Any patient who is more than 50 years old and with rectal bleeding symptoms should be screened with proper clinical and rectal examination. This should be followed by  colonoscopy to rule out sinister causes of rectal bleeding. The clinical exam and test will identify accurate diagnosis and then appropriate treatment can be advised.

Which surgery is best DEPENDS on stage type grade location etc factors about piles. Now there are many surgical options which have excellent results. Piles can be cured COMPLETELY but if constipation occurs recurrence can occur.