Pain and depression are taking over my life.

You should be having a high fibre diet and drinking plenty of water.

You should not be forcing your BM. If you are use fybogel.

If this is the third time go back to your doctor and get something prescribed by them.

First off, I am so very sorry you are experiencing this as it's not fun at all. I have issues with my bowels sometimes in that I go too often and urgently or have constipation. Irritable bowel issues with both C and D. I have been on a regimen of 3-5 tsp of metamucil a day (I have 3 with my first meal and 2 with my last meal) and drink 12 or more glasses of water a day. You have to so you don't end up constipated because metamucil can do that if you don't drink enough water. I am also on laxaday but only take 1/2 tsp with my first meal. 

The other thing I do is take 2 heaping teaspoons of ground golden flax (I grind it myself and finds that is really important to get it to work properly) and either stir warm water into it in a glass till it creates a kind of slimy mucilage, or, add it to my cereal with warm water and do the same - create a warm, slimy consistency. THIS helps my bms come out without any force needed whatsoever. I have had the most success with this and it actually, over about 8 months caused my 3 internal hemmoroids to shrink in size so much so that the surgeon only had to take two out and not three and what he had to take out was much less. I wonder, if I had just been more patient, if I could have cured myself of them. It might have taken a year and a half to two years though and it's just speculation, but I did have very good results with doing the above mentioned protocol.

Now, having said this, if you are having motility issues, in that your intestines just aren't working properly and not getting the faeces moving, then that's a whole other issue. Have you been to a gastroenterologist to check your motility issues, if you have any? Do you have irritable bowel disease? Diet is a huge factor in controlling it. 

Start with drinking 12 glasses of water a day and add in the metamucil (slowly, start with just one tsp in the first meal and one tsp in the last. Do that for a week then add another teaspoon in the morning and keep on in the evening, again, do for one week, add a second tsp in the evening meal for the third week, and then you can ramp up to 3 in the first meal and 2 tsp in the last). It should take 5 weeks to ramp up to the full dosage. DO NOT DO THIS if you are not willing or able to drink 12+ glasses of water a day!!! You will only become constipated. Becky, if you don't increase the water, you won't get a softer bowel movement and therefor you won't get better. 

Lots of good advice - I would add smoothies to your diet. Leafy greens, carrots, cucumbers, apples, etc, all with skin on that'll add a boat load of nutrients AND fibre that'll help you go. 

Also I was allergic to all piles creams but found that coconut oil to moisturise the area and push them back in helped. Lots of porridge and chia pudding to eat which are soft and full of fibre. A warm sitz bath every time you go to the loo. And take it easy if at all first. I had a particularly bad bout in November and remember feeling like I would never recover, it took

3 weeks but with using the toilet stool every day they have not returned. Good luck xxx 

All I can tell you is plenty of water, get a squatty potty(but like HellyM said a pile of books will do, any thing that puts you in a squatting position to poo). HemoTreat, it comes in suppositories and cream(get both). Sitz baths with Epsom Salt(as many times a day as you can). You don't have to sit in a tub of water, you can get sitz baths that fit over your toilet(lid up) and sit you aching butt in that. All of these things are available on Amazon. I wish they could somehow come up with a portable squatty potty to use anywhere. 

?We're just here giving suggestions hoping that something will work for you. What works for one person may not work for you it's definitely trial and error and after three surgeries, I wouldn't want them digging around in my butt anymore either!