Brief Answer:
follow the advises.. maintain a healthy lifestyle..

Detailed Answer:
Hello XXXXXXX welcome to HCM,
I've gone through your query and understand your concern,

Now, as you've rightly pointed out, symptoms of piles/hemorrhoids get aggravated due to chronic constipation, so it's good to know that motions are regularized now..

Please take a high fiber diet (replace your daily wheat/flour containing foods with equivalent of whole wheat/grain food products, include a lot of green leafy vegetables, drinking a lot water ~ 3 ltr per day, avoiding spicy/deep fried foods)..please continue to maintain them as they'll provide a lot of relief in long term..

Start taking Syp Lactulose 10-15 ml Once Daily at bedtime (you can titrate the dose as per your body's response and total bowel movements), it'll help you in maintaining the soft consistency of the motion which is extremely important to keep the piles under control..

Please do not strain during passing motion (as it's directly related to further progression of the piles, pain, trauma even bleeding during motion etc.), follow all these above mentioned advises along with a proper timing for motions, you'll see the benefit..

Since there's pain now, take SITZ bath in XXXXXXX warm water mixed with some regular salt twice to thrice daily for next 7 days, it'll help , I'm sharing a link of a demo video of Sitz bath, please go through it before so that you can take it properly - https://www.youtube.com/watch?v=YNzBcJWTLwc

Try not to sit down in a rough/hard surface for the time being, also avoid sitting down for a prolong duration..

If still the pain is not relieving, then you can take pain killers like Tab PARACETAMOL 650 mg two to three times a day after food for next 3-4 days..

Meanwhile, I'd advice you to schedule an appointment with a Proctologist / a GI-Surgeon for a detailed clinical examination of the area for further gradation and prognostication (this is extremely important as it's a progressive ailment, which needs follow-up examination by the Surgeon/proctologist from time to time to decide on the further course of management)..

Don't worry, just follow the advises, let me know if there's any further queries, I'll be glad to clarify..

Let me know how you stay in the due course..


Take Care
Kind Regards

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