There’s a good chance the hemorrhoid(s) will clear up without any need for surgery. The Anusol should help calm them down. It does feel like the end of the world while they are inflamed, though! I think the most likely connection between your pouchitis and hemorrhoids would be more frequent bathroom trips with more straining. Reducing/eliminating straining is very important to enabling the hemorrhoids to heal. You may also get some relief from sitz baths.