Patients with chronic constipation, if they do not get better after taking medication for a long time, it is possible that the constipation is caused by other diseases, so they must go to the hospital for relevant examinations in time. Among them, colonoscopy is the most important examination. Colonoscopy is the most direct and important item to detect colitis and intestinal tumors (such as colon cancer)! Colonoscopy includes colonoscopy and small boweloscopy, and at present, people mainly refer to colonoscopy when they talk about colonoscopy. Figure 1: Structure of colonoscope The colonoscope is mainly composed of a thin tube with a camera, which has a diameter of about 1 cm and can be bent (as in Figure 1). During the examination, the end with the camera enters the rectum through the anus and slowly moves through the colon. This process involves inflating the intestine to hold it open while feeding the colonoscope inward, so the distended stomach will be noticeable at this point. The other end of the thin tube is connected to a computer monitor, so the doctor can observe the inside of the intestine through the screen (Figure 2). Figure 2: Schematic diagram of the colonoscopy process Also, if abnormalities in the intestine are found during the examination, they can be treated promptly with colonoscopy. For example, if lesions such as intestinal polyps are found, they can be removed directly with colonoscopy; if there is bleeding in the intestine, the bleeding can also be stopped immediately. In recent years, colonoscopy treatment technology has greatly improved, and relatively large colon noon can also be treated under colonoscopy. During the colonoscopy, the doctor may also remove small pieces of intestinal tissue for more detailed histological evaluation (called “biopsy pathology”) to help confirm the patient’s diagnosis. There are two types of colonoscopy: sigmoidoscopy and total colonoscopy. The instruments and procedures are the same for both types of examinations, but the depth of the colonoscopy is different and the scope of the examination is different. The sigmoidoscopy examines a relatively short segment of the intestine, usually up to about 60 cm from the anus (i.e., the sigmoid colon, as shown in Figure 3). Figure 3: Sigmoidoscopy Full colonoscopy has a broader scope and can examine the rectum and the entire colon. We recommend a full colonoscopy for patients with chronic constipation. Figure 4: Full colonoscopy Of course, there are some risks associated with colonoscopy, such as bleeding or perforation of the colon wall. However, the incidence is low. Which patients are not suitable for colonoscopy? 1, because when doing colonoscopy, there is some stimulation to the human intestine, so patients with unstable blood pressure and heart rate cannot do colonoscopy. 2, to do colonoscopy requires good patient cooperation, if the patient has mental and psychological problems (uncooperative or emotionally unstable) can not do, reluctantly do will have a high risk, such as colon wall bleeding or even perforation. 3, if the patient has recent serious cardiovascular and cerebrovascular problems, such as just had a myocardial infarction, cerebrovascular accident, etc., also do not recommend colonoscopy. If the patient has serious intestinal adhesions due to other diseases, it is also not suitable for colonoscopy. Because of intestinal adhesions easily cause intestinal obstruction, colonoscopy is more difficult to insert into the colon. If forced to do the examination is likely to lead to bleeding or perforation of the intestinal wall. 5, patients with abnormal abdominal blood vessels, such as with abdominal aneurysms, fragile blood vessel walls, the risk of stimulation of colonoscopy is greater! 6, for some special types of bowel disease patients, their colon itself is already very weak in a state close to perforation, can no longer do colonoscopy. In addition to colonoscopy, what other tests may be done for patients with constipation? These tests can help your doctor understand the cause of your constipation, analyze whether there is organic disease, and thus provide targeted treatment. 1.Anal rectal manometry – it can determine whether it is outlet obstruction type constipation and abnormal rectal sensory function and nerve reflexes, and check adult megacolon. 2.Colonic transmission test – to test the time of some opaque markers passing through the colon, to determine whether it is slow transmission type constipation. 3.Defecography – can check the lesions in the anal canal and rectal area, and observe the structural changes in the colorectum during defecation. 4.Colonography – can check colon tumors, polyps, chronic inflammation of colon, congenital abnormalities of colon, colon obstruction and intussusception, etc. 5, abdominal CT – can check abdominal inflammation, tumors, etc. 6.Also need to check blood sugar, thyroid function, blood calcium, etc. to exclude thyroid disease. Because some systemic diseases can lead to slowing down of intestinal movement and thus constipation.