An anal fissure is a tear in the opening at the end of the gastrointestinal tract, called the anus.

Causes

Constipation, resulting in the passage of hard or large stools, is the primary cause of an anal fissure in children. Chronic diarrhea may also cause an anal tear. One time anal fissures are most common in young children, though youth with Crohn's disease may experience multiple, more severe or recurrent tears due to their disease.

Symptoms

• Blood in stool
• Painful bowel movement

Exams and Tests

Your child's doctor can diagnose an anal fissure by pulling apart the buttocks and looking at the anus. The pediatric gastroenterologist may perform a rectal exam to determine if a fecal impaction (build-up of hard stool) is present. A rectal exam is performed by inserting the tip of a gloved finger in the child's anus. Your child may feel mild discomfort.

Treatment

Most anal fissures will heal without treatment over time. Several home treatments can aid healing. Your child's doctor may recommend the following:

• Sitting in a warm bath for 20 minutes, two or three times a day
• Application of petroleum jelly or zinc oxide ointment
• Use of a stool softener or increased fiber in the diet to ease constipation