Can definitely recommend wet wipes, make you feel so much more comfortable. I have had both internal and external piles usually when ovulaing and then miraculously disappear ing when bleed started. And I do drink water, and am not constipated, in fact usually the opposite at that time. Have been to Dr as anusol and other over counter preps didn't help, was given Protosedyl which really helped relieve the pain. Not sure how that effects open wounds though, it doesn't say on the leaflet.
Have to say though since being on Feostan and then oestrogen gel and utrogeston I haven't had them, touch wood...
Hope it improves for you soon
Rx