A 12 yr old boy presented with complaints of profuse bleeding while passing stool. bleeding was also associated with pain and itching. h/o constipation present . similar episode 1.5 yr ago which got relieved on medication....what should be the management?

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Ac. fissure ano. treat with laxatives , Diltiazem ointment, sitz bath. sigmoidoscopy to r/o internal piles and rectal polyps

A simple case of Acute anterior midline fissure in Ano .due to passage of a hard scybalous stool mass .No need of any further investigations. Treatment is either conservative or Lords anal dilatation under G.A. I would prefer surgery as such acute fissures are extremely painful and conservative treatment with laxatives, antibiotics, anti inflammatory analgesics, local anovate and sitz bath will take 2-3 weeks time for fissure to heal

so many comments whatever medical treatment advised above by many respected doctors, I do agree but mind it that pt is just 12 yrs old, in this case any kind of surgery like anal dilatation or sphincterotomy should not be done.
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as the bleeding is associated with passing of stool which may be hard as the boy is also having constipation treat him on the line Of fissure with paraffin based laxatives and local anaesthetic based ointment. needs further evaluation as the problem has occurred second time.

acute anal fissure. laxatives should be given. local application of xylocaine jelly. sitz bath, twice a day

acute fissure in ano
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Advised colonoscopy to rule out polyposis coli.

it is fissure in ano. treat the primary cause which is constipation and give supportive care for the fissure like local anaesthesia ointment

fissure in ano, as the child is having complaint of profuse bleeding while passing stool, as well the child is constipated. Treatment consists of laxatives, Diltigesic oint locally 3 to 4 times locally and Sitz bath. Deferred Sigmoido/colonoscopy to rule out Rectal Polyps.

internal haemorroid RX haemorrhoidectomy

Sir in photo clearly we can see the fissure
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fissure doesn't bleed profusely. To R/o solitary rectal ulcer syndrome.

Acute fissure in Ano T. styplon 1/2 bd. T. triphala guggulu 1 bd cap. laxsen 1 hs sitz bath Kusumolin ointment for External application

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