When Do Hemorrhoids Occur in Children?

Discussion Common anorectal problems come to the attention of clinicians because of blood, pain or a mass lesion. These include anal fissures, perianal abscess and fistulas and hemorrhoids. Anal fissures are tears of the distal anus usually in the midposterior line that often occur in toilet training children and those with constipation. Rectal bleeding and pain are common. Treatment is conservative. Perianal abscess and fistulas present as masses that are firm or fluctuant. Treatment is antibiotics along with various types of incision and drainage. Recurrence is high and may require additional surgery. Crohn’s disease should be considered if a perianal fistula occurs. Hemorrhoids are swollen vein in the anus. Symptoms include bleeding, pain, prolapse and itching. External hemorrhoids can be noted by external examination but internal hemorrhoids require anoscopy. External hemorrhoids occur below the dentate line (the mucocutaneous junction that occurs at the upper 2/3 and lower 1/3 of the anal canal) and are covered by skin. Thrombosis causes pain because of their cutaneous innervation. Thrombosis generally resolves in 2-3 days with regression around 1-2 weeks. A skin tag may remain. Internal hemorrhoids are covered by columnar epithelium. They generally are painless if thrombosed because of their visceral innervation. Bleeding and prolapse are more common. Hemorrhoid treatment is conservative with increasing fluids and dietary fiber along with Sitz baths. Cooling p...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news