Hemorrhoids and cycling. Any advice or tips?

sounds like you about nailed it with the summary. I'm going to phone this one in about the same as the "tell me what saddle to buy" threads and say... everyone's ass is different, gonna have to test some stuff out and figure out what works best for you. But, that being said, it sounds like you've got the right start.

Advice? I've got advice. But it's not necessarily good advice.

The burning, itching syndrome is still ridable. Thrombosis? Still ridable. However nothing worked. The swelling wouldn't go down. Things got uncomfortable enough I had the Dr cut it out. He then recommended 3 days off the bike. I took them. No problems.

Actual advice? Keep it clean. Hemorrhoids are basically varicose veins. Have you heard the phrase, "Don't pop a vein!". Careful how you stress the muscles down there. Squats or the other kind of squats.. Preparation H does help with the burning and itching. Did I mention cleanliness?

Get the stuff with glycerin (lube), phenylephrine (vasoconstrictor) and pramoxine (anesthetic). It's usually white. The tan and clear gel versions lack one or more of these ingredients. The version with witch hazel is less effective.

Phenylephrine is often sold as an OTC alternative to Sudafed (pseudo-ephedrine) as a sinus decongestant, but it's useless for that purpose. However it is effective for reducing swelling with hemorrhoids.

To prevent hemorrhoids most experts recommend minimizing time on the can. No reading material, phones, etc. Take care of business and get off the can, pronto. There's a humorously advertised device called the Squatty Potty designed to elevate the feet/legs to get a more natural position for evacuation too.

First, after bowel movements, cleanup is essential. A gentle glycerin based liquid soap like Klar & Danver helps. No additional water needed, just a dab on some toilet paper bunched into a something resembling a large cotton ball. It reduces friction and irritation too.

Rather than using the provided injector tube, which can further irritate swelling, bunch up some toilet paper to make a compression pad. Squirt a bit of the hemorrhoid cream on the pad. Press on the affected area and hold for 15-60 seconds. This gives the cream time to work and the compression reduces painful swelling.

After a ride, soak in a hot bath with Epsom salts. The Epsom salts draw out liquid and helps reduce the swelling. Helps the whole body. First thing you'll notice is the fingertips getting wrinkled, like they do after swimming in the ocean. About 15-30 minutes soaking in a hot tub of Epsom salt really helps.

Or, if you have the time and space, a sitz bath with Epsom salts and similar stuff can help after bowel movements.

No idea about saddles, mine are pretty ordinary -- whatever came with my used bikes. They're moderately padded and covered with Lycra fabric -- pretty comparable to snug fitting bike shorts with those gel foam pads. I'm thinking of trying a firmer saddle with pressure relief cutout to minimize perineum pressure but not because of hemorrhoids. FWIW, hemorrhoids bother me least on the bike. The saddle pressure actually provides some relief. It's later sitting in the desk chair that I notice some discomfort.

But I do avoid excessive padding. That seemed to irritate me more. I have a couple of padded liner shorts that came with my Pearl Izumi baggies. Way too much padding. It just soaked up sweat. So the only padded shorts I wear are Aerotech Pro, their lowest priced shorts with minimal padding (black/tan), not the thicker, denser 3D foam that's often covered in blue fabric, etc.

Hemorrhoids are a pain in the arse.

phenylephrine is sorta effective when applied to the posterior regions. The big scam is it replaced psudoepinephrine in OTC nasal decongestants where it does absolutely nothing.

BTW, in a pinch, you can saturate a wad of toilet paper with nasal decongestant spray (oxymetazoline or phenylephrine types are common, although there are others) and use it as a compress to relieve hemorrhoids.

So if you're out of conventional hemorrhoid ointments you can make your own. Any neutral soothing ointment -- zinc oxide, glycerin, etc. -- plus a topical decongestant (listed above), on a compress made from a wad of toilet paper. For best results use the topical decongestant first since the ointment would probably prevent the decongestant from acting effectively. Follow up with the ointment.

Pramoxine and other topical analgesics approved for use on sensitive tissues can also be found separately in many stores, so even if they're out of hemorrhoid ointments the basic ingredients are usually still available.

Probably work as well or better, and you might find the ingredients very cheaply at a dollar store.

Hemorrhoids are brought on from dehydration. Use your cycle computer to put yourself on a hydration schedule. (at least a bottle an hour). Drink plenty after rides too. Anymore, If I start to feel it coming on, I drink, and can feel it going away.