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Anal Fissure in Children
Barbora Patkova1,2, Tomas Wester2,3
1Department of Pediatric Surgery, Uppsala University Hospital, Uppsala, Sweden.
Summary
Anal fissure in children causes painful bowel movements and bleeding. Nonoperative treatments like topical medications aim to relax the anal sphincter, but optimal choices and recurrence rates require further study.
Area of Science:
- Pediatric Gastroenterology
- Colorectal Surgery
Background:
- Anal fissure is a common pediatric issue, characterized by anal canal tears.
- Symptoms include painful defecation and rectal bleeding, often linked to hard stools and sphincter pressure.
Purpose of the Study:
- To review current nonoperative treatments for pediatric anal fissures.
- To assess the efficacy and comparative success rates of various nonoperative management strategies.
Main Methods:
- Review of recent studies focusing on nonoperative treatments.
- Analysis of treatments including glyceryl trinitrate, calcium channel blockers, and botulinum toxin.
Main Results:
- Nonoperative management is now preferred over surgery, with higher success rates than placebo.
- Success rates vary, and optimal nonoperative treatment is not clearly defined.
- Recurrence rates after nonoperative management are significant.
Conclusions:
- Nonoperative therapies are effective but lack comparative data for optimal selection in children.
- Addressing constipation is crucial for preventing recurrent anal fissures.
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