I have struggled with severe hemorrhoids since the birth of my first child. they are extremely painful now during my 2nd pregnancy. best rx?

Depends: Many hemorrhoids can be treated by surgical excision. Although it sounds horrific, the area can easily be numbed and the hemorrhoid removed. Still other hemorrhoids can be banded and they will fall off. However, there is always the possibility of recurrence. Mainstays in treatment include stool softners, plenty of fiber, maintaining a good diet, and limiting time on the commode.

Fluids: In addition adequate fluids are critical keeping in mind anything with caffeine or alcohol dehydrates you and can lead to constipation, straining and hemorrhoidal flares.

Fiber!: Constipation is the enemy of hemorrhoids. Pregnancy exacerbates constipation quite a bit. Go to the drugstore, buy some fiber (many kinds available, metamucil makes powder and wafers), take daily. Do not sit on toilet longer than 10 minutes trying to have bm. Postpartum, consider seeing a surgeon. While hemorrhoid surgery not fun, this is not likely to get better over time.