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ANAL FISSURE
ANAL FISSURE
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GENERAL INFORMATION
DESCRIPTIONAn anal fissure represents splitting or tearing of sensitive anal tissue. Anal fissures can affect both sexes, all ages, but are most common in infants and young children. This affects more females than males.
Appropriate health care includes:
Home care.
Physician's monitoring of general condition and medications.
Surgery to remove the fissure or to alter the muscle that contracts and prevents normal healing.
SIGNS & SYMPTOMS
Sharp pain with passage of a hard or bulky stool.
Streaks of blood on the toilet paper, underwear, or diaper.
Itching around the rectum.
CAUSES
Stretching of the anus from a large, hard stool.
RISK FACTORS
Constipation.
PREVENTING COMPLICATIONS OR RECURRENCEYour child can avoid constipation by:
Drinking at least 8 glasses of water daily.
Eating a diet high in fiber.
Using stool softeners or other laxatives, if needed (rare).
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Examination of the anus and rectum with an anoscope or sigmoidoscope to rule out other causes of anal or rectal bleeding.
POSSIBLE COMPLICATIONSPermanent scarring that prevents normal bowel movements.
PROBABLE OUTCOME
Most infants and young children recover after the stool is softened.
TREATMENT
HOME CAREThe following should be done to prevent constipation in children until the fissure heals:
For infants: Before bedtime, fill a rubber ear syringe with plain mineral oil. Gently insert the tip and squeeze the mineral oil into the infant's rectum. Repeat the next morning. If no bowel movement occurs, repeat at noon. After the bowel movement, clean the anus gently with cotton and water.
For older children: Gently squeeze 4 ounces of mineral oil into the rectum. Use a sanitary napkin to catch oil that seeps out in the night.
To relieve muscle spasms and pain around the anus, apply a warm towel to the area.
Sitz baths also relieve pain. Use 8 inches of very warm water 2 or 3 times a day for 10 to 20 minutes. Be careful not to burn a young child.
MEDICATION
For minor pain, use non-prescription drugs, such as acetaminophen or topical anesthetics.
After sitz baths, apply a non-prescription ointment containing zinc oxide to help heal the fissure.
Use mineral oil as a laxative for infants. Give the infant 1 teaspoon by mouth for each 10 pounds of body weight. Repeat each day for about 2 weeks after blood disappears from the stool.
After giving mineral oil, wait several hours to give vitamins. Mineral oil interferes with the absorption of vitamins and other nutrients.
ACTIVITY
No restrictions. Physical activity reduces the likelihood of constipation.
DIET & FLUIDS
Encourage a high-fiber diet and extra fluids to prevent constipation.
OK TO GO TO SCHOOL?Yes, unless pain is too severe during treatment.
CALL YOUR DOCTOR IF
Your child has symptoms of an anal fissure--especially pain--that persists despite treatment.
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From Complete Guide to Pediatric Symptoms, Illness & Medications by H. Winter Griffith, M.D. Copyright by Putnam Publishing
Group. Electronic rights by Medical Data Exchange.
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