Medication-induced constipation Quiz: Ace Your Exams
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A 37-year-old man presents to the primary care clinic due to constipation. For the past two months the patient has only been having bowel movements every 5-6 days. The patient’s stool is very firm and difficult to pass, and frequently causes anal pain after defecation. Sometimes there is a small amount of bright red blood on the toilet paper after the patient wipes. The patient’s appetite has been poor lately due to bloating and mild lower quadrant abdominal pain. Vital signs are unremarkable. On physical examination, the patient’s abdomen is slightly distended and mildly firm and tender to palpation in the lower quadrants. On the digital rectal exam, there is a firm stool in the rectal vault as well as a 1 cm mucosal tear at the posterior anus. Which of the following is the next best step in management?
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