Red flags & when to go in person for Anal Fissure in Children

Audience: pediatric

An anal fissure is a small tear in the skin around the anus that can cause pain and bleeding, especially in children. It often happens when a child has hard stools or constipation. Many anal fissures heal on their own or with simple care, such as softening stools and keeping the area clean. However, some signs mean your child should see a healthcare provider in person. These include severe pain, heavy bleeding, fever, or if the fissure does not improve with home care. Telemedicine can help you understand symptoms, get advice on care, and decide if an in-person visit is needed. This guide explains when to seek urgent care, what telemedicine can and cannot do, and how to prepare for and follow up after a telehealth visit. Remember, this information is educational and not a diagnosis. Always seek professional care if you are worried about your child's health.

Red flags — go in person / ER

• Heavy or continuous bleeding from the anus — seek urgent medical care.
• Severe pain that does not improve with home care — see a healthcare provider in person.
• Fever or signs of infection around the anus (redness, swelling, warmth) — get prompt medical evaluation.

What telemedicine can do

• Assessing symptoms and providing education about anal fissures.
• Advising on home care measures such as stool softeners and hygiene.
• Determining if in-person evaluation is needed based on symptoms.

What telemedicine cannot do

• Performing a physical examination of the anal area.
• Treating severe bleeding or infection that requires immediate care.
• Diagnosing other conditions that may mimic anal fissures without physical exam or tests.

What is an Anal Fissure?

An anal fissure is a small tear or cut in the thin skin around the anus. It can cause pain, especially during bowel movements, and sometimes bleeding. In children, anal fissures often happen because of constipation or passing hard stools. They are common and usually heal with simple care.

Common Symptoms in Children

Children with an anal fissure may have:

If your child shows these signs, gentle care and stool softeners may help.

When to Go In Person: Red Flags

Some symptoms mean your child needs to see a healthcare provider in person quickly:

If you notice any of these, seek medical care promptly.

How Telemedicine Can Help

Telemedicine visits can help you:

Telemedicine is a safe and convenient way to get guidance without leaving home.

Limitations of Telemedicine

Telemedicine cannot:

If your child has red flags or worsening symptoms, an in-person visit is necessary.

Preparing for a Telemedicine Visit

Before your telemedicine appointment:

This helps the provider give the best advice.

After the Telemedicine Visit

After your visit:

Keeping track helps your child's recovery.

How to prepare for your tele-visit

• Write down your child's symptoms, including when they started and severity.
• List any treatments or medicines your child is currently using.
• Note your child's bowel habits and diet.
• Prepare questions or concerns to discuss during the visit.
• Ensure you have a private, quiet space with good internet connection for the telemedicine call.

After your tele-visit

• Follow the healthcare provider’s advice on stool softeners and hygiene.
• Monitor your child’s symptoms closely for any worsening or new red flags.
• Schedule an in-person visit if recommended or if symptoms do not improve.
• Keep a record of your child’s symptoms and treatments for follow-up visits.
• Contact your healthcare provider promptly if you notice any red flags or have concerns.

FAQs

What causes anal fissures in children?

Anal fissures in children often happen because of constipation or passing hard stools. The strain and pressure can cause small tears in the skin around the anus.

How can I help my child’s anal fissure heal at home?

You can help by ensuring your child drinks plenty of fluids, eats a high-fiber diet, and uses stool softeners if recommended. Keeping the area clean and using warm sitz baths may also ease pain and promote healing.

When should I worry and see a doctor in person?

If your child has heavy bleeding, severe pain, fever, signs of infection, or if the fissure does not improve after a few weeks, you should see a healthcare provider in person.

Can telemedicine replace an in-person visit for anal fissures?

Telemedicine is helpful for initial advice and symptom assessment but cannot replace a physical exam. Severe symptoms or unclear diagnosis require an in-person visit.

Is an anal fissure serious?

Most anal fissures are not serious and heal with care. However, if left untreated or if complications occur, they can cause ongoing pain and discomfort, so proper care is important.

Sources

1. Anal Fissure — MedlinePlus, U.S. National Library of Medicine.
2. Anal Fissure - Symptoms and Causes — Mayo Clinic.
3. Constipation in Children — American Academy of Pediatrics.
4. Anal Fissure in Children — National Library of Medicine.

This telemedicine guidance is for educational purposes only and is not a substitute for professional in-person medical care. If your child has any concerning symptoms or red flags, please seek prompt medical attention.