Hi. The treatment of the thrombosed piles is standard. The patient has to sleep in a head-down position in prone ( back is up) position. Continue sitz bath. Antibiotic and Anti-inflammatory medicines with pain-killer properties like Ibuprofen. The Surgeon can try to put in the thrombosed pile with the help of lubrication done with Xylocaine jelly. This relieves pain dramatically. Emergency Surgery to remove the piles mass is tried now-a-days , if there is no infection. Discuss this with your GP , get a reference for a General Surgeon.