual stool, blockage, by anoscopy, enteroscopy, no abnormal findings, fecal imaging suggests that may belong to the rectal mucosa ligature, if treated as “enteritis”, is bound to be ineffective, or even add insult to injury. 3, the complexity of constipation is not understood, too much believe in surgery. Because do not understand or do not have a special examination about constipation, constipation is considered to be the use of drugs for conditioning, treatment is not effective, and blindly chase the surgical treatment or too much believe in surgical treatment, especially the external treatment of Chinese medicine or surgical treatment of constipation principle is not understood, in fact, a few grass-roots hospitals do not have constipation examination spare parts, and even in the pursuit of economic interests, the risk of surgery, a time into the climax, deflated the surgery Expectations, not only increased the patient’s suffering, but also the confusion caused by surgical treatment of constipation. 4, the test results of false negative or false positive. Constipation test results are not true, its treatment will be biased. In the current examination methods, colonic transmission test is the main means of diagnosing slow transmission constipation, focusing on checking the peristaltic function of the colon, defecography and anorectal electromyography is the main means used to diagnose defecation disorders, focusing on checking the elasticity of the anterior rectal wall, the relaxation of the rectal mucosa and the coordination function of the pelvic floor muscles, but all examination methods have a problem, that is, they are not under physiological conditions The examination method, the thinness of the contrast agent, the site of insertion of the electric needle, the depth, the degree of cooperation of the patient and the patient’s position {defecation is squatting, examination is side-lying}, etc., will affect the examination results. Then there is often such a kind of clinical situation, usually the patient 7-8 days defecate once, or even longer, but after oral colon markers on the second day that empty stool, the results suggest that the colon transmission test is normal, often need to do 2 or even 3 transmission test, in order to reflect the real situation, so, Rome III regulations transmission test is at least 2 times more is a certain reason. Conversely, treatment based on this will inevitably be biased. Conditioning misconceptions Clinically, it is also found that there are misconceptions in dietary structure and eating behavior. Some elderly people think that eating more fruits will raise blood sugar, thus reducing the intake of fruits, which leads to constipation. Other elderly people have a monotonous intake of vegetables, which reduces the intake of dietary fiber, resulting in constipation caused by slowed gastrointestinal motility. It has also been found that milk may be more related to the occurrence of constipation, and it is recommended that honey be added to milk to prevent constipation. Constipation can also be caused by eating too little, when the daily diet is significantly lower than one’s past level. For example, many diseases require fasting for several days during treatment or chronic gastrointestinal disorders cause loss of appetite and too little food, elderly people have a decline in food intake due to declining digestive function, and excessive dieting to maintain body shape and lose weight. Due to low food intake, the gastro-colonic reflex is caused by the inability to produce effective gastrointestinal stimulation, which causes the intestinal contents to run slowly in the intestinal lumen, slows down intestinal peristalsis, and causes dry stools due to excessive absorption of water. Different opinions In the clinic, we often hear patients say that they have had surgery before, but the effect is not ideal, or relapse soon after surgery, and some experts are inconsistent in their statements about surgical treatment of constipation, and even suggest that surgical treatment is ineffective, so we should be cautious. The author believes that the implementation and development of each method is not perfect, but with the accumulation of experience and awareness, the efficacy will be more accurate. For example, in patients with long or slow transmission of the colon, how much colon resection is appropriate, initially resection of the sigmoid colon, the left hemicolectomy, the recent effect can be, the long-term is not ideal, and later changed to the whole large intestine sub-total resection, worried about the number of stools will be more, but in fact, after 1 month after surgery, the number of stools is only 3-5 times, individual patients 7, 8 times, after six months more to 2-4 times, the long-term effect is good. Then is for the rectus pubis muscle hypertrophy, spasm caused by export obstruction type constipation, surgery, is to solve the urgent problem, more importantly, but also regular anal dilatation, to prevent recurrence after surgery, and how to master the operation (cut off how much sphincter for the best) degree of the problem. There is also an important issue of post-operative recurrence, that is, the problem of determining the cause of export obstruction, causing a variety of reasons for export obstruction, such as puborectal muscle hypertrophy, puborectal muscle spasm, pelvic floor muscle spasm, perineal descent, rectal protrusion, rectal mucosal prolapse, etc., a patient is not caused by a cause, may be the result of two or even a variety of causes acting together, the treatment of only one of course, the effect of treatment The effect of treating only one of them is not good.