I have problem of piles, not bleeding, not came...

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What is the treatment of piles ?

1. Drink plenty of water daily 
2. Eat well balanced diet, and avoid eating fat as it may cause constipation
3. Lactulose syrup 3 times daily for constipation
4. Neo-heamorhan cream 3 times daily 
5. Trufen 400 three times daily
6. Surgical removal of the piles is the last but the only cure for it 

What are the clincal manifestions of piles ?

1. Pain on defecation
2. bleeding
3. sensation of a lump 
4. pruritus 

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