Fissures

TheWeeklyMnemonic is back with two mnemonics related to anal fissures. The first is the “classic fissure triad” for the findings on physical examination of patients with chronic anal fissures. The second is the “WASH” regimen for the treatment of anal fissures. (These memory aids have been obtained from this Medscape article):

Classic fissure triad:

1) Deep ulcer

2) Sentinel pile (may appear as a skin tag once resolved)

3) Enlarged anal papillae

“WASH” mnemonic for the treatment of fissures:

W= Warm water/sitz bath after each bowel movement

A = Analgesics

S = Stool softeners

H = High fiber diet

Approximately 50% of anal fissures will heal in 2-4 weeks with conservative management.

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