Medical Q&As

Anal fissure

Our 7-year-old daughter is having great pain when having a bowel movement. We also noticed a lot of blood in the toilet bowl after she had been to the toilet. She is now scared to go to the toilet. Any ideas?

I wonder if your child was constipated in the days preceding the onset of her symptoms? If a child is constipated and passes a large firm stool they may sustain a little tear in the anus. This can cause a sharp pain associated with bleeding each time the child has a bowel movement. The child then becomes frightened that they will experience further pain and they tend to avoid defaecation. Eventually they pass another large bulky stool that causes the tear to open up again and the cycle repeats itself. You should have the diagnosis confirmed with your GP. An anal tear usually heals spontaneously once the problem of constipation has been dealt with. The objective is to soften the stool so that it has the consistency of toothpaste. This prevents excessive stretching of the anus thereby stopping the tear from opening up again.