In a study of 700 children with anorectal complaints, anal stenosis, redundant rectal mucosa, fissures, fistula in ano, cryptitis, colitis, and polyps were diagnosed in all but 20%. In this 20%, two thirds of whom were seen for constipation, no organic cause for the complaint could be found. An anorectal examination should be a part of every physical examination of the newborn, infant, and child. Careful examination of the distal bowel is indicated in all instances of gastrointestinal complaints. All too often, many of these infants and children are treated for intestinal colic, milk allergy, and emotional problems when definite pathological abnormality amenable to correct treatment was present.
Arminski TC, McLean DW. Proctologic Problems in Children. JAMA. 1965;194(11):1195-1197. doi:10.1001/jama.1965.03090240029008