Objective: After an anal fissure (AF), patients frequently avoid defecation, even if they have diarrhea, due to severe anal pain. This is particularly evident in constipated patients, however the type of functional disease that causes AF is not limited to constipation or persistent diarrhea. The aim of this study was to examine the prevalence and the clinical importance of diseases associated with AF in childhood age groups among young patients with different clinical pictures. Methods: The data related to age, sex, and the accompanying disease of AF patients were collected from a hospital database. Of 7406 patients, 728 were identified and categorized in 6 distinct disease groups associated with AF: constipation; constipation with anal incontinence, urinary incontinence, or anal incontinence and urinary incontinence; infantile colic (IC); and diaper dermatitis (DD). The symptoms of the AF-related diseases were recorded and it was assessed whether AF-related symptoms were reduced after AF treatment. Results: Of the 728 AF-associated patients of all groups, it was observed that 1 week after AF therapy, 529 (72%) experienced a regression in both current disease and AF-related symptoms (p
Amaç: Anal fissür (AF) başladıktan sonra, kabızlığı olanlarda daha belirgin olan şiddetli anal ağrı nedeniyle, hastalar ishal olsalar bile defekasyondan kaçınırlar. AF’ye neden olan fonksiyonel hastalığın tipi, kabızlık veya ishal ile sınırlı değildir. Bu çalışma, tüm çocukluk çağı yaş gruplarında AF ile ilişkili hastalıkların prevalansını ve klinik önemini, farklı klinik tablolarla açıklığa kavuşturmayı amaçlamıştır. Gereç ve Yöntem: Hastaların yaşı, cinsiyeti ve AF ile ilişkili hastalıkları veri tabanından toplandı. Yedi bin dört yüz altı hastadan AF ile ilişkili altı farklı hastalık grubu belirlendi: 1. kabızlık, 2. anal inkontinans, 3. üriner inkontinans, 4. anal inkontinansla birlikte üriner inkontinans, 5. infantil kolik (IC) ve 6. diaper dermatit (DD). AF ile ilişkili hastalıklarda semptomları ve AF tedavisinden sonra AF ile ilişkili semptomların gerileyip gerilemediğini belirledik. Bulgular: Anal fissür tedavisinden bir hafta sonra, tüm grupların AF ile ilişkili 728 hastasından 529’unda (%72) hem mevcut hastalıkta hem de AF ile ilişkili semptomlarında azalma vardı (p
1. Lund JN, Scholefield JH. Aetiology and treatment of anal fissure. Br J Surg 1996;83:1335–44.
2. Klosterhalfen B, Vogel P, Rixen H, Mittermayer C. Topography of the inferior rectal artery: a possible cause of chronic, primary anal fissure. Dis Colon Rectum 1989;32:43–52.
3. Dykes SL, Madoff RD. Benign Anorectal: Anal Fissure. In: Wolff BG, Fleshman JW, Beck DE, Pemberton JH, Wexner SD, editors. The ASCRS textbook of colon and rectal surgery. New York: Springer Science and Business Media LLC; 2007. p. 178–91.
4. Thomson JPS, Nicholls RJ, Williams CB. Anal Fissure in colorectal diseases. London: William Heinemann Medical Book Limited; 1981. p. 312.
5. Van Outryve M. Physiopathology of the anal fissure. Acta Chir Belg 2006;106:517–8.
6. Dohil R, Robers E, Verrier Jones K, Jenkins HR. Constipation and reversible urinary tract abnormalities. Arch Dis Child 1994;70:56–7. 7. Chase JW, Homsy Y, Siggaard C, Sit F, Bower WF. Functional constipation in children. J Urol 2004;171:2641–3.
8. Nocerino R, Pezzella V, Cosenza L, Amoroso A, Di Scala C, Amato F, et al. The controversial role of food allergy in infantile colic: evidence and clinical management. Nutrients 2015 7:2015–25.
9. Johnson JD, Cocker K, Chang E. Infantile Colic: Recognition and Treatment. Am Fam Physician 2015;92:577–82.
10. Xinias I, Analitis A, Mavroudi A, Roilides I, Lykogeorgou M, Delivoria V, et al. Innovative Dietary Intervention Answers to Baby Colic. Pediatr Gastroenterol Hepatol Nutr 2017;20:100-6.
11. Stamatas GN, Tierney NK. Diaper dermatitis: etiology, manifestations, prevention, and management. Pediatr Dermatol 2014;31:1–7.
12. Evans SE, Akıncı H, Doğan S, Atakan N. Diaper Dermatitis: A Review of 63 Children. Pediatr Dermatol 2016;33:332–6.
13. Doig CM. ABC of colorectal diseases. Pediatric problems-I. BMJ 1992;305:462–4.
14. Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterology 2006;130:1480–91.
15. Yakut HI, Tunç B. Infantile colic. Turkish Journal of Pediatric Disease 2007;1:57–63.
16. Poh A, Tan KY, Seow Choen F. Innovations in chronic anal fissure treatment: a systematic review. World J Gastrointest Surg. 2010; 27:231–41.
17. Zivkovic VD, Lazovic M, Stankovic I, Dimitrijevic L, Kocic M, Vlajkovic M, et al. Scintigraphy evaluation of the types of functional constipation in children with bowel bladder dysfunction. J Pediatr Urol 2014;10:1111–6.
18. De Paepe H, Renson C, Van Laecke E, Raes A, Vande Walle J, Hoebeke P. Pelvic-floor therapy and toilet training in young children with dysfunctional voiding and obstipation. BJU Int 2000;85:889–93.
19. Sarici H, Telli O, Ozgur BC, Demirbas A, Ozgur S, Karagoz, MA. Prevalence of nocturnal enuresis and its influence on quality of life in school-aged children. J Pediatr Urol 2016;12:e1–6.
20. Haid B, Tekgül S. Primary and Secondary Enuresis: Pathophysiology, Diagnosis, and Treatment. Eur Urol Focus 2017;3:198–206.
21. Mackie RI, Sghir A, Gaskins HR. Developmental microbial ecology of the neonatal gastrointestinal tract. Am J Clin Nutr 1999;69:1035– 45.
22. Gutiérrez-Castrellón P, Indrio F, Bolio-Galvis A, Jiménez-Gutiérrez C, Jimenez-Escobar I, López-Velázquez G. Efficacy of Lactobacillus reuteri DSM 17938 for infantile colic: Systematic review with network meta-analysis. Medicine (Baltimore) 2017;96:e9375.
23. Sinha S. Dysfunctional voiding: A review of the terminology, presentation, evaluation and management in children and adults. J Urol 2011;27:437–47.
24. Carman KB, Ceran O, Kaya C, Nuhoglu C, Karaman MI. Nocturnal enuresis in Turkey: prevalence and accompanying factors in different socioeconomic environments. Urol Int 2008;80:362–6.
25. Özkan S, Durukan E, Iseri E, Gürocak S, Maral I, Bumin MA. Prevalence and risk factors of monosymptomatic nocturnal enuresis in Turkish children. Indian J Urol 2010;26:200–5.
26. Jirapinyo P, Densupsoontorn N, Kangwanpornsiri C, Pongdetudom K. No difference in prevalence of anal fissure among infants who are breast-fed, formula-fed and mixed-fed. J Trop Pediatr 2011;57:499– 500.
27. Garrison MM, Christakis DA. A systematic review of treatments for infant colic. Pediatrics 2000;106:184–90.