Suggest Treatment For Lesion Near Anal Region And Blood In Stool

Posted on Tue, 21 Jul 2015

Question: hi sir,

my son was born with arthrogryposis affecting his lower limbs...he is 9.5 months old now...weight 8.5 kgs..from the past one week he is passing solid hard stools...today we noticed bit of blood in his stools and we also noticed a cut near anal region...1)can you prescribe a lotion or cream to apply to the area so that it can heal and also 2)pls prescribe me a stool softener so that his stools become a bit loose and make it easy for him to pass..3) and also natural things that we can add to his diet so that will make the formation of stool a bit soft and easier to pass...i'll be highly thankful to you if u can help me out on this...he is having these problem after we started him on cows milk i guess..please take time to answer all the queries i have posted.

Answered by Dr. Deepak Kishore Kaltari (3 hours later)

Brief Answer:
Likely to be anal fissure

Detailed Answer:
Hi
Welcome to healthcare-Magic
Greetings of the day
Dear Mr XXXXXXX

Thanks for writing to me. Constipation in child could result in tear near anal opening leading to anal fissure in child. If the child is not excessively crying then there is no cause for concern.

Majority of the cause of constipation in children is related to diet factors. Its more common among those children who have the following
1. Diet mainly consists of milk based feeds
2. Decreased intake of water
3. improper weaning diet

I would suggest you the following

1. Hot Seitz bath: To a small tub of lukewarm water add 1/2 spoon of antiseptic solution. make the baby sit in for 5 to 10 minutes. Do it atleast once a day. After tht you can bath the baby. The warmthness will reduce the inflation

2. Short term use of Laxative like Lactulose 5 ml at night bedtime for a week will be helpful

3. Local application of small quantity of Xylocaine Ointment at anal opening will help

4. Give sufficient quantity of water before feeds

4. Avoid giving refined flour based weaning diet

Do send me clinical photograph for further assessment.

Take Care

Wishing you happy parenthood

Regards
Deepak

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (4 days later)

hello sir,
as you are very well aware of my sons condition of arthrogryposis..i would like to ask you about the cold my sons sufferng from the past 2-3 days...
he is 9.5 months old..8.4 kg...he has a nose blockage and throat irritation and we feel there is kind of a cough like thing when he wakes up in the morning and for a little while after that..his chest is clear...we are giving him asthalin 1 ml and budecort 1 ml respules through nebulisation in morning and night..rest in between we r using plain saline for nebulisation...he is also on solvin 2.25 ml thrice a day and relent at night 2 ml once...do we need to use antibiotic? or any other medicine you may prescribe?also the medicines we r using can u tell us wehter the dosage is correct?

Answered by Dr. Deepak Kishore Kaltari (3 hours later)

Brief Answer:
Antibiotic not indicated

Detailed Answer:
Dear Ms XXXXXXX

Majority of respiratory tract infection in babies and children are caused by viral infection and are self limiting. There is no need for antibiotic to be added . If the following criteria are fulfilled then there is no cause for concern

1. Respiration is normal and quite

2. Child is accepting feeds well

3. Baby is sleeping well

4. Absence of high grade fever

The medicine you are give are okay. Apart from it I would also advise normal saline nasal drops two drops in each nose thrice a day

Take care

Best Regards
Dr Deepak

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (18 hours later)

Thank you for your quick response..sir looks like the problem has increased now..when he woke up this morning he is coughing a lot and seems like there is cough building in his throat..post nasal drip? He has no fever..taking feeds well..sleeping properly..what shall we do? Coughing is getting worse

Answered by Dr. Deepak Kishore Kaltari (1 hour later)

Brief Answer:
The baby should settle down soon

Detailed Answer:
Dear Mr XXXXXXX

Being a parent myself , I understand your concern and apprehensions. Coughing is quite common in babies, likely to be due to post nasal drip. Solvin drops and Normal saline nasal drops should take care of it.
I would also advise applying Vicks vaporub over the clothesof baby , this will provide soothening relief. Do not apply it directly to skin, apply a little quantity of shirt and collar area of baby.
As there is no fever and baby is accepting feeds well , do not worry the baby should improve.

Take Care

Regards
Deepak

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (2 hours later)

Hello sir ...thank you so much for ur reply...I would like to ask you abt ambrodyl s syrup which was started by his paed when he suffered from cold when he was 3 months old..shall we start it? Can u Telme the dosage? For 8.5 kg child...also solvin and ambrodyl s ..what is the difference?because I remember he started both along with relent...pls help me out..I would be glad if u could help me relive my son ..can't see him like dis...

Answered by Dr. Deepak Kishore Kaltari (7 hours later)

Brief Answer:
Use of multiple cough syrup is not recommeneded

Detailed Answer:
Dear Mr XXXXXXX

Solvin is good syrup. Continue giving that. Ambrodyl S contains salbutamol which is bronchodilator, it is not recommended unless there us spasm of bronchi of lungs.

I would also advise steam inhalation. You can use electronic steamer , avoid direct contact with baby. use the steamer near the baby for 10 minutes each session. Warmthness and humidified air will help relieve cough.

Use of multiple cough syrup is not recommeneded.

Take Care

Regards
Deepak

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (28 hours later)

Thanks for your response sir..sir he is suffering from vomiting due to cough..I called his doctor and he said give ondem syrup for vomiting..but before I could ask him the dosage I thnk his cellphone got switched off...can you tellme what dosage of ondem syrup can be given to a 9.5 month old 8.5 kg child?

Answered by Dr. Deepak Kishore Kaltari (11 minutes later)

Brief Answer:
DOSAGE MENTIONED

Detailed Answer:
Dear Mr XXXXXXX

The dosage of Ondem is 0.08 mg per kilogram body weight per dose twice a day. For the child you can give 1.5 ml twice a day

Take care

Best Regards
Dr Deepak

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar