NeuropathicGuy wrote: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?
I have posted a main reply but would just like to say thankyou. I hope all goes well with your little boy and you get him home soon.
sending my love and best wishes to you both.