Yes piles are a pain in the ass, I've had them for 11and half years now, and now I'm premenopausal it's seems to get rid of them. This summer 3 months to get on top again and that included 3 weeks of bleeding. I have internal and external piles.
I don't use much medicine as it's not good for long term use. But when I do I use Proctosedyl suppositories for internal and Proctosedy cream for external piles.
I do a lot off self treatment that keeps the pain away. After 9 years I started doing a lot of internet researching and found lots of natural treatment.
The best one is a spritz bath. After poo sit in your bath tub with 5cm of water about half a cup of salt. For 15 minutes at a time up to three times a day.
In Australia the treatment for natural piles treatments are not really around so I started making my own. I use T.N.Dickinsons witch hazel, in America they make a pile treatment, but not here.
You will need a clean bottle, fill it up half way with witch hazel, the other half with cooled boiled water and a squeeze of aloe vera. Give it a good shake, applied to cotton wool ball and stick between your butt cheeks. This can also be done with a bottle of salty water.
A high fibre diet is great too, and how I survive.
DO NOT USE apple cider vinegar, I found this on the internet and stings like hell.
I hope this helps

Lyncola