AKT-2512

You are evaluating a 37-year-old man who presented with an anal fissure caused by constipation and straining. He reports no systemic symptoms and is generally in good health. Despite using lidocaine ointment as prescribed, he continues to experience severe rectal pain during bowel movements and passes bright red blood with every stool. His stools have become softer due to modifications in his diet and regular lactulose use. What is the next step in managing this patient’s condition?