While childhood hemorrhoids are not generally a serious health problem, nor are they a common childhood condition, childhood hemorrhoids can often be both a symptom of a more serious health problem and its cause. Hemorrhoids, as they are known, are swollen veins that originate around the hemorrhoidal pad that helps the anal canal to function. When a particular large vein that runs through the area is under enough pressure, the walls of the vein swell and subsequently encroach on some tissue. Internal or external hemorrhoids in children? In both children and adults, if the hemorrhoid occurs within the anal canal, above the dentate line, then it is an internal hemorrhoid. However, if the distended vein originates from a point below the dentate line, it is an external hemorrhoid. The actual opening of the anal canal is called the anal verge, and the dentate line is about two centimeters into the body at the anal verge. The dentate line is important because it marks the beginning of a major and sensitive area of nerves that help control the anal sphincter. Internal hemorrhoids don’t hurt much because none of them are in this nerve area, if at all, unless they prolapse to the outside. However, because of their location, external hemorrhoids generally hurt like the devil, and children are more likely to suffer from pain than adults. Causes of hemorrhoids in children: There are many potential causes of hemorrhoids in children, from constipation to Crohn’s disease (which is a serious disease of the lower gastrointestinal tract) to simply sitting on the toilet for too long. Although there are quite a few relatively normal causes, hemorrhoids are still very rare in childhood, so it is especially important to check for more serious problems. While adults can be very aware that their hemorrhoids and constipation are the result of an unhealthy diet, lack of exercise, and sedentary lifestyle, children are not normally bothered by these problems. Children, in fact, are very active, which makes us adults wonder where they get all this energy from. An inactive lifestyle, the most common cause of hemorrhoids, is a lesser factor for children, so other problems come to the fore. A more serious cause of hemorrhoids in children is known as portal hypertension, which means there is backward pressure within the portal vein that carries blood from the digestive tract to the liver. Diseases that affect the liver often show its first signs through portal hypertension. Crohn’s disease, a chronic inflammatory bowel disorder, is also a possible cause of hemorrhoids in children. They should be examined, especially in infants who are unable to express clearly or accurately what has been injured. The most common cause of hemorrhoids in children is constipation, and one of the main causes of constipation is dehydration. Those children who are dehydrated are the ones who are at risk. While dehydration is not good for anyone, it works especially quickly in children because of pediatric anatomy, and children often do not have the same body reserves as adults to resist dehydration, heat stroke, hypothermia, and other conditions. Constipation in children can be diagnosed by dry, hard, clay-like stools, nausea, vomiting, and weight loss. Some fluid on the child’s underwear indicates that stool is stored in the child’s rectum and that the child does not want to have a bowel movement because of pain. The child is not good at expressing the exact cause of internal pain, but if he sees the toilet, he looks like he is straining all over, especially his legs and hips, wiggling his toes up and down, blushing, and crying. Infants may anticipate pain and start crying when they feel the need to have a bowel movement. Constipation in children is usually caused by the same things as anyone else, a low fiber diet, insufficient hydration, and lack of exercise. One particular reason for children is that they will ignore the urgency of a bowel movement until it is too late, because they are distracted or don’t want to withdraw from play, or because they are afraid to go through a repeat of a painful experience. Under no circumstances should a child be shamed into going to the toilet, as any shaming or scolding will only make the associated problems worse and may undermine previous successful toilet training. Another common cause of dehydration and hemorrhoids in children is diarrhea, which is a relatively common childhood condition. The large intestine is where water is reabsorbed into the body, and diarrhea occurs when intestinal contents pass through the large intestine too quickly. Since various enzymes and fluids are added in by the body to digest food, if water is not reabsorbed properly, the child will undoubtedly lose water even if he or she drinks a comparable amount, eventually triggering constipation. In addition, prolonged sitting on the stool, which usually involves diarrhea, and straining can lead to hemorrhoids. Whether your child has hemorrhoids or not, don’t let them spend time on the toilet without having a bowel movement, and give them pediatric electrolytes to drink. Your local doctor or pharmacist can help you pick the best brand in your area. Pinworms can have anal itching similar to hemorrhoids in children: Another potential cause of anal itching in children is pinworms. You will want to take your child to the doctor to make sure it is not these little parasites before deciding what course of treatment to pursue. Trying to treat your child for itchy hemorrhoids while he or she has pinworms is both useless and potentially devastating. Treatment for hemorrhoids will do nothing for pinworms, and the powerful infection of these parasites can expose your child from anywhere. As adults, it’s hard to get pinworms simply because adults don’t get to play in the mud & dirt as often as children do, which means they can easily be passed on to others in your family if your child brings some home. When should I go to the doctor if I suspect my child has hemorrhoids? You should take your child to the doctor if an episode of constipation has lasted more than three weeks, your child is unable to participate in their normal activities, the skin around the anus has developed small fissures, normal straining does not pass stool, or if your child’s anus begins to leak consistently. Obviously, if a lump develops in or near the anus, you should see a doctor as soon as possible. Children with hemorrhoids present special difficulties: When children do have hemorrhoids, they need to be watched carefully, especially if they are painful or itchy. Children often have no self-control to avoid constant scratching, which can cause the hemorrhoid to tear open and bleed. Scratching can cause the hemorrhoid to break open, which in turn can lead to serious infection and painful inflammation. In addition, the associated pain can make the child irritable, unwilling to go to the toilet, unwilling to leave the toilet, and eventually associate many bad things with toilet training itself. If constipation is a factor, the leakage or leaks associated with constipation can also bring with it the potential for infection, especially if the child refuses to defecate and tries to ignore the problem. All in all, it is a very unpleasant situation for all concerned, especially the child,. Treatment of Hemorrhoids in Children – Immediate Relief for Hemorrhoids in Children: It may be helpful to wipe your child with wet tissues, and your pediatrician or pharmacist may be able to recommend a softer moistener than plain water. Dry toilet paper should be avoided, as trying to scratch, rub or scrub with it could potentially cause excessive force. Keep your little one clean and dry, and bathe your child in hugs and love so that he or she knows it’s not the end of the world and that your love is constant. Once the pediatrician determines that your child, indeed, has hemorrhoids, there are a number of things you can do to give your little one immediate relief. There are no hemorrhoid creams or ointments currently available in pharmacies that are made specifically for children, but ibuprofen is indeed available for children and infants and may help relieve pain and inflammation. Of course, do not use anything that is not recommended by your doctor for infants under two years of age, but if you call and ask, your child’s pediatrician will calculate the appropriate dose of ibuprofen based on age and weight. The reason pediatricians must calculate dosages is because babies weigh so little and because the way babies metabolize is so different from older children. Between these two factors, some degree of integration is needed to calculate the correct dose of the drug for the infant. In addition to medication, warm sitz baths for twenty minutes at a time, three times a day, often bring great relief. Oatmeal powder, which can be found in many drugstores, can also be added to the sitz bath to bring additional soothing power. If your child is itching badly, plain cornstarch can be sprinkled on the area, as well as on the child’s diaper or underwear. Some children find that sitting on a towel-wrapped ice pack for a few minutes also helps relieve the pain. Please check and make sure your child is not sensitive or allergic to your use of current laundry soaps and softeners. If in doubt, purchase a bottle or two of hypoallergenic laundry detergent and softener, as this can reduce some of the irritation that should occur. Treatment of Hemorrhoids in Children: Once they get immediate relief, hemorrhoids are relatively easy to deal with. The best treatment for hemorrhoids for anyone of any age is to get more fiber from foods such as whole grains, fresh fruits and vegetables. Getting enough fluids from water, juice, or milk sources is very important to avoid constipation. Since it is very important for your child to get enough fiber, do not try to treat childhood constipation with enemas or laxatives without medical supervision. Laxatives can dehydrate your child quickly and dangerously. If your child drinks soda, tea or coffee, these things need to be removed. The caffeine found in them is a diuretic, which means “increased urination.” Or, in other words, drinks with caffeine are actually taking water out of the body. Also, the sugar in soda doesn’t help because it speeds up a child’s metabolism and subsequently digestion, something that is most needed for regularity. Exercise can be very beneficial – for a child, this means physical play. Treatment of infant hemorrhoids: If your child is still an infant and has not yet eaten food, then it makes no difference whether he is breastfed or fed an unfortified iron formula. Either iron-fortified or soy-based formulas can cause constipation in infants. There are a considerable number of formulas on the market today that are specifically made for stomach sensitivities or as an anticonstipation, which is beneficial. While mom’s milk is best and not an option for everyone, to you can try and get as close as possible. Increasing movement and activity is also beneficial, so going to play in the sun is a good idea and can even give mom and dad a moment to breathe. Babies who are not yet walking like to move their own arms and legs like a game of bicycle, which is when an adult takes the baby’s feet in their hands and alternately moves the legs and knees up and down as if the baby were on a pedal board. Doing this while chanting silly songs and making silly faces is, of course, strictly optional, but highly recommended. Children’s Hemorrhoids – Conclusion: When taken seriously and treated promptly, children’s hemorrhoids will resolve on their own. Due to the unique biology of the human child, surgery is usually not an option, as their small bodies are not yet well equipped to handle the severe physical shock that accompanies any surgical procedure. However, there is still a chance that a child’s hemorrhoid will thrombose (this means that a blood clot becomes stuck inside) or prolapse (this is when the internal hemorrhoid runs outside of the body), but fortunately the chances are quite small. Both of these conditions pretty much require surgical treatment, but the chances of these occurring in children are close to none. Most children’s hemorrhoids will go away on their own with proper diet and, of course, tender loving care.