Brief Answer: Consult a surgeon for a simple surgical procedure Detailed Answer: Hi XXXXXXX Thanks for your query. The protruding piles are dilated veins, which protrude out of the anus due to pressure exerted during defecation. Relief of chronic constipation (if present) with daily intake of stool-bulking agents, such as, Isabgol husk 10gm twice a day, along with at least 2.5 liters of water/day will reduce the incidence of protruding piles. Pain and discomfort is due to bruised, infected piles. A 5-7 days' course of a suitable oral antibiotic will help. In addition, daily use of anti-hemorrhoidal rectal jelly will further reduce the pain. However, protruding piles cannot be cured without surgical procedures. Alternatively, there are two simple out-patient procedures which are as effective as surgery:- * Injection of a sclerosing agent into the piles, which will clot the blood inside and collapse them permanently, and * Insertion of rubber-band like device (procedure is called Banding), which will collapse the piles by cutting of the blood supply to the piles. Both procedures are very effective in treating piles. Consult a surgeon and apprise him of my opinion. I am certain that he will agree with me. He will examine you and- depending on the severity of piles- advise the best course of action, apart from prescribing suitable treatment as advised. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Take care, Col (Dr.) Rakesh Karanwal

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