Hello, Thank you for your query. I understand your concerns. You are right in thinking that the lumps could be haemorrhoids/piles. Haemorrhoids are lumps filled with blood vessels; normally they are present inside the anal canal, but due to straining when opening the bowels / (especially if a patient is constipated), these lumps bulge and pop out of the anus. Further, the skin covering these haemorrhoids is very delicate. Due to straining while passing stool, and if the stool is hard, the delicate skin of the haemorrhoids get cut and hence they bleed. Haemorrhoids when they become inflamed are swollen and painful. You could use Proctosedyl cream or Anusol cream over the haemorrhoids, apply the cream twice a day after opening your bowels for 1 week. In addition you could also use Proctosedyl suppositories (tablets which can be inserted inside your anus). These suppositories then work locally and reduce the inflammation from the inside of the anal canal. Use one suppository twice a day after opening your bowels for 1 week. You could also use painkillers like Ibuprofen 200-400 mg 2-3 times/day or naproxen 250-500 mg twice a day to relieve the pain. I hope you are not allergic to ibuprofen/naproxen. Do take these medicines with food, if taken on empty stomach they can cause gastritis. Sitting in a warm bath can help reduce the swelling, using an ice pack can reduce the inflammation too. Avoid constipation, eat plenty of vegetables and fruits and drink lots of water to avoid constipation. If fibre in your diet is less you can use Fybogel – one spoon mixed in a glass of water twice a day. By doing the above, you should start to see improvement in 2-3 days, and normally the inflammation will completely settle in a week’s time. Despite the above treatment if the haemorrhoids are still swollen and painful, or if the pain and bleeding worsens, then see your doctor sooner. I hope this answer has been helpful to you. Regards Dr Sunita Sayammagaru