Anal fissures

[puntasticusername]

Sorry for this topic at teatime :)

DS (2.9) has been toilet trained for about three months now. Almost as soon as he got the hang of doing his poos on the loo, we started seeing fresh blood on his bum whenever we went to wipe.

After a week or so, I got concerned enough to take him to the doctor; he advised that in such a young child, and as it is clearly fresh blood, the cause will be an anal fissure ie a little crack on the outside of DS's bum that opens up a little and bleeds whenever he poos.

Doctor recommended two possible treatments: giving lactulose to soften the stools, or backing off on the potty training and putting DS back in nappies so as to remove the temptation to strain on the loo. Me and DH didn't like either of these options - DS's stools tend to be pretty soft anyway, and if you gave him lactulose I think he'd just end up with diarrhoea, which I doubt would help him overall. And he'd been doing so well with the toilet training that we didn't want to undermine that (and now, three months on, I don't think he'd have the nappies back anyway - he's so proud of being a big boy etc etc).

I said all this to the doc and he said that's fine, but in that case all you can do is just wait for the thing to heal on its own, and discourage DS from straining (so all toilet trips now are done to a chorus of "don't force it, just let it come if it wants to come").

So. Three months later, it's not really any better. It doesn't happen all the time, but we'll have periods of a good few days when we see quite alarming amounts of blood on his bum and in the toilet bowl.

DH wants to take DS back to the doctor, but I'm not sure it's worth it given the previous advice that nothing much can be done and it's just a matter of waiting for it to heal. It doesn't seem to be causing him any pain or even discomfort. Has anyone got any ideas, please...?

My son had this at a similar age as he was fussy about vegetables. We gave him lactulose and tried to really push the vegetables. It's also really important that they are drinking enough. Maybe try a reward chart for eating vegetables and drinking if this is a problem? I appreciate it's very distressing to see but their little bums are so tender and won't heal well if the problem persists.

DD1 has the same from time to time and we always up her drinking water, reminding her to have drinks a lot, whenever it happens.

Ahhhhhh, that makes a lot of sense actually, DS has been a bit off colour the past few days with cough/cold and hasn't wanted to drink much. And that's when the problem has come back. And while I think we generally do ok diet wise, in all honesty - yes, there could be less cereal/toast and more veg...

Thanks guys, I'll make those changes and see what happens. Agree, on the one hand the doc says don't worry, it'll heal in time - but on the other, it just can't be good for someone to have a poorly bum for quite this long can it!

my ds went through this too. We did two things that were helpful. First, as suggested by others, drinking lots of water. Fibre without water turns to concrete!

But as you've said your son's poo is usually fairly soft anyway, I'll pass on what our gp said: she said that there is no such thing as too soft, because every time something passes through there the fissure is likely to open up. We have a product here called Osmolax, the key ingredient is Macrogol which iirc is inert, all it does is draw water in to keep the poo soft. (We had tried a couple of others that were NOT successful - poo falling out of his bum without him even being aware, or vile tasting so he wouldn't drink it, etc.) The gp advised keeping him on it a good 3 months to really allow it to heal up. We did and it did. Although starting school, we're back to having trouble getting him to drink enough water and it's happened again (sigh)...

good luck, hth