I had a really bad case of internal and external hemorrhoids for 8 months. I was in agony every minute of every day. Went to a doctor, and what they prescribed didn't work. Got metamucil...the name brand because the off brand didn't work. Took 2 heaping tablespoons twice a day in a glass of water. The directions call for teaspoons, but I used tablespoons. Within 2 weeks they were gone. The high doses of fiber allowed me to heal. Had previously tried everything else...creams, ointments, anusol, hot baths, off brand fibers, etc. Just take the metamucil brand twice a day, morning and night and don't skip a dose until the hemorrhoids are gone. In the meantime, take frquent hot baths and soak and don't rub. Use vaseline instead of OTC preparation H. Prep H seemed to cause me great pain.