Clinical Reference Systems: Pediatric Advisor 10.0
Anal Fissure (for Teenagers)
An anal fissure is a shallow tear or crack in the skin at
the opening of the anus. More than 90% of teenagers with
blood in their stools have an anal fissure.
- The blood is bright red.
- The blood is only a few streaks or flecks.
- The blood is on the surface of the bowel movement (BM) or
on the toilet tissue after wiping.
- You usually pass a large or hard bowel movement just
before you notice the blood.
- Touching the tear causes mild pain.
Injury to the anal canal during passage of a hard or large
BM is the usual cause of anal fissures.
Bleeding from a fissure stops on its own in 5 or 10 minutes.
- Warm saline baths
Cleanse the anal area with warm water on a washcloth.
If that doesn't help, sit in a tub of warm water with
about 2 ounces of table salt or baking soda added.
Do this three times a day for 1 or 2 days. Don't use
any soap on the irritated area. Then gently dry the
If the anus seems irritated, you can apply 1%
hydrocortisone ointment (nonprescription). If the pain
is severe, apply instead 2.5% Xylocaine or 1%
Nupercainal ointment (nonprescription) three times a day
for a few days to numb the area.
The most important aspect of treatment is to eat a
nonconstipating diet. Increase the amounts of fresh
fruits and vegetables, beans, and bran products that you
eat. Reduce the amounts of milk products you eat or
drink. Milk products are constipating.
Occasionally a stool softener (such as mineral oil) is
CALL YOUR PHYSICIAN DURING OFFICE HOURS IF:
- The bleeding increases in amount.
- The bleeding occurs more than two times after treatment
- You have other concerns or questions.