You should follow up with your doctor for both conditions, as they require proper evaluation and timely management. Piles are usually examined clinically, and FNAC (fine needle aspiration cytology) may be advised if your doctor wants to rule out any other cause or confirm a specific finding. At the same time, a positive VDRL test suggests a possible syphilis infection, but it should be confirmed with further tests like TPHA or other treponemal tests. If syphilis is confirmed, treatment with antibiotics, usually penicillin, is very effective and should not be delayed. It is important to complete the full course as prescribed. You should also inform your sexual partner so they can be tested and treated if needed to prevent reinfection. Continue regular follow-up, take medicines exactly as advised, and maintain good hygiene and a healthy diet to help manage symptoms.