A 24 year old female married complains of pain and bleeding from rectum since 6 to 7 month; on examination (local) fissures in rectum with bleeding and complains of chronic constipation from 2 yrs. As per pt. she has to take laxative alternate days; she used to drink lukewarm water daily lots of water consumption; has complaint of indigestion and regurgitation also.
What investigations are required and what could be diagnosis and tx? I gave her amoxyclav, ethamsylate, pantoprazole, Pepsin/amylase, diclofenac, laxative and shield ointment for local application for 5 days counseled her for lifestyle change and to include fibre rich food.
