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Piles otherwise called haemorrhoids,is a very common problem among adult population. Piles normally present as painless bleeding per rectum especially after passing motion. Anyone with passage of blood per rectum should see a surgical specialist. This is not to miss a cancer lurking in the rectum or colon. Severe degree of piles protrude from the rectum and sometimes need to be manually pushed back. Protruding pile masses will require surgical treatment. Smaller piles may get cured with injection sclerotherapy or piles banding. Piles surgery can be performed by stapler technique, harmonic scalpel, Doppler guided hemorrhoidal artery ligation etc..and all these procedures are essentially day care operations.