Hi - I just came across your post. I am 23 yrs old, and tomorrow I'm having a hemorrhoid surgery to remove both internal and external hemorrhoids. I was in a very similar situation to yours. I have always been very athletic and active, and generally consider myself to be very heathly and eat healthy.
I noticed hemorrhoids about a year ago, and ever since they just kept on getting worse. It got to the point to where I was seeing blood in the toilet, on the toilet paper, and I had a significant amount of discomfort and itching. I finally decided to do something about it, but with my insurance, I had to see my general physician, then he referred me to a specialist, I got a colonoscopy done (which turned out normal, thank god) and then he referred me to a colorectal surgeon.
And now here I am, scared to death that I am only 23 yrs old and going in tomorrow for, what I've heard, is a surgery worse than childbirth. It is something that needs to be done, though, and I keep telling myself they would've never went away if I sat around and did nothing about them.
Don't worry - I wouldn't panic just yet. You might have several options to consider, one being just changing your diet and consuming a lot more fiber to keep your bowel movements soft and regular. If you have tried every over-the-counter remedy and nothing has helped, I would at least consider going to your doctor to check things out. It sucks having to jump through so many hoops, but the longer you wait, the worse it could get. There's no point in holding off on it if you can make a few adjustments and not have to find yourself in the situation I am in now.
Lucky for me I have a very high pain tolerance (two drs have told me so) so this shouldn't be as bad as some of these posts. And we're young so I'd like to think we heal faster
Feel free to let me know how things go, and just remember that although you are young, this is actually a pretty common problem.