First of all, let me tell you that the most important decision in choosing the treatment of piles is the quality of the doctor and that of the treatment offered. So, it is very important to choose a doctor who knows what he is doing. Ayurveda has the treatment for the problem which does not require a person to go through surgery. Usually in the first & 2nd stage, Piles ayurveda specialist applies some kshar along with I.R.C/Sclero therapy on the pile mass that cause shrinking of the mass. In the late 3rd & 4th stage the pile mass is ligated by ksharsutra that leads to shedding off the pile mass in five to seven days, but the treatment through Ayurveda requires a person to be disciplined and sticking to the plan of action and precautions advised by the Ayurveda professional. Again, it depends entirely on you which path to choose but just make sure that you check the track record of the doctor. *(There is no guarantee of specific results and the results can vary)