Hi, Thanks for your question on Health care magic I do understand your concern As per your history is concerned you have pain and bleeding which transpired after your delivery so in my opinion it can not be ruled out from piles at all .so tell your doctor to exam it in proctoscope or sigmoidoscope for any internal piles.if found go for surgical treatments.you can do few things which may avail- 1)you can take 25 gms of fiber every day and for it take OTC fiber supplements and drink 8 glasses of water .continue with lactulose and anovate cream as conventional and apply an frozen ice wrapped in a cloth directly on the affected area for about 10 minutes. Do this an abundance of times a day until the hemorrhoid peregrinates away. 2)Try to avoid straining and holding breath when endeavoring to pass a stool engenders more preponderant pressure in the veins in the lower rectum . 3)Go to toilet as anon as you feel it 4)Do customary exercise daily which will ameliorate blood circulation to the area.You can sit in warm water tub 3 times a day. 5)Endeavor to evade long periods of sitting on toilet and use [xylocain 5%]ointments before going to toilet for pain . 6)For treating external hemorrhoids, apply remotely of aloe vera gel to your anus and slowly massage the area. This simple remedy will give assuagement from the pain and soothe the burning sensation.For internal hemorrhoids, cut aloe vera leaves in divests. Ascertain to cut off the thorn-like components of the plant. Place the slices in a container and freeze them. Apply the gelid cold aloe vera divest to the painful hemorrhoid to palliate the pain, burning, and itching sensation. hope that helps