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Please help - 4 yr old has fissures

My four your old son has been in so much pain these past few weeks. He never had any health issues until a month ago when I noticed blood in his stool. I took him to his pediatrician who confirmed he had several fissures. I was in shock since he never complained of pain and went to the bathroom regularly. Two weeks later an abscess appeared and turned all of this into a nightmare. He started to be in so much pain using the bathroom that he is now holding it in. He also started to have inflammation in his mouth. His gums are raw but he has no ulcers. I was referred to a GI doctor but ended up having him hospitalized twice for pain and the size of the abscess. He had to be sedated for an MRI that confirmed a fistula. I've been told by two different GI doctor's that they strongly feel like he has Crohn's disease. He is in the process of being scheduled to have scoping done.

My biggest issue is getting my son to go to the bathroom. He is refusing. I totally understand but don't know what to do to get him to go. The GI doctor prescribed a hydrocortisone 2.5% cream. We were doing four sitz baths a day and are down to two. I've even placed a wet rag and a hot pad on his bottom to increase blood flow. How in the world will these fissures heal???? Can you please share what has worked for you? Any advice will be helpful. I'm so scared and don't know how to help my son. Having him go through scoping with these fissures is making me even more nervous. Thank you in advance.
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I'm so sorry for what your son is suffering. My experience is that keeping the stool very soft, with regular doses of Restoralax is helpful.

We have dealt with fissures but not an abscess or fistula.

It is so tough with a 4 year old. I would also ask about a liquid formula diet while you are waiting for diagnostic scopes. We did this with my daughter at age 4. 100% calorie intake from Ensure or Boost shakes for 6 weeks helped calm inflammation and decrease blood. It is safe, but you would need help from a nutritionist to work out the right number of shakes, etc...

So sad you have to deal with this.

my little penguin

Staff member
Unfortunately you can’t do formula only (pediasure or kids boost ) until after the scopes .
Since formula only will completely heal the gut making it harder to determine the cause and get an accurate diagnosis
How long till they do the scope ?
In the US the can direct admit to the hospital and do the scope the next day ..
Can you ask the Gi for this since he is in so much pain ?
Otherwise the scope wait can be 6/8 weeks for “outpatient “
Miralax daily can help soften the stool the gi
should give you the dose
Since he is under the age of 8
Very early onset (veo ) ibd would be the case if he has crohns
There are a few pediatric hospitals in the US specialized in VEO ibd kids since they are difficult to treat and present differently and sometimes have extra “stuff” going on .
Children’s hospital of Philadelphia has a veo ibd clinic

Can you have him “sit “ on the toilet to read /watch tv etc.. without trying to “go” to get him to relax some?
Ds has had fissures but not an abscess or fistula
He was dx at age 7 and now is 16
I greatly appreciate your feedback!!! Since writing the post my son went to the bathroom and said the pain was a little better. The hydrocortisone cream appears to have worked. I just didn't know since he hadn't gone since the doctor prescribed it to me earlier this week. I honestly felt like the gates of heaven opened when he said it was better. We had to use a suppository since he held it in for so long a week ago, so that was such a BIG win!!! I will take a little better!!!!

To answer your question - singing songs, buying him new toys, watching tv, etc. made no difference in him going. The term poop alone had him terrified. At one point, he was begging me not to let him go. He said he felt like someone was cutting him. It's honestly been so sad to see and hear.

Since my son's dentist confirmed the inflammation and rawness in his mouth appeared to be coming from something internally, the GI moved the scope along. Last we spoke she was getting everyone together including an oral surgeon to take a biopsy since they can obtain details from his condition from his mouth under a microscope. I strongly believe it will be done within the next two weeks.

By the grace of God we live in the Philadelphia area. There are two children hospital's in our area - Nemours and CHOP. We had been referred to a GI at Nemours by our pediatrician, but we took him to CHOP when he was hospitalized and that allowed us to quickly be seen by one of their doctors. I can't even imagine the wait time to be seen if we were not admitted. I quickly learned this was a HUGE blessing. I didn't even know that CHOP was well regarded in this area. I guess I was in denial about him having any type of IBD, and really thought the doctors were negligent to even suggest something like this without confirming though testing. At this point I do understand their reasoning given all the symptoms my son is experiencing. I just pray whatever his issue treatment will help with simple things like eating and using the bathroom.

Thank you again for your time!!!! Parents like you are such a valuable resource!!! Your feedback alone honestly means the world!!! I will keep you posted.
Hi rhall, I'm so sorry to hear about your youngster having to go through this. I don't have any experience in this area to offer you, however, I just wanted to send my support and say that this website is a good means of information with parents who have dealt with many issues with their kids. Please keep us posted. Big hugs.