Anal fissure

What is an anal fissure?

An anal fissure is a tear in the lining of the anal canal. It usually occurs when a child is constipated and forces a large, hard stool (poop). It can also happen due to diarrhea. 

The tear makes passing stool (pooping) very painful until it heals. 

There can be a small amount of bleeding from the anal fissure. Anal fissures are the most common cause of bloody stools in babies and young children. 

Anal Fissure​​

Signs and symptoms of an anal fissure

Some of the signs and symptoms of an anal fissure are:

• Babies may cry and show discomfort, while older children may complain of pain when passing stool.
• Blood may cover the surface of the hard stool or be seen on toilet paper or baby wipes.
• Older children may avoid passing stool to avoid the pain of the anal fissure.
• There may be a visible tear or cut along the anal opening.

Treating anal fissures

For children who develop an anal fissure due to constipation, treatment begins with treating the constipation. Your child’s health-care provider may prescribe medication and recommend adding more fibre and fluid (liquid) to your child's diet. Wholegrain cereals, breads, fruit - especially prunes - and vegetables are good sources of fibre. 

Anal fissures usually heal over days to weeks. Until your child's fissure has completely healed, you can apply a thick layer of petroleum jelly or zinc oxide cream to your child's anus. Make sure to apply it over the fissure if it is visible. This will help the fissure heal and will make passing stool less painful. Using a moistened wipe to clean after a bowel movement (poop) may be more comfortable for children who are experiencing pain with wiping.

Older children who are experiencing pain from the anal fissure may find relief with a sitz bath or using a bidet to clean themselves after a bowel movement (poop). A sitz bath is a small tub that can be placed on the toilet and filled with warm water to soak the anal fissure. You can purchase a sitz bath at most pharmacies.  

When to seek medical attention

Talk to your child’s health-care provider if:

• their constipation is not improving
• the anal fissure is not healing after several weeks
• the pain is not controlled with petroleum jelly or zinc oxide
• you are concerned about the amount of blood from the fissure