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April 26, 2024

A 67-year-old man with a history of chronic constipation presents to the clinic with pain after defecating for the past 2 weeks.

A 67-year-old man with a history of chronic constipation presents to the clinic with pain after defecating for the past 2 weeks. He explains to the clinician that the pain feels like he is passing broken glass, and there is some bright red blood in the toilet. He has had a colonoscopy within the last 6 months that was negative for any masses or polyps. A digital rectal exam reveals a small longitudinal tear in the anoderm. Which of the following is the most effective management of this patient’s condition? Obtain a stool culture Order a colonoscopy Prescribe a laxative Prescribe topical nitroglycerin 0.2% ointment

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