An anal fissure is a small tear or crack in the skin at the opening of the anus. More than 90% of children with blood in their stools have an anal fissure.
You may notice the following symptoms:
Constipation or passing a hard or large BM is the usual cause of anal fissures. Rarely it is due to a Strep infection around the anus.
Bleeding from a fissure stops on its own in a few minutes. Fissures heal quickly, usually in 1 to 2 days.
Give your child warm baths for 20 minutes, 3 times a day until the pain stops. Have him sit in a basin or tub of warm water with about 2 ounces of table salt or baking soda added. Don't use any soap on the irritated area. Then gently dry the anal area.
After passage of stools, gently cleanse the anus with warm water. Do not use dry toilet tissue until the fissures are healed.
If the anus seems irritated, you can apply 1% hydrocortisone ointment (nonprescription). If the pain is severe, apply 2.5% lidocaine (Xylocaine) or pramoxine ointment (nonprescription) a few times to numb the area.
The most important part of treatment is for your child to eat more fiber and drink plenty of fluids to keep from getting constipated. Increase the amounts of fresh fruits and vegetables, beans, and bran products that your child eats. Reduce the amounts of milk products your child eats or drinks.
A nonprescription stool softener such as mineral oil, Miralax (Glycolax), or docusate may be needed for a short time.
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