AOBPr Proctology Practice Questions - AOBPr Proctology Certifying Examination Exam

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A 45-year-old presents with severe anal pain during and after bowel movements and bright red blood on toilet paper for 4 weeks. Exam reveals a posterior midline anal fissure with a sentinel skin tag. First-line therapy is:

Lateral internal sphincterotomy Topical nitroglycerin or topical calcium channel blocker (nifedipine/diltiazem) plus sitz baths and fiber Excisional hemorrhoidectomy Botulinum toxin injection

Correct Answer:

Topical nitroglycerin or topical calcium channel blocker (nifedipine/diltiazem) plus sitz baths and fiber

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