Constipation is a common complaint among children. Most of cases constipation can be classified as ‘functional’, meaning there is no physical problem except for the fact that the child has difficulty generating bowel movement. This can result in an anal fissure, which is a tear in the skin around the rectum. This tear is painful and is subject to bleeding.
It’s important to be tested by a pediatric surgeon, in order to rule out other possible diseases such as Hirschsprung disease (also called toxic mega-colon). After a physical examination to rule out other diseases, it’s important to determine if the constipation causes the child discomfort. If the child is not motivated, there is no way to fix the problem. When motivated, problem can be resolved within a week or two.
The main treatment method is inducing diarrhea. This is done with the help of:
Ung Nifedipine – rubbing this around the rectum relaxes the rectal muscles. It stings at first but is very successful.
Paraffin Oil – This oil is used for microscopy and sometimes used as a lubricant. It is not absorbed through the skin so it can be used for years without any side effects.
Peglax/Normalax – This medication contains polyethelene glycol which enables it to attach liquids, creating softer stool. It can be used for years with no side effects.
It is important to continue taking medication for at least a month after the stool begins to resemble diarrhea. Most children respond well to stool softeners, such as paraffin oil. Sometimes, treatment can last months or even years.
Surgical treatments are rare for anal fissures and constipation. There is no surgical treatment method for children with anal fissures.