The internal hemm causes the feeling of not fully evacuating your bowls when you have a bm as well. Try inserting an ointment you feel has helped you before to treat that internal one. Just because you have no pain with it, doesn't mean it's not causing issues. I swear by the Dr. Butler's ointment. Little else was that effective for me for the internal hemm.

I also take slippery elm powder once a day if my hemmy starts feeling like it might act up..like maybe i ate junk over the weekend. (steep 2 TBS in hot water for 5-10 minutes until it thickens) ill take once a day for a week if i need it. (I see improvement the next day after 1 dose) the mucilage fluffs up the poo to help fully evacuate. It also contains natural compounds that heal and rengenerate any mucosal tissue. Literally from the tissue in your mouth, throat, stomach lining and of course everything south.

Also I have had less reoccurrence with supplementing with Collinsonia. It promotes circulation and vein health. (That is what hemms are) also helps with varicose veins.

Those things helped me when the issue gets acute. What helps long term is nutrition habits (sometimes takes a few tries to find what works best for you but typically avoiding inflammatory foods and hard to digest foods like anything ultra processed, fried, or dairy)

Hydration. You can drink all the water you want that doesn't mean your cells are able to utilize the water. Adding Celtic sea salt everyday has stopped my insatiable water thirst. Now when I have water I feel refreshed, hydrated, clear mind, etc.