A 41-year-old woman presents due to rectal pain. The pain is brought on by bowel movements and is described as an intense tearing pain. She notes a small amount of blood on the toilet paper, but none in the stool itself. She has a bowel movement approximately every 2 to 3 days and notes that her stool is somewhat hard. On examination, a small crack is noted in the posterior midline. Hemoccult is negative. There are no masses noted on rectal examination.
What is the recommended initial treatment for the patient's condition?
A) Fiber supplementation and sitz baths
B) Oral miralax
C) Topical nitroglycerin ointment
D) Oral prednisone
E) Surgical intervention
