By far the most alarming anal problem in is bleeding, and the most common cause of bleeding in this area is a fissure, a crack or tear in the sensitive skin of the anal opening. Fissures are nearly always caused by the passage of a hard stool, although scratching or sometimes irritation from cleansers in wipes can promote the formation of fissures. Typically the blood appears as a streak on the stool, and it may not be present the next time the bowels move. If blood actually flows after a stool, it will usually stop on its own in five to ten minutes.
Treatment involves eliminating any underlying cause of the fissure, fissures will usually clear up on their own if they are not continually irritated. If stools are hard, increase in-take of fluids, dietary fibers (from fruit, vegetables, and bran), utilize a mild stool softener, or even mineral oil may be helpful. Multiple fissures and in-flamed tissues may improve with warm soaks and the use of a mild cortisone cream. If there are other contributing factors such as infection or pinworms (see below), these should be treated.
Hemorrhoids are dilated veins in the anal area that can bleed, itch, or clot. They are extremely uncommon in infants and children, and if discovered, a cause should be sought. While prolonged constipation and straining may be the cause, abnormalities in the venous system which returns blood to the heart, must be considered. Anal itching can be caused by irritated skin, a fissure, soaps and cleansers, or pinworms. If you discover your child intensely scratching this area during the night, pinworms might be the cause. A local infection involving the common yeast Candida albicans should be treated with antifungal cream.
Occasionally, a person with a bacterial infection in one area of the body will accidentally transfer the bacteria to the anal area.