Rectal Bleeding and Stool Thickness in Children - Surgery

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Rectal bleeding in children can be concerning for parents, and understanding the underlying causes is crucial for proper management. In your case, your son has been diagnosed with anal fissures, which are small tears in the lining of the anus often caused by passing hard stools. This condition can lead to pain and bleeding during bowel movements, and it is not uncommon in children, especially if they experience constipation.

The medication "腹樂疏" (which is likely a stool softener or laxative) is typically prescribed to help soften stools and make bowel movements easier, thereby reducing the risk of further fissures. However, it seems that after the dosage was reduced, your son began to experience bleeding again, albeit not daily. This could indicate that the stool is still not soft enough, or that the fissure has not fully healed.
Regarding the change in stool thickness, it is important to note that stool consistency can vary based on diet, hydration, and the use of medications like stool softeners. If the stool has become thinner, it may not necessarily be a direct side effect of the medication but could also be influenced by other factors such as dietary changes or the overall hydration status of your child.
In terms of whether to pursue further diagnostic testing such as a colonoscopy, it is essential to weigh the risks and benefits. Colonoscopy is generally not indicated for children with isolated anal fissures unless there are additional concerning symptoms such as persistent bleeding, significant changes in bowel habits, or other gastrointestinal symptoms. It is advisable to discuss your concerns with your child's primary care physician or the gastroenterologist managing his care. They can provide guidance on whether an increase in medication dosage is warranted or if other interventions are necessary.

In addition to medication, dietary modifications can play a significant role in managing constipation and preventing anal fissures. Ensuring that your child consumes a diet rich in fiber (fruits, vegetables, whole grains) and stays well-hydrated can help maintain softer stools. Encouraging regular bathroom habits and not delaying bowel movements when the urge arises can also be beneficial.

If your son continues to experience bleeding or if you notice any other concerning symptoms, such as abdominal pain, changes in appetite, or weight loss, it is important to seek medical attention promptly. Regular follow-ups with the healthcare provider will help monitor the situation and adjust treatment as necessary.

In summary, while anal fissures are a common cause of rectal bleeding in children, ongoing symptoms warrant close monitoring and possibly further evaluation. Open communication with your child's healthcare team will ensure that any necessary adjustments to treatment are made in a timely manner, promoting healing and preventing recurrence.