Recently I saw a 7 year old girl in my office with his father. She was here because they had found blood in her stools. The kid seemed every embarrassed and admitted that months ago this happened as well. The father said that she always goes to the bathroom and takes a long time but her stools are always soft and there were no worries for constipation. The kid denied straining when pooing. On top of my list of things that could be wrong were hemorrhoids or an anal fissure so I told the kid that I would have to take a look and poke around a little. She was nervous but with the help of the parent, I examined her.
No signs of any external hemorrhoids and I could not feel anything internally. No signs of any fissures or blood as well. I explored any chance of sexual abuse but the parent and kid denied it. I pulled the father aside and asked if I can speak with her alone. He left us alone. I asked the kid more questions to explore for any sexual abuse and I felt very comfortable that nothing was happening on that front.
I asked the kid how does she wipe herself and she said that she itches a lot so she has to wipe herself differently than others.
That was an interesting answer! I cut out a piece of paper from the sheet that she was sitting on and gave it to her and ask her to show me. She rolled the paper into a ball and then said that she has to stuff it in her anus and move it to stop the itching. "Do you do this everyday?", she said yes. That was so cute and was probably the cause of her periodic bleeding.
I called the father back in and told him the good news. Kids can be so inventive.
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