Overview

• Tears in skin around the anus, usually as side-effect of constipation.

Making Diagnosis

Clinical Features

• Painful passing of stool.
• Bright red blood on tissue.

Investigations

Management Plan

• Ensure stools are soft and easy to pass ⇒
  • Increasing fluid and fibre intake.
  • Constipation Treamtent → lactulose, macrogol.
  • Stool Softeners.
• Managing Pain (ANALGESIA) → GTN intra-anally or topical diltiazem. Sitting in shallow, warm bath can help relieve the pain.
• Safety Net → If not healed after 2 weeks or child remains in pain, seek help.
• Advise on importance of anal hygeine and advise against stool witholding.

Complications →

Prognosis →