<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 4-year-old boy is brought into your office by his parents who state that the boy has been noncompliant with his toilet training and passes stools every 4 days. They describe his stool as hard pellets. They deny any problems during pregnancy and state that he was born at a weight of 7 lbs and 10 oz. They state that he remained in the hospital for one day after his delivery. Since then, he has not had any problems and was exclusively breast fed for the first six months of his life. On physical exam, there is a shallow tear in the posterior verge of his anus. Which of the following is the best treatment?? A: Colonoscopy, B: Proctoscopy, C: Fiber supplementation, D: Laxatives and stool softeners, E: Sigmoidoscopy and biopsy,  <response>: This is a question about the appropriate treatment for a 4-year-old boy with constipation and anal fissure. Based on the information provided, the likely diagnosis is functional constipation. The history indicates normal birth and development, breastfeeding for 6 months, and hard, infrequent stools starting around toilet training. The physical exam finding of a posterior anal fissure is consistent with passing hard stools. Colonoscopy and sigmoidoscopy with biopsy would be too invasive for initial management. Proctoscopy could identify the anal fissure but would not guide treatment. The best initial treatment is increasing dietary fiber and using laxativesstool softeners to soften the stool, allow the fissure to heal, and establish regular bowel movements. D: Laxatives and stool softeners 