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A 37-year-old woman with a body mass index of 18 kg/m2 has been experiencing rectal pain for 6 months. She has no rectal bleeding, no family history of colon disease, and no chronic change in bowel habits. Findings of digital rectal examination, anoscopy, and flexible sigmoidoscopy are remarkable for grade 2 internal hemorrhoids and tenderness with manipulation of the coccyx. What is the best next step in management?

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