In this article:
Imagine having these little extra bits of skin around the edge of your anus. They’re called sentinel piles, but don’t worry, they’re usually harmless and nothing to be alarmed about.
These sentinel piles often show up alongside other uncomfortable issues such as anal fissures (which are like tears in the skin around the anus), hemorrhoids (swollen blood vessels), or inflammatory bowel disease (when your gut gets all inflamed).
Sentinel piles develop when chronic anal fissures cause a tear in the skin around the anal region. When this tear keeps happening and healing over time, the edges of the anus can look a bit raised or lifted, leading to sentinel piles.
These sentinel piles are also called sentinel anal skin tags or rectal skin tags. Basically, they’re just lumps of extra skin that have grown bigger.
Note: Did you know that the word “piles” actually comes from Latin and means “a ball”?
Home Remedies for Sentinel Piles
The following natural remedies can help relieve sentinel piles discomfort.
1. Do a sitz bath
Sitz baths have been a part of the treatment regimen for anal fissures and associated issues such as sentinel piles for a long time now. This is because of their various benefits, which include better hygiene, reduced pain levels, and a drop in the hypertonicity of the anal canal.
A study was done to evaluate the use of warm water baths or sitz baths in patients with fissures, symptomatic hemorrhoids, and proctalgia fugax. The researchers of the study concluded that a warm sitz bath can be helpful in managing anal fissures and other such problems. (5)
Another trial revealed that warm sitz baths for 15 minutes twice every day along with good fiber intake after every bowel movement showed promising and quicker symptomatic relief with better healing only after 3 weeks. (5)
How to perform a sitz bath:
- Clean your tub and scrub off any dirt.
- Fill the tub with 3–4 inches of water.
- Check the temperature of the water to see if it is warm enough (do not exceed 120°F).
- Add any salt suggested by your healthcare professional to the water.
- Get inside the tub and make sure you immerse your perineum in the water.
- Stay for around 15 minutes.
- Pat yourself dry with a clean cloth.
- Do this daily.
2. Eat more fiber
Fiber is very important for healthy bowel movement as hard stools can exacerbate anal fissures and cause sentinel piles.
One study found that consuming 5 g of unprocessed bran fiber thrice a day for 1 year lowered the recurrence rate of anal fissures. So, make sure your diet has a good amount of fiber.
- Potatoes with peel
- Whole grains
3. Take ispaghula or psyllium husk powder
Your rectum and anal canal are like a busy highway for your poop. It’s important for the poop to be soft and formed so it can smoothly make its way out without causing any trouble.
However, if you’re dealing with constipation, it can feel like a traffic jam down there. That’s where psyllium comes to the rescue!
Psyllium adds bulk to your poop, making it soft. It is a type of fiber that you can find in things like ispaghula. When you consume psyllium, it helps increase the size and weight of your poop, making it easy to pass.
How to take psyllium husk powder:
- Go over the packaging of your psyllium husk powder to examine the suggested dose or follow the advice of your doctor.
- Mix the recommended dose of psyllium husk powder in 8 ounces of water.
- Stir for around 10 seconds.
- Drink instantly after stirring without allowing the powder to settle down.
- Take this remedy every day.
4. Incorporate Triphalaguggulu into your everyday life
According to Ayurveda, sentinel piles happen because of an imbalance in the body’s doshas (the body’s unique energy). So, the first step is to rebalance those doshas through diet and special herbal treatments.
One of these magical herbal remedies is called Apamarga Kshara. It has this power that helps stop bleeding and reduces inflammation.
Another ancient Ayurvedic formulation called Triphalaguggulu has some serious healing powers. It’s made from Emblica officinalis (amla) and Terminalia chebula (hareetaki).
Note: Triphalaguggulu is available in tablet or capsule form. A typical recommended dosage is around 1-2 tablets or capsules, taken two times a day after meals, with a glass of warm water.
5. Drink sufficient amounts of water
Constipation is characterized by a sluggish gastrointestinal transit due to small, hard stools that cause problems in defecation. Inadequate fluid intake is an expected reason for constipation, and boosting fluid intake is a frequently indicated treatment.
6. Apply aloe vera gel on the affected area
You may have heard of aloe vera as a magical plant that can soothe the skin after a sunburn, but did you know it can also help heal wounds and reduce inflammation?
In a clinical trial, patients with anal fissures who used the aloe vera cream reported less pain, less bleeding, and faster wound healing. This may point toward the potential use of aloe vera for sentinel piles. (12)
Experts have not reported any side effects with using aloe vera on the anal region.
7. Perform anal-self massage
As talked about above, sentinel tags are commonly associated with anal fissures. An easy option to treat this condition is anal self-massage.
This can be done by two methods. The first method involves giving yourself a little anal massage using your finger. The second one involves using something called anal dilators, which are little tools that help gently stretch the anal muscles. (13)
In a study, 80% of the patients who did the self-massage with their finger saw their anal fissures disappear, while 60% of those who used anal dilators had the same result.
So, the conclusion is that using your finger for anal self-massage can be a possible way to deal with issues related to anal fissures including sentinel piles. (13)
8. Start doing pelvic floor exercises
Pelvic floor physical therapy can help manage anorectal issues. It’s like a workout for your pelvic floor muscles.
Studies have found that this therapy produced significant results. The muscle tone of the pelvic floor improved, and the pain ratings went down.
This therapy was also found to improve dyssynergia, in the your muscles aren’t working together as they should. Overall, people who tried this therapy had fewer complaints and better quality of life. (14)
How to do pelvic floor exercises:
- Take a deep breath and relax your body.
- Identify the muscles of your pelvic floor. These are the muscles you use to stop the flow of urine or prevent passing gas.
- Squeeze and lift these muscles.
- Hold the squeeze for about 5 seconds or as long as you can comfortably manage.
- Relax the muscles and rest for a few seconds.
- Repeat the squeeze and lift for a total of 10 repetitions.
Note: Don’t strain yourself more than your comfort level and avoid overexertion.
9. Apply ointments twice a day
Nitric oxide is like a messenger in your body. It helps relax the inner anal sphincter, which improves blood flow to the area and promotes healing.
In a study of nonsurgical therapies for anal fissures, glyceryl trinitrate was established to be significantly better than placebo in treating anal fissures. The normally used dose is 0.2% applied topically 2–3 times every day.
However, the major issue with using topical glyceryl trinitrate is low patient compliance due to side effects such as headaches. (5)
But don’t worry, there’s more to the remedy! To avoid the pain of passing stools when you have acute fissures and those pesky sentinel piles, you can use a local anesthetic cream or gel, which is a numbing agent that can give you some relief.
These creams usually contain opiates, lidocaine, amethocaine, or cinchocaine. You just need a small amount of the cream, and you apply it directly to the affected area with your finger. (9)
How to Prevent Sentinel Piles?
Here are some tips for preventing sentinel piles:
- Some painkillers contain an ingredient called codeine, which can make you constipated! So, it’s best to avoid them if you want to keep your bottom happy and avoid sentinel piles.
- Be gentle when you’re wiping after using the toilet.
- When nature calls, listen to it! If you feel the urge to go to the toilet, don’t hold it in.
- Do not take ibuprofen without talking to a doctor first.
Risk Factors for Sentinel Piles
Researchers have found various predisposing factors that contribute to anal fissures that are associated with sentinel piles. These include: (9)
- Passage of hard stool
- Irregularity in diet
- Consumption of spicy and pungent foods
- Faulty bowel habits
- Lack of local hygiene
- Pregnancy and childbirth
When to See a Doctor
Don’t let the shame or fear of humiliation prevent you from obtaining essential medical assistance. A physician can assist you with self-help steps to manage your condition.
According to the American Society of Colon and Rectal Surgeons (ASCRS), sentinel piles usually heal on their own and do not require treatment. However, if they are too large or interfere with movement, surgical removal may be recommended.
Most-Asked Questions About Sentinel Piles
If I have an anal fissure, will I have sentinel piles?
Although sentinel piles are understood to be one of the indications of the chronicity of anal fissures, they are not present in 100% of the cases.
Why do sentinel piles form?
The exact reason for the formation of sentinel piles is not known.
How are sentinel piles diagnosed?
It’s pretty easy to tell if you have sentinel piles just by looking at them. They’re like these small, flappy bits of skin around your anal area. But, if you want to be extra sure, the doctor might take a closer look using a special tool called anoscopy or flexible sigmoidoscopy.
Is there a difference between hemorrhoids and sentinel piles?
Yes, unlike hemorrhoids, sentinel piles are typically painless.
Sentinel piles can be extremely painful to deal with. They are a common problem associated with anal fissures. You can develop them because of constipation and other reasons.
Sentinel piles can make life tough, but bringing in some lifestyle changes and following the advice of healthcare professionals can bring relief to your symptoms. Drinking plenty of water and eating a high-fiber diet can be helpful.