A 35-year-old man presents with bright red rectal bleeding on the toilet paper and streaks on the stool. Examination shows a small posterior anal fiss...

Question

A 35-year-old man presents with bright red rectal bleeding on the toilet paper and streaks on the stool. Examination shows a small posterior anal fissure; digital rectal exam is otherwise normal and he has no anaemia or weight loss. What is the most appropriate initial management?

Accepted Answer

High-fibre diet, stool softeners and topical nitrates or calcium channel blocker ointment

Answer

Immediate colonoscopy

Answer

Empiric antibiotic therapy

Answer

Haemorrhoid banding

Answer

Total parenteral nutrition

ca-mccqe1 MCQ (SBA): Anal fissure

A 35-year-old man presents with bright red rectal bleeding on the toilet paper and streaks on the stool. Examination shows a small posterior anal fissure; digital rectal exam is otherwise normal and he has no anaemia or weight loss. What is the most appropriate initial management?