hi @jkaplan3606, welcome to Mayo Clinic Connect. I agree with your suggestion that @sarahandy consult with a specialist.

Stools passing by internal or external hemorrhoids can cause pain and bleeding. Thus fiber and staying well hydrated will keep stools soft and easier to pass, reducing hemorrhoid flare-ups.

@bill54321 Epsom salts can soothe in a sitz bath, but I haven't found a reputable source that demonstrates the benefits of drinking Himalayan salt dissolved in water. Bill can you provide a link to a study or evidence regarding this home remedy?