percy, being a lifelong pile expert (I had them way before I even thought about having children), I have found that Proctofoam is the only thing that works. Get your gp to prescribe it and don't accept any substitutes (most chemists have to order it in for you).
I have just had my butt prodded by a series of American doctors in the hope that the bad new that all the english doctors gave me ("You'll have to learn to live with them" "We can operate, but it doesn't really help" was wrong, but unfortunately the diagnosis was the same. Ugh. Men should have babies.