Problems in and around the anus in children

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What is it about ?

The anus is the star-shaped opening located in the intergluteal sulcus. It connects the end of the intestine to the skin from the outside. Children often have minor sores and other symptoms in and around the anus. We describe some of the most common problems below.

Red, itchy skin around the anus

The presence of red, itchy skin around the anus is usually harmless.

  • It is often caused by irritation from the stool.
  • Sometimes it can be due to an infection of the skin caused by bacteria or fungus. In this case, it can be relieved by antibiotics or an ointment.
Itching in and around the anus

Children often suffer from anal itching.

  • Usually, they are caused by irritation from the stool.
  • Small children can have toward. These are itchy, especially at night and when the child has a bowel movement.
Crack in the anus

A crack in the skin around the anus is very painful. The pain is most severe when the child has a bowel movement. Sometimes you can see a little blood in the bowl.

Sometimes a child will refrain from having a bowel movement to avoid pain. As a result, he becomes constipated and the crack reopens the next time he has a bowel movement.

the processing generally confined to:

  • a fatty cream to protect the anus and the fissure;
  • a laxative to soften the stool and reduce pain.

An operation is only necessary if the crack no longer disappears. This type of intervention is rarely necessary in children.

Abscess or fistula near the anus
Abscess

An abscess is a cavity filled with pus. An abscess near the anus is usually caused by inflammation of a small gland inside the anus. Children with an abscess near the anus have pain when they have a bowel movement, when they sit down, and sometimes even when they pee. He may also have a fever.

The doctor may make a small incision in the abscess, which helps drain the pus.

Fistula

A fistula is an extra passage that forms in the skin around the anus. It may come out of pus. A fistula is usually not painful.

In the baby, it goes away on its own. In adolescents, a fistula often needs to be operated on.

If the abscess or fistula comes back frequently, the doctor will try to find the cause. It can be chronic inflammation of the intestines, for example.

Hemorrhoids

The hemorrhoids are swellings around the anus or in the last part of the intestine. They may catch fire or contain a blood clot.

Hemorrhoids are rare in children. But, if this happens despite everything, the doctor will refer the child to a specialist to identify the cause.

Sagging bowel

During a collapsed intestine (intestinal prolapse), a piece of intestine comes out through the anus. It is also visible to the naked eye.

This problem is not common in children. In very young children, the collapsed bowel may be congenital. Slightly older children can develop the condition after a long period of cough or diarrhea. Most often, the condition heals on its own.

Skin folds in the anus

The folds of skin in the anus are usually innocent. If they have the appearance of a cauliflower, they may be a sign of a Crohn’s disease.

What is their frequency?

Children very often have problems in and around the anus. The frequency of these conditions is impossible to demonstrate with precise figures.

How to recognize them?

When you take care of your child’s toilet, you may notice some abnormalities in and around the anus.

Sometimes your child complains of itching, pain, or bleeding.

How is the diagnosis made?

The general practitioner usually makes the diagnosis after a physical examination. Sometimes the doctor needs to have the child’s stool tested.

What can you do ?

  • Make sure your child eats enough fiber and drink enough water. This is important for preventing constipation.
  • If the problems persist, consult the general practitioner.

Some people are embarrassed to talk about problems in the anal area. As a result, they wait too long. This is useless.

What can your doctor do?

The general practitioner can prescribe medication. Depending on the cause, it may be an ointment or antibiotics.

Sometimes a small operation is necessary, for example an incision in case of abscess. If necessary, the doctor will refer the child to a specialist.

Source

Foreign clinical practice guide ‘Anal problems in children’ (2011), updated on 03/08/2017 and adapted to the Belgian context on 01/19/2020 – ebpnet

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