Pile of Guts is a Resource in DayZ Standalone. It can be obtained by skinning and quartering an animal with a knife. It is possible to be dropped after skinning and quartering human players, too. Pile of Guts are edible, however eating them has a chance to make you Sick. Guts can also be used as Rope to craft Improvised Fishing Rod, or any other item that requires Rope to craft.
When a Pile of Guts is first cut out of an animal, it will appear with a red background in your inventory to show that it is hot. Because of this, Pile of Guts can be used much the same as a Heatpack to heat up your character while in your inventory. Actually, Pile of Guts arguably works better than a Heatpack due to the fact that Pile of Guts does not deteriorate, and that they can be re-heated at a Fireplace.