Children with blood in stool

The chance of children having bloody stools is not that high. If your child has bloody stools, it is relatively serious. It may be a precursor reaction caused by problems in the internal body tissues. In this way, you must take them to the hospital for a detailed physical examination so that you can clearly know the reason why your child has bloody stools, and you must also keep the area around their anus clean.

Most patients with chronic anal fissures have their primary constipation or diarrhea corrected, or have a trial of topical medication. For patients who do not respond well to conservative treatment, anal fissure resection and/or internal sphincter lateral incision may be considered. Acute or new anal fissures can be healed by increasing fiber and water intake and taking warm sitz baths.

1. Correct abnormal bowel movements

Constipation is one of the main symptoms of anal fissure and the main cause of anal fissure. It can be softened and kept smooth by increasing dietary fiber foods or taking vitamin supplements. For constipation, you can use laxatives and take probiotics.

2. Clean the anus and take a sitz bath

Take a sitz bath with 1:5000 potassium permanganate in warm water after defecation or before going to bed to keep the area clean.

3. Topical medication

(1) Analgesic anesthetics (such as lidocaine gel) and non-steroidal anti-inflammatory drugs (such as diclofenac cream, ibuprofen cream, etc.) can relieve pain symptoms.

(2) Hemorrhoid creams that promote wound healing, recombinant human epidermal growth factor, etc.

(3) Topical application of nitroglycerin ointment: Apply 0.2% nitroglycerin ointment to the anal fissure twice a day for 5 to 8 weeks. This drug has the effect of inhibiting neurotransmitters and relaxing smooth muscles and dilating blood vessels. It can relax the internal sphincter, reduce anal canal pressure, and improve local blood circulation.

(3) Local injection of small doses of botulinum toxin can weaken the tension of the internal sphincter. 0.1 ml of diluted botulinum toxin is injected through the external sphincter next to the anal fissure, causing chemical denervation and local muscle paralysis, thereby reducing muscle tension.

4. Anal dilation

Suitable for patients with acute or chronic anal fissures without concurrent papillary hypertrophy and sentinel piles. Dilatating the anus with fingers or instruments (the trumpet-mouthed anoscope commonly used in anorectal surgery can be used) is effective in relieving severe anal pain, but it can recur and may be complicated by adverse reactions such as anal hematoma, bleeding, and anal incontinence for a short period of time.

5. Surgery

It is suitable for patients with anal fissure triad or chronic anal fissure that is resistant to non-surgical treatment. Commonly used surgical procedures include anal fissure resection and lateral internal sphincterotomy.