What Treatment for Rectal Ulcer in a Young Man?

Constipation-related straining may be the cause of the lesion. How would you proceed?

A 27-year-old man presents to the emergency room after experiencing several episodes of hematochezia. He has a history of constipation and occasionally uses a laxative to have a bowel movement. On colonoscopy, he is noted to have internal hemorrhoids and an ulcer along the anterior wall of the rectum.

Which of the following treatment options would you recommend?

A. Witch hazel
B. Biofeedback
C. Topical corticosteroids
D. Pramoxine hydrochloride
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