Anal Fissure
Fissure means crack. Anal fissure is caused by the longitudinal tearing of the anal mucosa due to the trauma of solid stool. This pathology is one of the most important causes of painful defecation, bloody stool and constipation in children. Most of these get better on their own within a few weeks. Fissures that do not heal for up to three weeks are also called chronic fissures.
What are the Causes of Anal Fissure in Children?
As hard stool passes through the anus, it causes tears in the tissues. Changes in the consistency of the stool with the use of some drugs, frequent defecation in diarrhea, and attempts to the anus can also cause fissures. Anal fissure may also be the first sign of inflammatory bowel diseases. The anal fissure is often located in the posterior middle of the anus, where the blood supply is impaired.
What are the Clinical Signs and Symptoms of Anal Fissure?
Pain and bleeding occur during defecation. Pain is a more prominent finding. It causes crying when passing gas and stool in babies who are not yet out of diapers. In older children, it is the most important cause of constipation and holding back poop. Deepening anal fissure causes bleeding. In these children, fresh blood is seen in the form of lines on the stool or on the toilet paper when cleaning their bottoms after defecation.
How is Anal Fissure Diagnosed?
On physical examination, tear progressing towards the anus can be seen, they are usually detected on the back of the anus. In female babies, they are located in the anterior middle part. There may be more than one in babies who have chronic constipation or who have a finger examination of the anus. After the anal fissure heals, a skin protrusion (guard battery) may occur on the edge of the anus. Especially if there is bleeding, this appearance can be mistakenly defined as “hemorrhoids”. An anal fissure can also be inside the anus. In this case, endoscopy is required for diagnosis.
What is done in Anal Fissure Treatment?
Most anal fissures heal on their own. If there is constipation and painful pooping, poop softener is given and diet therapy is applied. It was observed that the internal anal sphincter spasm was resolved with the application of the cream, and the anal fissure was healed. In cases that do not heal with medical treatment, an operation is required, but this is very, very rare in children. Surgical treatments are performed in the form of anal dilatation, sphincterotomy and fissurectomy.
What is Hemorrhoids?
Hemorrhoids, popularly known as piles, is the prolapse of the anus veins due to swelling. It is very rare in children.
What Causes Hemorrhoids in Children?
Constipation is the primary cause. Constipation will bring with it more straining to defecate. The pressure in the anus will increase and hemorrhoids will form. Obesity is another reason for the formation of this disease. In addition, diseases such as irritable bowel syndrome, inflammatory bowel disease and portal hypertension can be counted among other causes.
What Are The Signs And Symptoms Of Hemorrhoids in Children?
Itching around the anus, pain when pooping and bleeding in the following periods are the main symptoms. The cause of itching is that the tissue of the hemorrhoids secretes a mucus that moistens the anus and surrounding tissue. Pain and discomfort while pooping are other symptoms that force the child and cause him/her to go through a troublesome process. There is also a protrusion in the anus. Bleeding from the anus is rare in children. Bleeding is bright red in color.
What Kind Of Method Should Be Followed in The Treatment Of Hemorrhoids?
It is necessary to fight constipation, which is the most common cause in children. Sitting baths with warm water 2-3 times a day are an important part of the treatment. The hemorrhoid area should not be irritated during toilet cleaning. After using the toilet, cleaning the anal area should be done with a wet and soft toilet paper. Pain relievers and anti-hemorrhoidal creams should be applied to the anus area.
