A 34-year-old office worker presents with 3 months of intermittent rectal bleeding on the toilet paper and anal pain on defecation. He has no weight l...

Question

A 34-year-old office worker presents with 3 months of intermittent rectal bleeding on the toilet paper and anal pain on defecation. He has no weight loss or change in bowel habit. Examination reveals a tender anal fissure. What is the most appropriate initial management?

Accepted Answer

Increase dietary fibre and use topical Glyceryl trinitrate or Diltiazem

Answer

Urgent colonoscopy to rule out cancer

Answer

Immediate haemorrhoidectomy

Answer

Systemic antibiotics

Answer

Start high-dose oral steroids

uk-plab-1 MCQ (SBA): Anal fissure – initial management

A 34-year-old office worker presents with 3 months of intermittent rectal bleeding on the toilet paper and anal pain on defecation. He has no weight loss or change in bowel habit. Examination reveals a tender anal fissure. What is the most appropriate initial management?