Hi i was wondering if anyone on here has a child with anal fissures and if so how are they being dealt with. My daughter has 3 and has suffered for 6 months now. She hasnt sat down for that long and stands all day at school.
She was at hospital today and they have prescribed her rectogesic, i understand from the leaflet inside it has alot of side affects.
It would be great to hear from anyone who knows about this.
many thanks

I'm so sorry to hear about Selina's (I assume that's your daughter's name) troubles :( It's not unusual for children to get fissures, but usually it's when they are much younger (when they transition to more solid foods). Also 3 fissures at once is quite a few. Typically fissures in very young children resolve on their own.
Since your daughter has had multiple fissures for half a year already, have the docs said where the fissures are located (i.e., what "clock position" they are at around the anus) or screened her for any other underlying cause for the fissures? As I'm sure you're already aware, fissures are usually caused by constipation, and sometimes diarrhea. But in rare cases they can be caused by other things like inflammatory bowel disease -- this isn't meant to freak you out, and is a rare occurence, but is something that doctors often try to rule out if the fissures are in atypical locations.
Anyway rectogesic does have side effects. The main one is dizziness due to a drop in blood pressure and an intense throbbing headache. The first few times you use it are when the side effects are the most intense. You do get used to it after a few days. As adults, it's easy to ride out the side effects, but for a child it could be a bit scary so you'll probably want to assure and reassure her that the feeling is just temporary and will help with make her rear stop hurting :)
Also, have the docs suggested any stool softeners yet? Miralax is one that helps lots of us here, and it's also commonly used in infants and toddlers. It's highly effective in softening stool so bowel movements hurt much less. Your didn't mention if Selina has any aversion to going potty because of pain, but if she does, a nice stool softener like Miralax should help ease her anxiety. I'm guessing you're from Australia. I don't know what Miralax is called there (maybe Movicol?) but the ingredient in it is polyethylene glycol 3350 (a polymer that passes right through the gut without being absorbed at all) and it's an osmotic stool softener.
Finally, many of us adhere to the "fissure diet" which basically consists of tons of veggies and fruits with almost no meat (aside from chicken or fish) and processed starchy foods. Granted a growing child needs nutrients and doesn't have the luxury of just changing to some radical diet over the long term, but maybe you could try it for a week or two to see if it helps?
Anyhow if you let us know more about what you've already tried, the great folks here can offer more things to consider. Welcome to both yourself and Selina.

thanks for the reply!
Yes Selina is my daughter and we actually live in the U.K
She is currently on lactulose and senna which are stool softeners and laxatives.
she has had 3 different creams so this is the last resort.
she had a fissure repaired before with an anal stretch but they are reluctant to do that this time.
she only eats fruit veg salad ect hardly any junk as she doesn't like it ( i know not a normal childs diet bless her lol )
the fissures are 5,6, and 7 so all situated at the bottom of her.
Any help would be a blessing and knowing she is not suffering alone thanks

I feel sooooooooooooooooo bad for your little girl :( This just breaks my heart. It's bad enough for an adult to have this, but for a child :( :( ...I just can't imagine how she feels. Oh...I hope she gets better very soon. It breaks my heart that she stands all day in school. Can she take a small pillow to sit on???? Hugs to you and your daughter.

Oops sorry my "Rectogesic" and "mum" radar combined with the current time led me to conclude Australia. But I guess you're just an UK night owl :)
I guess the creams she tried before were nifedipine and diltiazem right?
I don't have any experience with Lactulose or Senna. I think others here have tried them, maybe they'll chime in on how they compare to Miralax. Miralax is definitely Movicol in the UK. How is her stool consistency? Is it already pretty soft like toothpaste? If it is then probably no need to try something else. But if she's still having hard stools then Movicol may not be a bad thing to at least try.
It's reassuring that the fissures are near the 6 o'clock position. That's where the vast majority of "normal" anal fissures occur. The remainder of the "normal" ones occur near the 12 o'clock position.
One other more aggressive treatment than the creams is Botox injections into the anal sphincter. It paralyzes the sphincter and gives the fissure time to heal. I don't know if they use Botox injections for anal fissures in children but I know for sure they use it in very small children (toddlers) for certain neuromuscular conditions (for example with leg muscle hypertonicity due to brain damage Botox is sometimes injected into the legs). It's something that might be worth asking Selina's doc about. I've had Botox, never anal stretch/dilation (here in the States it's fallen out of favor and isn't widely used anymore), but can't imagine the Botox would be any worse. She's a brave little girl for going through all of this and I'm positive she'd handle Botox just fine.
She's definitely not suffering alone, but I really am so sorry she has to go through all of this at such a young age. I have a 8 month old boy with cerebral palsy in the hospital at this very moment and it breaks my heart to see him suffer too :( At 8 Selina is obviously much more conscious of the discomfort, I'm sure, which makes her all the braver!
BTW do you know how she got the fissure? Was it preceded by bad diarrhea or constipation that you know of?

So sorry to hear that : ((( :(
Senna is not recommended for long periods since it is mechanical irritant and can permanently damage colon nerve endings - I am surprised your doctor recommended it : ((( Please try Miralax (look at Google what is name for the main ingredient ) - it is the best that is out there at this time for stool softening and that has very little to no side effects even with long term use.
My friend has a son that was suffering from severe constipation since birth :( :( :( . It was so severe that his colon got extended :(. At 2 years of age he had to go on Miralax and now he is 5 years and since that time never was constipated. His colon finally is regaining correct shape (KTW ) !!!!
My sister has a friend whose son was suffering from fissure sine age 4 . He had the LIS at age 8 and healed just fine !!!!! No problems now what so ever.
My biggest concern about your daughter is that she is having MULTIPLE fissures which are almost always in correlation with some inflammatory proceses being present in the GI : (((.
Did anybody ever test her food allergies or local proctitis or such ???
Hope you will find a solution for her soon !!! Poor baby : ((( Can you find another doctor and ask for a second opinion ??? I had to change 5 CRSs until I found one that solved my problem
Wishing you the best of luck !!!!!

Sorry to hear about your daughter, it's a sin that she's suffering at such a young age, as stated above, Movicol is the best stool softener in the world, Lactulose was the first laxative I was prescribed 2 years ago, it didn't take long before I was seeing the GP for something else, infact i've tried quite a few before accepting Movicol as being the best, also, what Fissulyna says is true, Senna is definitely no good, only use Movicol and try to get your daughter to drink plenty of water..
Sending healing thoughts..

Ditto to what Fiss stated. Senna is not good to use long term. Good luck!!

fire-cracker wrote:I feel sooooooooooooooooo bad for your little girl :( This just breaks my heart. It's bad enough for an adult to have this, but for a child :( :( ...I just can't imagine how she feels. Oh...I hope she gets better very soon. It breaks my heart that she stands all day in school. Can she take a small pillow to sit on???? Hugs to you and your daughter.

Many Thanks for your kind words. We have tried rubber rings, pillows ect but it just hurts her too much to sit down on anything at all.
Thanks again x

Many thanks for all your kind words for my little girl.
Selina has now been on senna since she was 3. She used to bleed alot and have lots of fissures from that age. they have tested her for several things but noticed that she has a skin disease down below called lichen sclerosis. This means she has not elasticity in her skin so tears easily. She was given the laxative you all suggested but hated it and we had trouble getting it down her.
her colon is obviously already enlarged but i didnt think senna caused any adverse effects so them comments have helped me out thankyou.
She has recently had more blood tests checking for any food allergies so we are waiting on the results.
These fissures are just taking so long to heal this time compared to the past when they would do something about them.