Overview

An anal fissure is a tear in the lining of the lower rectum (anus). It can itch and cause pain. There may be bright red blood on the toilet paper after your child wipes. A fissure may form if your child is constipated and tries to pass a large, hard stool. It may also form if your child doesn't relax the anal muscles during a bowel movement.

Most anal fissures heal with home treatment after a few days or weeks. If your child has an anal fissure that takes more time to heal, your doctor may prescribe medicine. In rare cases, surgery may be needed.

Anal fissures don't cause colon cancer. And they don't lead to other serious problems. But if your child has blood mixed in with the stool, talk to your doctor.

How can you care for your child at home?

• Be safe with medicines. If the doctor prescribed cream or ointment, use it exactly as prescribed. Call your doctor or nurse advice line if you think your child is having a problem with a medicine.
• Have your child sit in 8 to 10 centimetres (3 to 4 inches) of warm water (sitz bath) 3 times a day and after bowel movements. The warm water helps the area heal and eases soreness. Do not put soaps, salts, or shampoos in the water.
• Avoid constipation:
  • Include fruits, vegetables, beans, and whole grains in your child's diet each day. These foods are high in fibre.
  • Give your child lots of fluids.
  • Encourage your child to do moderate to vigorous activity for at least an hour each day. Your child may like to take a walk with you, ride a bike, or play sports.
  • If your doctor recommends it, have your child take a fibre supplement, such as Benefibre or Metamucil, every day if needed. Read and follow all instructions on the label.
  • Have your child use the toilet when your child feels the urge. Or when you can, schedule time each day for a bowel movement. A daily routine may help. Ask your child to take time and not strain when having a bowel movement. But do not let your child sit on the toilet for more than 10 minutes.
• Support your child's feet with a small step stool when your child sits on the toilet. This helps flex the hips. It places the pelvis in a squatting position.
• Your doctor may recommend an over-the-counter laxative, such as Milk of Magnesia or Restoralax. Read and follow all instructions on the label. Don't use these medicines on a long-term basis.
• Don't use over-the-counter ointments or creams without talking to your doctor. Some of them may not help.
• If your doctor recommends it, use—or have your child use—baby wipes or medicated pads, such as Preparation H or Tucks. Use them instead of toilet paper to clean after a bowel movement. These products do not irritate the anus.