Q: My 6-year-old daughter passes stools on alternate days. She has been complaining of severe itching in the anal region for the past 2 months. The paediatrician suggested application of a local anaesthetic in her anal area. He also suggested to give her anti-worm syrup. But she complained about the same problem the next night. I applied local anaesthesia gel, but it didn't work, she kept screaming whenever the itch troubled her. The doctor suggested putting her in a tub of warm water but it gave her no relief. He finally suggested to give her 5ml of Atarax, which put her to sleep, but at 4 A.M. she started screaming again. We called the doctor again, who suggested to give her a kid enema. We inserted a glycriene stick in her anus and gave her a 5ml of Atarax again. She went off to sleep after some time. She didn't pass her stools. At around 6.30 she passed her stools, hard and covered with some whitish matter. She went off to sleep again. She finally got up at 11 A.M. and was normal. There was no itching. The paediatrician says that the intense itch could be due to pinworms or chronic constipation. What do you opine of her condition?

A:It is likely that the intense itching was due to mucous irritation of the anal canal and the perianal area. This occurs due to chronic constipation, dysentery, colitis, worm infestation or any other condition causing excessive mucous secretion. In your daughters case it is possible this was because of severe constipation. Relieving constipation would have cured the problem.