Well come to HCM Thank for asking to HCM I really appreciate your concern, few conditions are there that causes such symptoms that you have first is constipation, over consciousness for defecation, some functional factors are there like anxiety depression, it is the IBS too, over all these could causes the hemorrhoid, now firs is to get done the hemorrhoidectomy (Surgery for bleeding piles ), then change the diet, have more fiber containing diet, drink more water, you can try stool softening agent like Isabgol, third try to come out of the stress, do not exert the force for defecation it is no matter if you do not pass the stool, hope this information helps.