Q. A 45-year-old woman presents to the gastroenterology clinic complaining of painless, bright red blood on toilet paper after bowel movements for the past few weeks. She also reports a sensation of incomplete evacuation and an irritating lump near her anal sphincter that becomes more bothersome during bowel movements. Her diet is poor in fiber, and she has a sedentary office job. She has no significant past medical history. Her physical examination reveals swelling and bluish discoloration around the anus. A digital rectal exam shows tender, swollen veins that seem to prolapse but reduce spontaneously. Her complete blood count shows mild anemia with a hemoglobin level of 11.2 g/dL, while other lab values are within normal ranges. What would be the most appropriate next step in management?