Thus, a vicious circle is set up which is very difficult to break. Diagnosis of the condition is simple. History of intense pain during defaecation with bleeding per rectum at times is typically seen in these cases. The stool is usually smeared with a streak of blood, unlike in cases of rectal polyp, where the child passes drops of fresh blood after defaecation. A careful and gentle examination of the perineum done by separating the buttocks to visualise the anal canal, reveals the fissure which appears like a groove, or a cut.
Treatment is simple, but prolonged, especially in chronic cases.
The fissure takes some time to heal and during this time, passage of soft stools at all times is absolutely necessary. This can be ensured by using any emolient or stool softener like husk of Isabgol or liquid paraffin, along with a diet rich in fibre. Local application of an ointment with analgesic properties, such as lignocain applied after defaecation helps alleviate pain and sphinctre spasm. Sitz bath, i.e. immersing the child s bottom in warm water is also very soothing. This treatment is to be continued till the fissure heals.