Scenario 2, Part 2 of 3

Office record of Dr. Piper from two years ago

"…not been in for some time… history intermittent rectal pain…moving bowels usually accompanied by small amount of bleeding…saw physician in Florida this winter…told her…had fissure. In fact…has had similar symptoms for many years…attributed to vigorous back exercises and riding a horse. …has abandoned these now…examination shows normal sphincter…no evidence of any significant hemorrhoids…had in posterior aspect…anal ring…left…superficial fissure quite definite. Stool guaiac was negative…really had no trouble since stopped riding…just wonders if it's just going to recur…discussed fact…to be totally complete…ought to do colonoscopy…but she feels she would like to avoid this if at all possible."

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