Hello, Welcome to HCM, Proper treatment of piles requires thorough assessment by Surgeon. It s unusual to have pain in case of piles be it external or internal. Presence of pain indicates thrombosed pile ( Piles are dilated blood vessel, clotting of blood is thrombosed pile) or also possibility of fissure in anus is to be considered. Proper management will therefore require thorough clinical examination to know the character of pile and other associated complication. I would suggest you the following which will definitely help 1. Increase water consumption-Consume at least 2 to 3 liter of water per day. 2. High fiber diet- Two serving of vegetable salad everyday 3. Hot Seitz bath- Add a handful of common table salt to a tub of lukewarm water. Immerse your bottom by sitting in it for 15 to 20 minutes each session twice a day. It will decrease pain and inflammatory oedema. 4. Stool softener- Syrup Lactulose 10 ml twice a day will keep the stools soft preventing constipation and decreases bleeding and pain. Further management will depend on clinical assessment by your Surgeon Thank you.