QuestionSBA
QuestionChoice
This man likely has an anal fissure due to the pain and presence of bright red blood when opening his bowels. Although there is a family history of bowel cancer, there are no red flags that would indicate the need for a colonoscopy or further investigation at the moment.
10027929
d
Refer non-urgently for a colonoscopy
QuestionChoice
This is a very acute history for Crohn's which makes it unlikely. It would be inappropriate to refer to gastroenterology as an anal fissure would likely have healed by the appointment with appropriate management from primary care.
10027927
b
Refer to gastroenterology for suspected Crohn's disease
QuestionChoice
This man likely has an anal fissure due to the pain and presence of bright red blood when opening his bowels. Although there is a family history of bowel cancer, there are no red flags that would indicate the need for a colonoscopy or further investigation at the moment.
10027928
c
Refer via 2-week wait pathway for suspected colorectal cancer
QuestionChoice
This man likely has an anal fissure due to the pain and presence of bright red blood when opening his bowels. Although there is a family history of bowel cancer, there are no red flags that would indicate the need for a colonoscopy or further investigation at the moment. Topical analgesics such as lidocaine are used alongside increased dietary fibre and fluid intake to soften the stools.
10027926
a
Advise use of topical analgesics
QuestionChoice
This man likely has an anal fissure due to the pain and presence of bright red blood when opening his bowels. There are some surgical management options for anal fissures, including sphincterotomy, but this is reserved for chronic anal fissures that have not responded to conservative management options.
10027930
e
Refer to general surgeons
Concept
Chapter
2693
6018
Anal Fissure
Topic
135
General surgery
17983
A 32-year-old man presents to his GP with bleeding per rectum. He states that it is very painful to pass stools and on wiping there is bright red blood on the tissue. This has been going on for a few days. He is very worried and would like a colonoscopy to rule out bowel cancer, which his father has recently been diagnosed with.

What is the most appropriate management?
a