Yes you read the headline correct piles can be managed without medication or surgery depending on which stage it is. Often piles that are small or are at its initial stages can be managed with some lifestyle and diet modifications without medical interference. Usually chronic constipation is thought to be an underlying cause that triggers piles and in women it may develop during pregnancy due to pregnancy-induced constipation. Every person who develops piles doesn t need medication or surgery to rectify it. Sometimes some lifestyle and diet changes can help to get relief and correct the problem on its own.