Doctors tend to work on the assumption that their actions have cured a problem unless they're told otherwise. So, if your problem hasn't got any better, you need to HASSLE your doctor!
However, given the existing diagnosis of piles (irrespective of whether it's actually correct or not), the first thing a doctor is likely to ask you is "Have you tried squirting some Anusol up there?". So, if you've not already tried that simple cure, that should probably be your first step.
Note: The foregoing is written partly from experience. I was having some anal bleeding which, as I've got incurable prostate cancer, I thought might indicate that the cancer had spread. When I mentioned it to my consultant though, he just sighed and said "Get yourself some Anusol!" It seems to be working for me. (I only need to use it occasionally now, as most of the time I'm free from bleeding).
At about six quid for a small tube, Anusol can seem expensive when you first buy it but, fortunately, it turns out that 'a little goes a long way' with the stuff.