Q: Dear Sir, I am suffering from piles for more than 15 years now. In the beginning, I had only bleeding piles and no protruding ones. Then I had rubber band treatment for one of my internal bleeding haemorrhoids which gave relief for about 4 years. But now I have protruding piles along with the bleeding ones, though bleeding is only occasional when I have diarrhoea or upset stomach. A surgeon here told me to go for cold technique because he felt I have second degree piles. He said that he will freeze the affected haemorrhoid which would cure it. But then I read your article where you advised avoiding cold treatment. May I request you to advise the appropriate treatment for my condition, preferably permanent, because I am fed up with the pain and I cannot eat non-vegetarian food because that aggravates my suffering?

A:At present several good options both surgical and non-surgical are available for the management of piles so that they do no recur. It is best that you consult a general surgeon or a colo-rectal surgeon who would be able to discuss the advantages and disadvantages of different methods of treatment with you. Piles can certainly be cured on a permanent basis. However, it is necessary for you to be examined so that other causes of rectal bleeding are ruled out and the piles graded so that a proper choice can be made.