The following could be a cause:
-Straining in constipation
-Straining in urinary obstruction
-Persistent cough
-Prolapsing hemorrhoid or polyp
Direct injury to to anus may also be a factor and most affected children may be healthy with no obvious cause for the disease.
Therefore, there is a need to always present to a hospital on time though majority recover spontaneously without treatment. Most children respond to non-operative measures.

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