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What is a Sentinel Pile and How Can You Treat It?


A sentinel pile is a tag of skin that develops on the edge of the anus, below the fissure. It feels like a small bump or skin sticking out of your anus. It is generally harmless but can be tender, causing pain and discomfort.

What is A Sentinel Pile?

As per research, one calls a sentinel pile, a sentinel anal skin tag or sometimes a rectal skin tag. It is an extra growth hanging off the skin around the anus, at the edge of the anus and perineum. According to research, an anal fissure is an oval-shaped or linear tear in the anal canal. A sentinel pile is an anal skin tag located below the fissure.

Sentinel tags can be single or multiple. This sentinel anal skin tag is not cancerous, but it can be a cause of concern as it can lead to -

  • Pain during or after bowel movements.
  • Bright red blood with stools
  • Itching and irritation around the anus
  • Discomfort

Sentinel Pile Causes

Anyone can get an anal skin tag, both male and females of all age groups. But they are more commonly found in association with other anal conditions like swelling around the anus or anal injury. It is more prevalent in obese people.

Causes of sentinel anal skin tags are:

  • Straining from constipation
  • Diarrhoea
  • Crohn's Disease
  • Anal Fissure persisting for over six weeks
  • Anal injury due to passage of large and hard stool
  • Skin left behind after haemorrhoid treatment
  • Blood clot
  • Friction or irritation from exercise

Also read: Homeopathic medicines for a piles fissure

Sentinel Pile Diagnosis

Your doctor may check the bump or bulge to rule out other causes such as a tumor for diagnosis.

Most patients believe the pain they are experiencing is due to haemorrhoids. The difference between a haemorrhoid and a skin tag is that haemorrhoid is caused by the collection of swollen blood vessels around the anus, and anal skin tags can come from a healed haemorrhoid.

A doctor can diagnose the sentinel skin tag based on the symptoms and a visual, physical examination. They may perform a digital rectal exam to ascertain unwanted growth in less visible areas. It can be done by -

Anoscopy

This procedure involves inserting a thin, flexible tube with a light and camera at the end of the anal canal. One can provide local anaesthesia to avoid discomfort to the patient.

Sigmoidoscopy

It follows a similar procedure as Anoscopy but involves examining the rectum and lower area of the colon. It is required for people above the age of 40.

Colonoscopy

It involves a similar procedure as in Sigmoidoscopy but needs an examination of the entire colon. It is essential to determine the underlying cause.

Your doctor may take tissue samples for biopsy to rule out other causes like tumours before treating the skin tags.

How to shrink a sentinel pile?

Generally, Sentinel Piles are harmless, but they can cause discomfort and pain. It makes the treatment of the underlying cause important.

You can also shrink the hemorrhoidal skin tag naturally. For this, you need:

  • Sitz bath, a small plastic tub that fits over a toilet seat
  • Witch Hazel to reduce itching and pain
  • Stool softeners
  • Soothing wipes
  • Wear clean, dry and, loose clothes  

Medical Treatments for Sentinel Pile

As per studies, there are several methods for skin tag removal. The doctor may remove one tag at a time to provide healing time and prevention of bacterial infection. Procedures include:

Cryotherapy

Your doctor may freeze off the sentinel pile by applying liquid nitrogen. It falls off within a few days.

Ligation

One commonly uses this for cutting off the blood supply to the skin tag.

Laser

Laser therapy is responsible for killing specific tissue gradually.  With time, the skin tag drops.

Surgery

One can remove tags by surgical incision. It may need an incision, and the wound will heal in a few days. Proper care will be required while passing the stools.

Sentinel Pile Prevention

To prevent the sentinel skin tags, remember these pointers mentioned below:

  • Consume plenty of fibres
  • Stay hydrated
  • Do not put off an urge to pass stool
  • Maintain good bowel health, keep the area clean and dry and use soft wipes
  • If you have conditions like Crohn's Disease, take proper treatment
  • Use laxatives
  • Maintain healthy weight

Sentinel skin tags are harmless and can cause pain and discomfort. Diagnosis is essential to rule out other causes, and only then should you undergo treatment. You can prevent Sentinel Piles by eating a healthy diet and maintaining healthy bowel habits.

Also read: Ayurvedic medicine for piles

References

Jennifer Berry (2018) How should anal skin tags be removed? (Medical News Today) https://www.medicalnewstoday.com/articles/321769

Jennifer Sam Beaty (2016) Anal Fissure (U.S. National Library of Medicine) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755763/

https://ranapileshospital.com/project/sentinel-pile/