Anal Fissure


An anal fissure is a shallow tear or crack in the skin at the opening of the anus.  More than 90% of children with blood in their stools have an anal fissure.   Trauma to the anal canal during constipation is the usual cause of anal fissures.  The main symptoms are as follows:

  • The blood is bright red, and in streaks or flecks.
  • The blood is on the surface of the stool or on the toilet tissue after wiping.
  • Your child usually passes a large hard bowel movement just before the bleeding starts.
  • You may see a shallow tear at the opening of the anus when the buttocks are spread apart (this cannot always be seen).
  • Touching the tear causes mild pain.

Home Care  

Warm Baths:  Give your child warm baths for 20 minutes, 3 times each day.  Have him sit in a basin or tub of warm water with  baking soda added.  Don’t use any soap on the irritated area.  Then gently dry the anal area.
Ointments:  If the anus seems irritated, you can apply 1% hydrocortisone ointment.  If the pain is severe, apply 2.5% Xylocaine or 1% Nupercainal ointment (no prescription needed) 3 times each day for a few days to numb the area.
Diet:  The most important aspect of treatment is to keep your child on a nonconstipating diet.  Increase the amounts of fresh fruits and vegetables, beans, and bran products that your child eats.  Adding Benefiber or Fibercon can be a helpful.  Reduce the amounts of milk products your child eats or drinks including cheese and yogurt. Other constipating foods include bananas, applesauce, and high fat foods. Occasionally, a stool softener is needed temporarily.


Call our office during regular hours if . . . 

  • The bleeding increases in amount.
  • The bleeding occurs more than two times after treatment begins.
  • You have other concerns or questions.