Andrew...If this ice/snow clears out, we have travel plans for this weekend. However, this may be postponed due to start of new pain med (patch) and gel injections in both knees earlier this week.
And...Since one never knows when one may disappear without warning, I will post my information for you (and anyone else this may help).
I suffer with IBC (heavy on the C). I have a surgically altered gastrointestinal tract, which includes a colon flex (like a kinked garden hose) which delays movement of fecal matter. I think you mentioned that you drink tremendous amount of water and eat healthy with fiber. Me too=) For me, it doesn't resolve the issue. Even though I use a nightly regimen of Senokot, Perdiem, Dulcolax, Miralax, along with legions of prunes and apricots...NOTHING. My tummy distends especially on the left where the flex is located, painfully to the point of unrecognizable. I've found myself @ 11 days with no BM (not recommended). By that point I was compelled to seek out the hospital issue enema contraption. TMI but I spent hours in the bathroom floor with multiple applications of warm water. Finally, results (not relief) came. Sadly, I no longer have to introduce my rectum to "say hello to my little friend" the enema hose. Let's just say that neither enjoys the brutal encounter.
Internal vs. External: I had an internal hemorrhoid which caused a huge blood clot. My doctor cauterized it (not fun) but I had hurt so badly that the "burning" came as a sense of relief. Within 2 years, my colonoscopy revealed what they thought was a polyp. It was not, but rather a prolapsed hemorrhoid. I had surgery that afternoon at the adjacent hospital. I thought he would "fix" them all, but NO-o-o-o. He had not touched the external hemorrhoids or tags. He said he feared disturbing that nerve center. WHAT? I wanted you to make it feel and LOOK better. Nope...It looks like the sign of Spring year round...A little pink "flower" with puffy petals. Yes, it still hurts.
Two years later, I was in tremendous pain again. My procto said that he could snip the tags, but wanted the fissure to heal on it's own with meds. I had him perform surgery the second time. I spent many long nights walking the floors with "Mr. Fissure"...a difficult guest. I, like you, performed all of the "remedies" to obtain any morsel of relief.
Both surgeries were horrifically painful, because I remained constipated regardless of "remedies". The first 2 nights, my rectum hurt/burned so badly, I discovered a new use for the elongated ice cubes. AH-h-h-h=) I joked that I was going to create "assicles" for cool relief. I'm sure there's no app for that=)
Surgery, as always, is a personal decision. I make it my mantra to educate myself before a procedure and advocate for myself. Despite the surgical procedures, the IBC will be lifelong for me. I have to be vigilant to keep the bowel soft and moving. There's a wonderful new med that my GI gave me samples of. It's Linzess by prescription (but is expensive). It's the most comfortable method I've used. You just swallow with a full glass of water. Of course you continue to drink much water throughout the day and eat your fruits and veggies.
I never allow myself to be without the Lidocain ointment, HC (prescription strength) suppositories and finger condoms for inside application. The Hydrocortisone suppositories should shrink the swelling of your internal hems. Just be faithful with insertion. I personally avoid use of the Nitro cream, though it was quite necessary immediately following surgery. If you can tolerate anti-inflammatories, they will also be helpful.
I have no poems to add. But there is this thought...Did you know that Penguins as a species practice a burial vigil for their fallen? Yes, they do. Sadly, they gather 'round their deceased on the snowy tundra. They "speak" a few words for the family. They say their final good-byes and hold hands while kicking him in the ice hole. 
Take care~~Dixie