Anal Fissure: Teen Version

What is an anal fissure?

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.

You may notice the following signs or symptoms:

  • The blood is bright red.
  • The blood is only a few streaks or flecks.
  • The blood is on the surface of the stool or on the toilet tissue after wiping.
  • You usually pass a large or hard bowel movement just before you notice the blood.
  • Pain usually occurs during the passage of a BM.
  • Touching the tear may cause mild pain.

What causes an anal fissure?

Injury to the anal canal during passage of a hard or large stool is the usual cause of anal fissures. Rarely it is due to a Strep infection around the anus.

How long does it last?

Bleeding from a fissure stops on its own in a few minutes.

How can I take care of myself?

  • 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 3 times a day for 1 or 2 days. Don’t use any soap on the irritated area. Then gently dry the anal area.

  • Ointments

    If the anus seems irritated, you can apply 1% hydrocortisone ointment (nonprescription). If the pain is severe, apply 2.5% lidocaine (Xylocaine) or pramoxine ointment (nonprescription) a few times to numb the area.

  • Diet

    The most important part of treatment is to more fiber and drink plenty of fluids to keep from getting constipated. Increase the amounts of fresh fruits and vegetables, beans, and bran products that you eat. Drink plenty of water. Reduce the amounts of milk products you eat or drink. Milk products are constipating.

    A nonprescription stool softener (such as mineral oil, MiraLAX, or docusate) may be needed for a short time.

When should I call my healthcare provider?

Call during office hours if:

  • The bleeding increases in amount.
  • The bleeding occurs more than 2 times after treatment begins.
  • You have other concerns or questions.
Written by Barton D. Schmitt, MD, author of “My Child Is Sick,” American Academy of Pediatrics Books.
Pediatric Advisor 2015.1 published by RelayHealth.
Last modified: 2012-05-15
Last reviewed: 2014-06-10
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright ©1986-2015 Barton D. Schmitt, MD. All rights reserved.

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