I'm trying to decide of the friend developing down there is a sentinel pile or a hemorrhoid, and interested in what that might mean, or how to 'treat' it.
It's around where the fissure is I believe. It's getting bigger, and pink. It doesn't hurt when I touch it, and tends to be dry. It's growth has largely been over the course of the last week or more. It's very noticeable, but provides no discomfort to me really.
If it is a sentinel pile, would hydrocortisone cream help or hinder it? And would it be possible for a sitz 'shower' as I've been doing it, using an adjustable shower head to sitz the area with warm water, have made it worse or better?
And is it true that sentinel piles in the area make things worse because the scar tissue doesn't 'stretch' like anal tissue, meaning I would forever be at a greater risk for it reopening if BMs aren't just right?

From what I've read, a sentinel pile develops if the fissure becomes chronic. It's there to protect it and may or may not go away when the fissure heals. It does get smaller when the fissure is not as active, though, which I've noticed in my case. I know they sometimes remove them in surgery if they are causing a problem or are fairly large. Mine is internal and rather small, so it doesn't bother me that much.
I'm not that familiar with hemorrhoids, so I can't help there. Have you been to a CRS yet?

Hi,
I'd think of a regular pile in pretty much the same was as a sentinel skin tag - similar in nature and may well reduce in size once the area calms down.There's not a lot you can do with the little blighters! Some creams (anusol in UK) can really help in soothing it but if it's not giving you any discomfort, just leave it alone. I have something similar too, which is fairly large in size but doesn't bother me either. A CRS will leave them alone generally too if they are not hurting in anyway. They just look a bit unsightly!....I always clean with a medium force shower head (first warm water to clean and then lots of cold for relief) It seems to work for me OK. I have a couple of internal hemmies now since my bum issues started but they're easier to manage than anything else and if that's what it is, can be banded if desperate. :)

Luka wrote:I'm not that familiar with hemorrhoids, so I can't help there. Have you been to a CRS yet?

Unfortunately no. I went to a general practictioner for help, thinking it was either hemorrhoids or anal fissures, and found it to be fissures from there based on what unfolded.
And @Ever the Optimist - are cold sitz baths/showers good for this stuff too? I've always done warm and it provides relief, but if cold would be affective at reducing inflammation, that'd be useful to. For me, in addition to periodically doing warm ones throughout the day, I always have one after a BM to calm the muscle spasms... Or at this point, diminish their pain temporarily before having to flop around on the floor/couch/bed like a fish until I find a position that's marginally less painful while I wait them out.

I also have a sentinel pile that developed many years ago, very small, in the beginning, I also believe it to be a hem.
But to my surprise it did got the biggest ever when the fissure i have now became very active, no only big but swollen, pink and painful to the touch.
I asked my doctor if he would remove it if I decided to have surgery for the fissure, he said he would because is just skin.
So, my skin tag started to recede and became very small as my fissure started healing, but I developed a stomach flu caused by food Sunday and my fissure has become irritated again to the point that the tag is starting to get bigger again.
No a good sign when I was doing so well.