Thanks for posting your query.
Are you sure that you are suffering from piles or something else? In this area a patient may have anal fissure
and treatment of anal fissure is different from hemorrhoids.
Painful piles means thrombosed hemorrhoids and at times very difficult to treat.
There are multiple medicines are available for piles but clinically few patients are treated by these oral medications.
As you have already taken Proctosedyl
for > 45 days but still not getting any major relief so there is least chances of improvement.
You should also consult with surgeon for faster recovery.
Dr. Mayank Bhargava