To find a cure for anal fissures - Poor DS :(

[RedRose55]

I’m completely fed up. DS is 3.5. He started having hard pellets like poop around 6 months ago. Around the same time we started noticing tiny specs of blood on the toilet paper. It was diagnosed as anal fissures. He is on 5ml lactulose to soften poop while his fissures heal on their own. While lactulose helps soften poop, he is STILL bleeding when he goes. We then were given Movicol. His prob is not “moving” it, IFKWIM. He has a BM every day.

Has anyone faced this before with your DC? What did you do? I’m worried sick about how much damage is happening there as it has been bleeding for 6 months :( Tiny amounts, but def there.

Personally, I’d be wary about treating a chronically constipated child with food. You’re way past a few prunes and some orange juice. Don’t be afraid of medication. Movicol is a very safe and effective stool softener. Prunes and fibre aren’t going to be much use at this stage, honestly. He needs a full gut clearout and THEN you can make dietary changes, along with the meds, to keep everything moving as it should.

Also be wary that fibre, in a slow moving gut, will set hard like concrete unless you’re drinking tons of water. It can do more harm than good in some cases.

When my son was young he suffered terribly from constipation and used to cry with pain. and the GP advised us to add spinach to as many meals as possible.
He also suggested juicing spinach, apple juice and kiwi and giving it to my son every day with his breakfast.
Within a week or so my son was a lot better and no longer cried when passing stools.
My son is now 22 but he still loves spinach and will eat it most days along with drinking it as a juice.

I've always found that laxatives and lactulose just made me fart and then gave me diarrhoea that made the fissures sore. It's a careful balancing act.

I don't know whether lidocaine creams are suitable for children but I'd ask your GP/a good pharmacist about them. They do calm the pain down and make going much easier.

Yeah, Lactulose does make you windy. It’s horrible stuff.

I’d try a bit more lactulose. Movicol is nasty stuff but it does work. Maybe have a look at changing his diet too. My little one had a similar issue and we received a particular diet from a dietician which helped

The Movicol should be helping. How many sachets is he on a day? He might need his dose upping. My son used to have blood in his stools when he was very small but the movicol did help.

You have my sympathies. Yes it could be the dairy thing making his poo harder. You could try dairy free for a bit to see if it helps (but consult the doc).

My 3yr old son has chronic constipation and is on a sachet of movicol per day - but even with that on occasion can have v hard poos or difficulty going. When that happens we up to two sachets for a couple of days and give him some extra prunes (we just have a few of the ella's -or sainsburys version- pureed prune sachets in the cupboards). He eats plenty of fruit and veg and roughage, so not a diet thing - unless he has a dairy issue too. When we next go to the docs we are going to ask about that too. Lactulose didn't really do much for him when he was taking it.

Is it white rice? That's a known cause of constipation.
Swop for jacket potato/sweet potato.

Thanks everyone. I’m incredibly grateful for all the advice and support. The GP appointment didn’t happen today. We’ll hopefully see her tomorrow. In the meanwhile, I’ve made changes to his diet.

Breakfast: apple porridge + 1 cup diluted juice

Snack: Raisins

Lunch: baked beans on toast (seeded brown bread), some melon and 1 cup diluted juice

Snack: 2 biscuits and 1 small satsuma. Another cup of diluted juice.

Dinner: tomato Lentil soup with wholemeal flat bread, carrot and cucumber sticks. One more cup of diluted juice

No dairy throughout the day. No bananas. Juice is just 20%, rest is water. I gave him some prunes, he didn’t like them. I’ll purée tomorrow. I got a big bag of spinach today. I’ll add a bit to every meal from tomorrow.

Thanks again everyone. I realise that all of us eat a very carb heavy diet. Now we are all making positive changes to what we eat along with DS.

I can’t help with diet for a child as mine is not eating yet, but I had a fissure after giving birth and what really helped to heal it was manuka honey! And I mean putting it on there, rather than eating it. It might have been the effect that it eased the no 2 out more easily (like Vaseline as suggested up thread) but honey is good for wounds too. Just a suggestion...nb a very little goes a long way.

You really need Movicol. He could have a big blockage further up and the hard poo is working it's way out. Sometimes bits can seep out found the sides as if they are soiling themselves but they can't help it.

You can up the dose as needed.

Also be careful not to give too much fibre. I know it sounds mad but the doctor we saw said too much can actually cause constipation in children.

Does he have a water bottle available to him at all times during the day? Fluid isn't just for mealtimes. Encourage the habit of drinking little and often all the way through the day. My LO sometimes gets a bit of constipation and I now say 'Good drinking!' with a beaming smile everytime she voluntarily goes and helps herself. She loves it, but is a lot younger than your boy.

@ALoadOfTwaddle He does have a water bottle available at all times. One upstairs and one downstairs - washed and refilled every morning. DS is rubbish at drinking water on his own though. Just one sip now and then - that’s all.

We had similar with our dd at about 18 months. We were so frustrated with the gp offering only lactulose to help her which wasn't working that we finally decided to see a consultant privately.
We had a long appointment with him during which she helpfully filled her nappy which illustrated the problem as she was clearly in a great deal of pain and distress.
He simply upped the dose and frequency of lactulose and within a very short time her fissures had a chance to heal and the whole issue went away.
This is just our experience op, obviously there's a lot of other good advice from pp and no two dc are the same but I thought I'd post this as our solution was so simple.

Steroid cream cured my vaginal fissures almost overnight. It can thin the skin if used repeatedly but a teeny bit as a one off may help. I would chck with gp first, because hes young. I checked with gp and was told not to do it due to the skin thinning thing but I did my own research and it's been fine. The freedom and ability to wipe without wincing is amazing.