Pediatric Anal Fissure/Fistulotomy/Sphincterotomy Surgery
What Is an Anal Fissure?
An anal fissure is a tear in the skin inside the anal canal. When this skin is torn, you may have pain with each bowel movement and pass bright red blood.
What Is a Sphincterotomy? Sphincterotomy allows a fissure or fistula to heal. A small part of the anal sphincter muscle is cut to open the anal canal. This relieves pressure when you move your bowels and allows a fissure to heal.
What Is a Fistula?
An infection of the gland inside the anus can cause it to fill with pus. This is an abscess. After an abscess is drained, there may be a tunnel from the anus to the skin. This is a fistula. It can cause pain, fever, and drainage.
What Is a Fistulotomy?
A fistulotomy is surgery to open a fistula and allow it to heal.
After Surgery
Rectal Care
- Give your child a sitz bath at least 3-4 times a day and after each bowel movement. This will help decrease the pain of rectal spasms and aid healing. Sit in a bathtub of warm water for 10-20 minutes.
- Avoid hard wiping of the anal area for the first few days. Do not use toilet paper, instead, use alcohol-free baby wipes.
- Your child will have reddish-yellow drainage from the rectum for at least 7-14 days. Your child will need mini-pads or sanitary pads for the undergarments during this time. The drainage will decrease in amount and become lighter in color. With bowel movements and increased activity you may notice an increase of bloody drainage.
Activities
- Avoid sitting or standing for longer than 1 hour at a time.
- For the first 6 weeks, do not lift more than 10 pounds. Lifting puts extra strain on the surgical site and may increase the chances of bleeding.
- Check with your child’s doctor before you return to school.
- Your child will return to see the surgeon in 1 – 3 weeks.
The doctor may order pain medicine for your child.
Constipation
Avoid constipation while your child is taking pain medicine. Your child may need to take a stool softener (Docusate sodium) and a bulk fiber laxative such as Miralax® to prevent constipation. These will help the stool pass more easily.
Diet
Have your child eat a well balanced, high fiber diet each day.
- 8-10 (8 oz) glasses of non-caffeinated fluid
- At least 4 servings of fruits and vegetables
- At least 4 servings of breads and cereals (2 of these should be whole grain)
When to Call the Doctor
- Large amount of bright red blood from the rectum that does not stop with pressure to the rectum for 10 minutes.
- Temperature over 100.4ºF for 2 readings taken 4 hours apart. Take your child’s temperature once a day for a week.
- Foul-smelling drainage.
- Breaking open of suture line.
- Excess swelling in the rectal area.
- You cannot control your bowel movements.
- Trouble passing urine.
Phone Numbers
Pediatric Surgery Clinic: (608) 263-6420 Mon-Fri 8:00 am-4:30 pm
After hours, holidays and weekends, this will give you the paging operator. Ask for the Pediatric Surgery resident on call for
Dr. _____________. Leave your name and phone number with the area code. The doctor will call you back.
Toll Free: 800-323-8942
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 08/26/2011
Copyright © 08/26/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6808
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