Springdale Mason Pediatrics

Anal Fissure

Definition

  • An anal fissure is a shallow tear in the skin around the anus
  • This is the cause in over 90% of children with blood in the stools

Call or Return If

  • Bleeding gets worse
  • Small bleeding occurs more than 2 times
  • Your think your child needs to be seen
  • Your child becomes worse

About This Topic

Symptoms

  • It causes blood on the surface of a stool.
  • Blood may also be found on toilet tissue after wiping.
  • The blood is always bright red.
  • Only a few streaks or flecks are seen.
  • You may see a shallow tear at 6 or 12 o'clock on the anus.

Cause

  • Anal fissures usually are caused by passage of a large or hard stool.
  • Wiping dried stool off the anus can also cause a fissure.

After Care Advice

Overview:
  • An anal fissure is the most common cause of blood in the stools.
  • It is caused by passing a hard or large stool.
  • Here is some care advice that should help.
Warm Saline Baths:
  • Give a warm salt water bath for 20 minutes.
  • Add 2 ounces (60 ml) of table salt to a tub of warm water. You can also use baking soda.
  • Do 2 times per day for 1 day to cleanse the area and to help healing.
  • Don't use any soap in the water or on the anus.
Steroid Ointment:
  • If the anus seems red, use 1% hydrocortisone ointment. No prescription is needed.
  • Put a little around the anus.
  • Use 2 times per day for 1 day to help healing.
  • Could also use petroleum jelly to protect the anus while it heals.
High-Fiber Diet:
  • For children more than 1 year old, change the diet.
  • Increase fruits, vegetables and grains (fiber).
  • Reduce milk products to 3 servings per day.
  • Treat constipation if that is the cause.
Prevention of Anal Fissures:
  • Keep the stools soft and release them daily
  • Cleanse the anus gently with warm water after passing stools.
What to Expect:
  • Bleeding from a fissure will stop on its own in a few minutes.
  • Most often, anal tears heal up quickly in 1 or 2 days.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2020 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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