I'd definitely bring this up with your PD or see a doctor soon, just to be sure it's the piles coming back and not something else, since you've had it before. In the meantime, try to keep things soft down there by drinking lots of water and getting enough fibre, and be gentle when wiping - use wet wipes or even just splash with water instead of rough wiping. Most of the time managing piles is about preventing constipation so there's less strain, but since yours keeps coming back, the doctor can give you proper advice on whether you need any treatment or if there's something else going on.