I have hemorrhoids not sure if internal or external prep h sups do work better than topical creams doing sitz baths not getting well any advice?

Hemorrhoids: This can take a very very long time , weeks or even months. Make sure your stools are soft. All that said , a warning , you can have more than one problem .You can have hemorrhoids and other problems at the same time that could cause bleeding at your age.

Hemorrhoids vs crack: There are several causes of pain in this region, often external hemorrhoids which are thrombosed (clotted) can cause significant pain. So is fissure (a crack in the crack), which usually causes intense pain during a bm. If intermittent, brief, shooting pain in rectum could be proctalgia fugax--a difficult to treat medical mystery. Internal ones can bleed, but no pain. So, consult doc. Good luck.