Instructions

• Instructions for new users

Call 911 Now If:

• Fainted or too weak to stand

Call Your Doctor Now If:

• Your child looks or acts very sick
• Large amount of blood, blood alone without any stool or the toilet water turned red
• Tarry or black-colored stool
• Blood with diarrhea
• Pink- or tea-colored urine
• Vomited blood
• Abdominal pain or crying also present
• Skin bruises not caused by an injury
• Age < 12 weeks

Call Your Doctor Within 24 Hours If:

• Blood in the stools, but none of the symptoms described above (probably anal fissure). (NOTE: Try to save a sample of the "blood" for testing if your child needs to be seen)

Call Your Doctor During Weekday Hours If:

• See other columns for appropriate advice

Home Care (Read "Call Your Doctor…" first):

Definition

An anal fissure is the #1 cause of blood in stools:

• The blood is bright red, but only a few streaks or flecks are present
• All the blood is on the surface of the stool or on the toilet tissue after wiping
• Usually follows passage of a large or hard bowel movement
• You may see a shallow tear at 6 or 12 o'clock on the anus

Warm Saline Baths

Give warm saline baths for 20 minutes 3 times per day to cleanse the area and to promote healing. Add 2 oz. of table salt or baking soda to a tub of warm water.

Ointments

If the anus seems irritated, apply 1% hydrocortisone ointment 3 times per day to help healing.

High-Fiber Diet

For children > 1 year old, offer a nonconstipating diet. Increase fruits, vegetables and grains (fiber). Reduce milk products to 3 servings per day.

Expected Course

Anal fissures usually heal up quickly with home treatment.

Call Your Doctor If:

• Bleeding increases in amount
• The bleeding recurs > 2 times after treatment begins
• Your child becomes worse or develops any of the "Call Your Doctor…" symptoms