Next stage / step?

Hello. For the last 10-15 years I've been dealing with internal hemorroids. Male 40 years.

It all started with bleeding during BM. With time it developed into stage 3 (prolapsed but still able to push back in).

I've been to the doctor a couple of times during the years for a banding operation, but it hasn't helped. The pain after these operations has been horrible, but luckily only lasting 24 hours or so. Banding has had zero help with the lumps.

Currently I need lube to push back in after BM. I'm using Aloe Vera gel which helps also for the slight pain/discomfort. Also I use the bidet shower instead of wiping with paper.

I'm worried next will be stage 4 (not able to push back in). These things don't seem to heal by themselves, rather only get worse with time?

I assume my only option is to go for surgery - or any other tips or tricks I could maybe still try? I eat healthy (fiber etc), workout, drink lots of water etc..

My issue is that I really can't skip work for weeks to recover and I'm unable to work from home.

My original plan was to wait for a few more years and then take a break from work and have the surgery, but as said I'm worried it will turn into stage 4 soon.

Any help/advice/comments greatly appreciated.

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