I don't do DX. If I come across a pile-up I tune on by. Not because I have indoor antennas - many people have worked DXCC with indoor or restricted antennas and/or QRP. But because pile-ups just frustrate me and raise my blood pressure, and that's not what I need from a hobby.
Normally I don't come across pile-ups very often because they usually happen away from the QRP frequencies. But in the last few days while I've been trying out the HB-1A I have been listening around the two 30m QRP frequencies of 10.106MHz and 10.116MHz and the usually quiet frequency has suddenly been disturbed by a bunch of people sending their call over and over again. A pile-up, presumably.
I listened, to try to hear who they were calling, and suddenly someone started sending a stream of dits on the frequency for a minute or so. I was prepared to think that someone had pushed something against their paddle accidentally, but any doubts were removed when it happened again, and again.
In his most recent blog posting Ed, N4EMG writes about the same sort of thing, and questions whether a new operating technique has developed where people who fail to work the DX decide to destroy anyone else's chances of working it as well. From what I heard, I think it's quite likely.
I can understand the frustration when you spend half an hour calling some DX without success. Do you carry on and hope your moment will come, or give up and live with the feeling that you've wasted half an hour of your life for nothing? Which is why I steer clear of pileups.
If you can't crack pile-ups leave that activity for those with the patience, the power and the antennas. There are far more interesting and rewarding things you can do with a radio than ticking off countries on a list, anyway.