anal fissure

Anal fissure is a small tear of the junction of the internal mucous membrane of the bowel with the external skin of the anus. It is caused by the forceful passage of a hard stool, and is mainly seen in infancy.

Children can get into a viscious cycle:

passage of a large, hard stool produces a tear
the child withholds the stool to avoid painful defecation
the withheld stool gets even harder and bulkier
stool passage becomes even more traumatic, leading to more stool withholding

Parents might note a little skin "tag" next to the tear, that represents healing tissue, secondary to the chronic inflammation.

Treatment involves:

helping the parents to understand how the tear happens and especially the mechanism of the cycle of constipation
working to see that the child has only soft stools to avoid overstretching the anus.
allowing the healing process to occur, which may take several days or even several weeks
a stool softener is indicated, but the parents will need to adjust the dose to keep the child's stools neither too hard or too loose

Site Information/Disclaimer