Pruritus in Surgery — 54yo Man | General Surgery | SMLE Q#1370
SMLE Question #1370
Surgery
General Surgery
Objective: OBJ-TRACH-EMERG-01
Last updated: February 2026
A 54-year-old man has 6 months of intermittent bright red blood per rectum with pruritus and rectal discomfort. Colonoscopy 1 month ago excluded colorectal neoplasia. He has tried adequate dietary fibre, bulk-forming agents, and stool softeners with limited relief. Digital rectal examination and anoscopy show prolapsing hemorrhoids requiring manual reduction, with a prominent external component. What is the most appropriate next step in management?
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