Hello and welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.
I noted the history of having some piles problem, irritates a lot, medications one has to take, what lifestyle changes to be made, beer worsens. With the short history, one can say that you have been examined by a doctor with per-rectal digital examination, ano-proctoscopy so that a proper diagnosis can be made.
Once diagnosed I would advise you the following:
- Laxatives to keep the stool soft.
- Sitz bath in a tub with warm water.
- Antibiotic and
metronidazole if there is irritation at the anal area or around.
- High fiber diet.
If the pile are large go for surgery.
Hope I have answered your query. Let me know if I can assist you further.
Regards,
Dr. T Chandrakant