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NEED ADVICE OF SENIOR/EXPERIENCED GASTROENTEROLOGIST FOR ANAL FISSURES FOR MY

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Posted on Wed, 12 Aug 2020
Question: NEED ADVICE OF SENIOR/EXPERIENCED GASTROENTEROLOGIST FOR ANAL FISSURES FOR MY CHILD (2 YEARS 8 MONTHS)

sir,

1. My daughter is 2 years, 8 months old. Weight 10.4 kg , lean built.

2. For first 06 months, since birth, she was on formula feed and little breast milk. She has constipation issues right from the day she started taking solid food. She may be lactose intolerant, but I am not sure.

3. I think she is having very sluggish digestion. She never had very soft/ watery stool. Her stool is always big and solid. She usually pass her stool twice a day.

4. In, october 2019, she had severe constipation issues and hard stool. For 1/2 day, she will pass little and hard stool and than one day she clears everything.
We had administered her with medicines as directed by doctor. we changed our place from Goa to Bhubaneshwar. she was good/recovered after a month and was fine in NOV/DEC at Bhubaneshwar.

5. Again in the month of January 2020, she had constipation issues and hard stool. This time, She also developed a anal tag/ cut . Since then we have shown her to homeopatic and auyrvedic doctors.. tried their medicines.
AFTER A LOT OF EFFORTS .. GETTING HER DRINK LOT OF WATER, MEDICNIES, LIVER TONIC, NEOPEPTINE gripe water, papaya, ETC... SHE WAS OK IN MAY-JUNE.

For last six months , I have also noticed that every month, irrespective of her healthy diet she first gets constipation for 2/3 days, thereafter salivary stool for 2/4 days and then she will have normal stool.

6. Present condition.
Her anal cut/ fissures has still there and not healed. . She is having pain while passing stool.The constipation/hard stool problem is still persisting. THE CUT MARKS ARE AGAIN SURFACED, AS IN THE MONTH OF JANUARY 2020. Whatever, she is eating, she is passing the same food particles, as it is... not able to digest well.

Kindly clear my doubts and provide guidance..
What exactly is the condition and if it is normal in child of 2/ 3 years old? How to treat her and how long it will take to heal? Any long term effect of this fissures? Any tests/ scan to be undertaken?

i have again consulted a doctor online and his prescription is attached. medicines not started.. need your suggestions/guidance. Also, sending pic/video of anus cut part.

Plz guide me as I am worried and suffering bcz of this present situation.. and non availability of doctors bcz of lockdown.

Waiting for ur reply.
XXXXXXX
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Follow up: Dr. Ramesh Kumar (0 minute later)
NEED ADVICE OF SENIOR/EXPERIENCED GASTROENTEROLOGIST FOR ANAL FISSURES FOR MY CHILD (2 YEARS 8 MONTHS)

sir,

1. My daughter is 2 years, 8 months old. Weight 10.4 kg , lean built.

2. For first 06 months, since birth, she was on formula feed and little breast milk. She has constipation issues right from the day she started taking solid food. She may be lactose intolerant, but I am not sure.

3. I think she is having very sluggish digestion. She never had very soft/ watery stool. Her stool is always big and solid. She usually pass her stool twice a day.

4. In, october 2019, she had severe constipation issues and hard stool. For 1/2 day, she will pass little and hard stool and than one day she clears everything.
We had administered her with medicines as directed by doctor. we changed our place from Goa to Bhubaneshwar. she was good/recovered after a month and was fine in NOV/DEC at Bhubaneshwar.

5. Again in the month of January 2020, she had constipation issues and hard stool. This time, She also developed a anal tag/ cut . Since then we have shown her to homeopatic and auyrvedic doctors.. tried their medicines.
AFTER A LOT OF EFFORTS .. GETTING HER DRINK LOT OF WATER, MEDICNIES, LIVER TONIC, NEOPEPTINE gripe water, papaya, ETC... SHE WAS OK IN MAY-JUNE.

For last six months , I have also noticed that every month, irrespective of her healthy diet she first gets constipation for 2/3 days, thereafter salivary stool for 2/4 days and then she will have normal stool.

6. Present condition.
Her anal cut/ fissures has still there and not healed. . She is having pain while passing stool.The constipation/hard stool problem is still persisting. THE CUT MARKS ARE AGAIN SURFACED, AS IN THE MONTH OF JANUARY 2020. Whatever, she is eating, she is passing the same food particles, as it is... not able to digest well.

Kindly clear my doubts and provide guidance..
What exactly is the condition and if it is normal in child of 2/ 3 years old? How to treat her and how long it will take to heal? Any long term effect of this fissures? Any tests/ scan to be undertaken?

i have again consulted a doctor online and his prescription is attached. medicines not started.. need your suggestions/guidance. Also, sending pic/video of anus cut part.

Plz guide me as I am worried and suffering bcz of this present situation.. and non availability of doctors bcz of lockdown.

Waiting for ur reply.
XXXXXXX
doctor
Answered by Dr. Ramesh Kumar (35 minutes later)
Brief Answer:
Please go through detailed answer dear.

Detailed Answer:
Hello Jayshree and thanks for choosing "Ask a Doctor" service for your query,
Have seen your details and I appreciate your concerns,
As per the query answer is-
Exclusive breast feed should be given to a baby for first six months of life. Not even water is required for first 6 months. As she had been given mostly soft diet with very little breast feed it's obvious that problems would be there in overall development and functioning of gut.
As she is constipated from a long time(side effect is fissure). Now healing depend on the length of fissure. The part of fissure you can see is called external however it usually extends to anal canal internally and therefore usually in most of the patients surgery is required(Relax it's a normal surgery very frequently done even by a general surgeon however a colorectal surgeon is better).
So once lock down period is over first thing to do is to track down the path of fissure(MRI has to be done for that).
As off now suggestions are-
Give her dulcolex tablet one tablet to half tablet daily to keep her stools loose(the consistency of the stool should be like it should not be too watery neither should the patient strain too much while passing stools;So try dose of dulcolex from one to half tablet and see at what dose she achieves that consistency).
2)Take Isapghul husk from market and give her 10 gram after soaking it in like warm water for 20 minutes(can add honey to flavour it).
3)Apply ointment Smuth on the fissure(till lock down period) to provide relief to patient.
4)Proper hygeine to be followed to prevent infection.

-Tests to be done would be proper examination of area by Surgeon/Colorectal surgeon.
Digital rectal examination.
MRI

-It may heal but usually surgery is required in most of the patients.

-If left untreated the area becomes prone to infection and large amount of pus may form in the area which may causes sepsis(severe infection).

Kindly attach the prescription of online doctor.
Kindly send a clean high definition clear photo of fissure with follow up.

Hope I was helpful.
Thank you and may God bless every one!
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Ramesh Kumar (0 minute later)
Brief Answer:
Please go through detailed answer dear.

Detailed Answer:
Hello Jayshree and thanks for choosing "Ask a Doctor" service for your query,
Have seen your details and I appreciate your concerns,
As per the query answer is-
Exclusive breast feed should be given to a baby for first six months of life. Not even water is required for first 6 months. As she had been given mostly soft diet with very little breast feed it's obvious that problems would be there in overall development and functioning of gut.
As she is constipated from a long time(side effect is fissure). Now healing depend on the length of fissure. The part of fissure you can see is called external however it usually extends to anal canal internally and therefore usually in most of the patients surgery is required(Relax it's a normal surgery very frequently done even by a general surgeon however a colorectal surgeon is better).
So once lock down period is over first thing to do is to track down the path of fissure(MRI has to be done for that).
As off now suggestions are-
Give her dulcolex tablet one tablet to half tablet daily to keep her stools loose(the consistency of the stool should be like it should not be too watery neither should the patient strain too much while passing stools;So try dose of dulcolex from one to half tablet and see at what dose she achieves that consistency).
2)Take Isapghul husk from market and give her 10 gram after soaking it in like warm water for 20 minutes(can add honey to flavour it).
3)Apply ointment Smuth on the fissure(till lock down period) to provide relief to patient.
4)Proper hygeine to be followed to prevent infection.

-Tests to be done would be proper examination of area by Surgeon/Colorectal surgeon.
Digital rectal examination.
MRI

-It may heal but usually surgery is required in most of the patients.

-If left untreated the area becomes prone to infection and large amount of pus may form in the area which may causes sepsis(severe infection).

Kindly attach the prescription of online doctor.
Kindly send a clean high definition clear photo of fissure with follow up.

Hope I was helpful.
Thank you and may God bless every one!
Above answer was peer-reviewed by : Dr. Kampana
doctor
default
Follow up: Dr. Ramesh Kumar (2 days later)
Good morning sir. Thanks for your reply.. but having so many questions in my mind.

Can she be cured by medicines only? Is homeopathic treatment is effective?

What about her guts and digestive system health? Any long term issue as she is only 3 years old?

Thanks again.
Regards

default
Follow up: Dr. Ramesh Kumar (0 minute later)
Good morning sir. Thanks for your reply.. but having so many questions in my mind.

Can she be cured by medicines only? Is homeopathic treatment is effective?

What about her guts and digestive system health? Any long term issue as she is only 3 years old?

Thanks again.
Regards

doctor
Answered by Dr. Ramesh Kumar (6 hours later)
Brief Answer:
Follow up.

Detailed Answer:
Hello again,
1)Definitely yes treatment is available but initially suggested tests should be done.
2)Being a English medicine practitioner I can't make a comment on that.
3)As she would grow up they would get stronger and better with time. However a good diet full of fruits vegetable and complex carbs with fibers would be best for her.
4)From fissure or from poor digestion?
Please reply
Waiting.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Ramesh Kumar (0 minute later)
Brief Answer:
Follow up.

Detailed Answer:
Hello again,
1)Definitely yes treatment is available but initially suggested tests should be done.
2)Being a English medicine practitioner I can't make a comment on that.
3)As she would grow up they would get stronger and better with time. However a good diet full of fruits vegetable and complex carbs with fibers would be best for her.
4)From fissure or from poor digestion?
Please reply
Waiting.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
default
Follow up: Dr. Ramesh Kumar (2 days later)
Thank you sir,I will undertake the tests as suggested by you. Can you tell me a good doctor/ hospital at XXXXXXX for the same?.

Sir, one more query.

Many a times, my daughter says she is having stomach pain ( and sometimes thereafter I give her some water) and then she pooh and pass her stool.. and then she is ok and there is no discomfort or pain.

Sometimes, she says stomach is paining and thereafter she fart.. and all ok.

Is it normal at this age or it is part of the fissure/ indigestion issue.. or gastric issue.

Waiting for your guidance.

Thanks and regards

default
Follow up: Dr. Ramesh Kumar (0 minute later)
Thank you sir,I will undertake the tests as suggested by you. Can you tell me a good doctor/ hospital at XXXXXXX for the same?.

Sir, one more query.

Many a times, my daughter says she is having stomach pain ( and sometimes thereafter I give her some water) and then she pooh and pass her stool.. and then she is ok and there is no discomfort or pain.

Sometimes, she says stomach is paining and thereafter she fart.. and all ok.

Is it normal at this age or it is part of the fissure/ indigestion issue.. or gastric issue.

Waiting for your guidance.

Thanks and regards

doctor
Answered by Dr. Ramesh Kumar (6 hours later)
Brief Answer:
Follow up.

Detailed Answer:
Hi there my dear,
You could consult any good Gastroenterologist of that area or you could visit a superspeciality hospital like Fortis XXXXXXX any one.
Fissures and all are basic problems in Gastroenterology all you need is a experienced doctor with availability of tests like colonoscopy 3 Tesla MRI.
See when a persons digestive system is not functioning properly as a whole then many times the food starts to ferment in intestines. This fermentation food release large amount of toxic gases which compresses the nerves passing through intestines.This compression may be a cause of such pain. Secondly stagnant food is a breading place for number of bad bacteria fungi etc.They causes inflammation in intestines. This inflammation may lead to spasms. However try to understand the complete digestive system functions as a unit. If something is wrong many other things too would be effected. So initially go for the tests.
Let's see the results.
You can take print out of answers and discuss them with treating Gastroenterologist.
Follow up with what He/She suggests on the link shared below.

http://doctor.healthcaremagic.com/doctors/dr-ramesh-kumar/72660

Do rate the answer.
In case any other query is left unanswered please feel free to follow up on link shared.
Regards!

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Ramesh Kumar (0 minute later)
Brief Answer:
Follow up.

Detailed Answer:
Hi there my dear,
You could consult any good Gastroenterologist of that area or you could visit a superspeciality hospital like Fortis XXXXXXX any one.
Fissures and all are basic problems in Gastroenterology all you need is a experienced doctor with availability of tests like colonoscopy 3 Tesla MRI.
See when a persons digestive system is not functioning properly as a whole then many times the food starts to ferment in intestines. This fermentation food release large amount of toxic gases which compresses the nerves passing through intestines.This compression may be a cause of such pain. Secondly stagnant food is a breading place for number of bad bacteria fungi etc.They causes inflammation in intestines. This inflammation may lead to spasms. However try to understand the complete digestive system functions as a unit. If something is wrong many other things too would be effected. So initially go for the tests.
Let's see the results.
You can take print out of answers and discuss them with treating Gastroenterologist.
Follow up with what He/She suggests on the link shared below.

http://doctor.healthcaremagic.com/doctors/dr-ramesh-kumar/72660

Do rate the answer.
In case any other query is left unanswered please feel free to follow up on link shared.
Regards!
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Ramesh Kumar

Gastroenterologist

Practicing since :1986

Answered : 2912 Questions

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NEED ADVICE OF SENIOR/EXPERIENCED GASTROENTEROLOGIST FOR ANAL FISSURES FOR MY

NEED ADVICE OF SENIOR/EXPERIENCED GASTROENTEROLOGIST FOR ANAL FISSURES FOR MY CHILD (2 YEARS 8 MONTHS) sir, 1. My daughter is 2 years, 8 months old. Weight 10.4 kg , lean built. 2. For first 06 months, since birth, she was on formula feed and little breast milk. She has constipation issues right from the day she started taking solid food. She may be lactose intolerant, but I am not sure. 3. I think she is having very sluggish digestion. She never had very soft/ watery stool. Her stool is always big and solid. She usually pass her stool twice a day. 4. In, october 2019, she had severe constipation issues and hard stool. For 1/2 day, she will pass little and hard stool and than one day she clears everything. We had administered her with medicines as directed by doctor. we changed our place from Goa to Bhubaneshwar. she was good/recovered after a month and was fine in NOV/DEC at Bhubaneshwar. 5. Again in the month of January 2020, she had constipation issues and hard stool. This time, She also developed a anal tag/ cut . Since then we have shown her to homeopatic and auyrvedic doctors.. tried their medicines. AFTER A LOT OF EFFORTS .. GETTING HER DRINK LOT OF WATER, MEDICNIES, LIVER TONIC, NEOPEPTINE gripe water, papaya, ETC... SHE WAS OK IN MAY-JUNE. For last six months , I have also noticed that every month, irrespective of her healthy diet she first gets constipation for 2/3 days, thereafter salivary stool for 2/4 days and then she will have normal stool. 6. Present condition. Her anal cut/ fissures has still there and not healed. . She is having pain while passing stool.The constipation/hard stool problem is still persisting. THE CUT MARKS ARE AGAIN SURFACED, AS IN THE MONTH OF JANUARY 2020. Whatever, she is eating, she is passing the same food particles, as it is... not able to digest well. Kindly clear my doubts and provide guidance.. What exactly is the condition and if it is normal in child of 2/ 3 years old? How to treat her and how long it will take to heal? Any long term effect of this fissures? Any tests/ scan to be undertaken? i have again consulted a doctor online and his prescription is attached. medicines not started.. need your suggestions/guidance. Also, sending pic/video of anus cut part. Plz guide me as I am worried and suffering bcz of this present situation.. and non availability of doctors bcz of lockdown. Waiting for ur reply. XXXXXXX