Hi thanks for contacting HCM...
You have pain while defecation with sometime
blood in stool....
You have consult surgeon for proctoscopic examination...
It will reveal piles mostly...
It will also help in rule out Fissure , rectal ulcer or
proctitis like inflammatory condition...
According to cause treatment guided.
In general for treatment avoid straining at stool....
Stool softener taken...
Anal area sitz bath by hot water can be taken...
Try to avoid
constipation by more water and fruits more.
If pain and inflammation more ibuprofen can be taken...
If no improvement then surgical management needed....
Hope your concern solved....
Take care...
Dr.Parth