Anusol HC is better than most, BUT I was told not to use it during pregnancy cos it contains hydrocortisone, so check this with your GP.
ktwiltshire, I could have written your post!! 5 yrs since having my son, and I still suffer a lot. Yet my GP has never, ever suggested surgery, so as you say, it takes an awful lot for that to be the only option. I just get a regular Anusol HC prescription (not now, tho, am just drinking lots of water and drinking smoothies...)
I am not a great lover of fruit/veg, but when I make a proper effort to eat 4 or 5 a day, it DOES make a big difference (I should learn, shouldnt I?!)
Buy a bag of fibre powder from health food shops, and add it to all the foods that you can (eg bolognese, stew, chilli, anything with a sauce) - just a spoonful a day can make all the difference. Make sure you drink plenty plain old water to stop yourself getting clogged up!
You can take Fibogel drinks in pregnancy too - available at all chemists. Theyre a big help, plus youre gulping down a glass of water at the same time. If you get constipated, Lactulose is another option in pg.
If they get sore, a warm bath really can make the world of difference, or some ice wrapped in paper towel.
I remember when I was 8 months pg, there was a full weekend that I could barely move cos I was in agony. I stayed in bed all weekend, crying. Lovely.
Hope any of these tips help.