Hi. Thanks for your query. Noted the history about your daughter having tight motion, scare to pass motion due to pain, skin has become white around anus, Duphalac not working properly. The causes are: Due to hard stool there is a small fissure that develop and with progressive time the pain from such fissure causes pain and further causes inability to pass motion. Infection and edema caused the white skin. I would advise you the following: Consult a Surgeon or a Pediatric Surgeon for clinical evaluation. Antibiotic and metronidazole. Painkiller with anti-inflammatory properties. Sitz bath. Changes in foods, avoid constipation causing foods. May need an enema under supervision. Glycerin suppository. Laxatives as per age and suitability. All these things help to remove the causative factors and help heaming the fissure.