Anorectal Diseases in children, Causes and Treatment

Children, like adults, can suffer from some anorectal diseases, for reasons that differ for each disease, and because anorectal surgeries on children are more difficult, Due to the weakness of the tissues in the region, there are several methods of treatment.

In this article, we will learn about these diseases, their causes, and their treatment.

1. Poor stool control in children

Fecal incontinence in children ,also called fecal suppression or fecal contamination, occurs when your child resists bowel movements, leading to impaction of stool that collects in the colon and rectum. And when your baby's colon fills with impacted stool, the liquid stool can leak out of anus thus staining the underwear. 

In most cases, fecal incontinence in children is a symptom of chronic constipation, and in a few cases it may result from developmental and psychological problems.

Causes:

-Chronic constipation

-In some cases, lactose intolerance or very high consumption of dairy products can cause constipation

-Psychological problems: the child may suffer from psychological pressure as a result of premature toilet training, or an important change in the life of the family.

Treatment:

-Medications, determined according to the cause of fecal incontinence.

-Diet changes.

-Exercise. 

-Bowel training: Your doctor may recommend that you make a conscious effort to train the child to defecate at a specific time of day

-Bulking agents: Injections of non-absorbable bulking agents can thicken the anal walls and help prevent leakage.

-Surgery: Treating fecal incontinence may require surgery to correct an underlying problem, such as rectal prolapse or sphincter damage from childbirth.

2. Anal Prolapse in Children

Causes:

-Intestinal catarrh and frequent diarrhea

-Muscle weakness and anemia

-Unequipped toilet designs (Traditional Squat Toilet)

Complications:

-Anal bleeding during defecation

-Severe anemia

Treatment:

-Treating the cause of recurrent diarrhea or anemia

-Surgical treatment if medication fails or complications occur

3. Anal fissures in Children:

Causes:

-Bleeding in the area that supplies the anus with blood. 

-Constipation severe enough to be chronic

-Inflammation

-Muscle stiffness: Lack of flexibility of the muscles surrounding the anus that help in the pressure process to expel stool

-Irritable Bowel Syndrome

-Decrease in immunity

Treatment:

If the condition does not improve within a week or two, the doctor recommends using an ointment applied to the anus to expand the blood vessels in the rectum and relieve pressure on the area.

If the condition does not improve during this period, an analgesic ointment can be used to relieve acute pain.

Topical medications may also be given to the affected area to loosen the knot in the rectum and increase blood supply to the fissures in the rectum, but these may cause side effects such as itching, burning or dizziness.

Doctors rarely resorts to surgery to treat anal fissures in children.

4. Anal Fistula in Children:

Causes:

-Unexplained congenital cause.

-Recurring infections and abscesses in the area around the anus, or not treating the abscess properly.

-Chronic intestinal infections such as Crohn's disease.

-HIV.

-Hormonal imbalances: such as an increase in the androgens, which leads to an imbalance in the function of the sebaceous glands in the region.

Treatment:

Treatment usually depends on the location of the duct and the extent of the condition:

Treatment begins with administering antibiotics to eliminate any inflammation in the area, in addition to pain relievers.

The second step is to treat the cause behind this fistula to avoid it from happening again.

Surgical Approach: different surgical methods for treating fistula vary according to the case.

Complications:

-The return of the fistula again.

-Complications from the operation, such as damage to the anal valve, which leads to loss of bowel control.

5. Pilonidal sinus in children

Symptoms:

Swelling and redness, accompanied by severe pain in the lower back between the buttocks, and secretion of pus or blood.

Treatment:

Surgical intervention: In the event of an abscess, the wound is opened and cleaned, and dressing changes and continuous washing are done until the healing is complete. After that, the patient comes to perform the operation to remove the fistula with all its ramifications, then the skin is closed with a medical drain in the wound. 

If your child suffers from anorectal problems, you can now book an examination with Prof. Dr. Muhammad Al-Barbari, Professor of Pediatric Surgery at Qasr El-Ainy, Faculty of Medicine  and Head of the Pediatric Surgery Department at the Hemocure.