### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Sir am suffering from external piles any home remedies please inform and wat care should I take and exercises if any please inform whether to use hot or cold water and does it effects my spine because am getting back pain when I stand for long time my age is 27 and ht 5.4 wt=80

### output:

**1. Piles are mainly due to cause and effect of Constipation, so make sure you are taking care of the same [take trifle churn at bedtime with Luke warm water]2. Endocrine disorders like under active thyroid, disturbed blood sugar can also lead to constipation with resulting piles [please check with the values]3.  Do not strain while passing stool, and use WARM water or wet toilet paper but without perfume or alcohol(without soap) to clean your anus after each motion. Avoid cold/tap/jet (western seat) water.4. Take: elephant yam, papaya, butter milk, pistachio, almonds, pear, apple, old rice, milk, crystallized sugar, raw radish and avoid tea, coffee,garlic, onion, fish, hot spices, sitting for long hours. Eat slowly, avoid haste-irregular eating and sweet/heavy food which are difficult to digest and cause indigestion. Take less of strong spices (ginger, garlic), oily-fried-fatty food and flatus producing foods (peas, beans,days). Fried cumin seeds 500 mg, fried safeties (thing) 125 mg, sheet parfait 500 mg, mix them and take with honey three times a day. 1 glass lukewarm water every morning and night. To stop bleeding [if there]: take coconut water from 1 coconut and add 2 tablespoon full (SF) sugar and Chat Doctor. . Trifle because of its high nutritional-detoxification [Showman] and cleansing value is very helpful in treating your present complaints. [take 3 gm with Luke warm water at bedtime]PS:. Again piles, is due to low digestive fire and taking AMLA & aloe vera juice will help in cleansing the liver to speed up the metabolism.  According to the Arthritis Foundation, either heat or cold may help with pain-it may be a matter of trial and error to find which works better for you. Back Pain could be due to being overweight [80Kg], thus seek an opinion of Spine Specialist for necessary Examination and also one has to focus on Weight Management Program.