Does an Epsom salt bath help hemorrhoids?
Do warm sitz baths, with or without Epsom salt, reduce pain, bleeding or other symptoms in adults with hemorrhoidal disease?
Compiled 2026-10-04 · checked 2026-10-04 · next 2026-11-04 · automated review, how it works
What the evidence says
Bottom line
No study has tested whether an Epsom salt bath helps hemorrhoids.
Every trial we found studied warm water sitz baths in people recovering from hemorrhoid surgery, not people managing hemorrhoids at home. The one trial that compared having a sitz bath against not having one found no difference in pain or painkiller use. None of them used Epsom salt.
How certain
Very low
The 5 human studies found measure a related question rather than this one, so they can only be read indirectly.
What it shows
Not studied
No study has measured this outcome in people with this condition.
- studies found
- 5studies found
- randomised trials
- 5randomised trials
- people studied
- 501people studied
- years covered
- 2008–2025years covered
What the research shows
Not studied
Bleeding
No trial measured bleeding.
Not studied
Itching and irritation
Measured once, after surgery, with no difference found.[1]
Not studied
Pain after hemorrhoid surgery
The only trial comparing a sitz bath with no sitz bath found no difference.[1]
No improvement shown
Whether Epsom salt adds anything
No trial used Epsom salt. Every trial used plain warm water.
Not studied
What it may help with
Important limitations
- Every trial enrolled people recovering from hemorrhoid surgery. None enrolled people with hemorrhoids who had not had an operation — which is who is usually asking.[1,2,3,4,5]
- Most trials compared a sitz bath with another active treatment such as a bidet, a water spray or an ice pack, so they cannot show whether either option helps.[1,2,3]
- Only one trial, in fifty patients, compared having a sitz bath with not having one at all.[1]
- No trial added Epsom salt to the water, so nothing is known about whether the salt itself does anything.[1,2]
What the studies found
- Found no clear effect2 · 40%
- Mixed or unclear3 · 60%
What kind of studies
- Randomised trial5 · 100%
The studies that decided it
Dis Colon Rectum 2025
Ice Packing Versus Warm Sitz Baths for Post-hemorrhoidectomy Pain Management: A Randomized Controlled Trial
Found no benefitRandomised trialModerate qualityRelated question
166 people2025
Ice packing beat the sitz bath on pain within 16 hours, swelling at 24 hours, wound healing at 7 days and morphine use.
- Who was studied
- Adults undergoing Ferguson hemorrhoidectomy
- What they received
- Warm sitz bath
- Compared with
- Ice packing
- Main outcome
- Postoperative pain and swelling
- Quality
- Randomised and adequately sized, but single-centre with short follow-up and no validated hemorrhoid-specific wound measure, as the authors note.
- Limitations
- Single centre; short follow-up; ASA III patients excluded.
Taken word for word from the abstract
- n
A total of 166 patients undergoing Ferguson hemorrhoidectomy were included
- intervention
warm sitz bath (n = 84) for initial postoperative care
- comparator
randomly assigned to receive either ice packing (n = 82)
- population
patients undergoing Ferguson hemorrhoidectomy
- primaryOutcome
Primary outcomes were pain (visual analog scale) and swelling
- result
The ice packing group showed lower pain scores within 16 hours postsurgery
Dis Colon Rectum · PMID 40145987 · Read it on PubMed ↗
BMC Surg 2025
Comparison of warm sitz bath and electronic bidet with a lower-force water flow for postoperative management after hemorrhoidectomy (BIDLOW)
Unclear resultRandomised trialLow qualityRelated question
101 people2025
Pain scores did not differ between the bidet and sitz bath groups, but non-inferiority was not demonstrated.
- Who was studied
- Adults after hemorrhoidectomy
- What they received
- Warm sitz bath
- Compared with
- Electronic bidet
- Main outcome
- Anal pain (VAS) at 7 days
- Quality
- Twenty-six of 101 randomised patients dropped out before analysis, and the trial failed to show the non-inferiority it was designed to test.
- Limitations
- High attrition; both arms received an active treatment, so neither tests whether bathing helps at all.
Taken word for word from the abstract
- n
Patients were assigned to the electronic bidet (51) or sitz bath (50) groups
- intervention
warm sitz baths for 7 days after hemorrhoidectomy
- comparator
randomly assigned (1:1) to use the electronic bidet
- population
Patients who underwent hemorrhoidectomy
- primaryOutcome
The primary endpoint was the difference in the anal pain VAS score for 7 days posthemorrhoidectomy
- result
The VAS score for anal pain 7 days posthemorrhoidectomy did not differ between the electronic bidet and sitz bath groups
BMC Surg · PMID 39757160 · Read it on PubMed ↗
Int J Nurs Stud 2024
Effects of early warm water sitz bath on urinary retention and pain after haemorrhoidectomy: A randomized controlled trial
Unclear resultRandomised trialModerate qualityRelated question
64 people2024
Starting the sitz bath earlier lowered pain scores but did not change urinary retention. Both groups received sitz baths.
- Who was studied
- Adults after haemorrhoidectomy for grade III-IV haemorrhoids
- What they received
- Warm water sitz bath started 6 hours after surgery
- Compared with
- Warm water sitz bath started the next day
- Main outcome
- Urinary retention and wound pain
- Quality
- Randomised and double-blind, but small and single-ward.
- Limitations
- Tests the timing of a sitz bath, not whether sitz baths work: every participant had one.
Taken word for word from the abstract
- n
A total of 64 participants (32 each in the experimental and control groups) were enrolled
- intervention
The experimental group started warm-water sitz bath 6 h after the surgery
- comparator
the control group started warm water sitz bath on post-haemorrhoidectomy day 1 as usual
- population
Patients who received haemorrhoidectomy for grade III or IV haemorrhoids
- primaryOutcome
preventing urinary retention and reducing wound pain
- result
There was no significant difference in the degree of change in the number of people with urinary retention between groups
Int J Nurs Stud · PMID 38642473 · Read it on PubMed ↗
J Gastrointest Surg 2009
Comparison of clinical effects between warm water spray and sitz bath in post-hemorrhoidectomy period
Unclear resultRandomised trialModerate qualityRelated question
120 people2009
No significant difference in pain, irritation or hygiene; patients found the spray more convenient and were more satisfied with it.
- Who was studied
- Adults after hemorrhoidectomy
- What they received
- Warm water sitz bath
- Compared with
- Warm water spray
- Main outcome
- Pain, irritation, hygiene and satisfaction
- Quality
- Randomised and reasonably sized, but both arms received an active treatment and outcomes were patient-reported on a visual analogue scale.
- Limitations
- Compares two ways of applying warm water, so it cannot show whether either helps.
Taken word for word from the abstract
- n
A total of 120 patients were randomly assigned to water spray or sitz bath groups
- intervention
sitz bath groups
- comparator
randomly assigned to water spray
- population
in the post-hemorrhoidectomy period
- primaryOutcome
Clinical parameters including pain, irritation (burning or itching sensations), hygiene, convenience, and overall satisfaction
- result
There were no significant difference in scores for postoperative pain (p = 0.23), irritation (p = 0.48), or hygiene (p = 0.725) between groups
J Gastrointest Surg · PMID 19337777 · Read it on PubMed ↗
ANZ J Surg 2008
Warm sitz bath does not reduce symptoms in posthaemorrhoidectomy period: a randomized, controlled study
Found no benefitRandomised trialModerate qualityRelated question
50 people2008
No difference in pain or analgesic use. The authors concluded there is no evidence to prescribe a sitz bath after haemorrhoidectomy.
- Who was studied
- Adults after haemorrhoidectomy
- What they received
- Twice-daily warm sitz bath plus antibiotics and analgesics
- Compared with
- Antibiotics and analgesics alone
- Main outcome
- Pain score, analgesic use and patient satisfaction
- Quality
- Small, but it is the only trial that compared having a sitz bath against not having one, which is the comparison that answers the question.
- Limitations
- Fifty patients, single centre, and still the only controlled test of the question.
Taken word for word from the abstract
- n
Fifty patients were randomly assigned
- intervention
a twice-daily sitz bath along with identical antibiotics and analgesics
- comparator
to receive antibiotics and analgesics alone (control patients)
- population
after haemorrhoidectomy
- primaryOutcome
pain scores, analgesic requirements and patient satisfaction ratings
- result
sitz bath does not offer pain relief, wound healing or reduction in consumption of analgesics
ANZ J Surg · PMID 18380741 · Read it on PubMed ↗
What actually helps, on this site
More about the condition:
All 5 studiesEvery study that answered the question, with its design, size and result.
The other 1 studyEverything else the search returned, including anything retracted.
Retracted by the journal — not counted
Evid Based Complement Alternat Med 2021
Effect of Kangfuxin Solution Fumigation Bath on Postoperative Patients with Hemorrhoid PPH and Influence on the Postoperative Complications
Unclear resultRandomised trialVery low qualityRelated question
106 people2021
Reported better outcomes in the herbal fumigation arm than the warm water sitz bath arm.
- Who was studied
- Patients after PPH hemorrhoid surgery
- What they received
- Warm water sitz bath (control arm)
- Compared with
- Kangfuxin solution fumigation bath
- Main outcome
- Wound healing, pain, bleeding, oedema
- Quality
- Retracted by the journal. Listed here because it appears in the search and a reader should see that it was considered and discarded.
- Limitations
- Retracted publication — excluded from every count and from the conclusion.
Taken word for word from the abstract
- n
A total of 106 patients with hemorrhoids were included in this study
- intervention
a control group treated with warm water sitz bath
- comparator
an observation group treated with Kangfuxin solution fumigation bath
- population
patients with hemorrhoids were included in this study, all of whom were treated with PHH surgery
- primaryOutcome
we recorded the time of wound healing and hospital stay
- result
the total effective rate of treatment in the observation group (92.45%) was significantly higher than that of the control group (77.36%)
Evid Based Complement Alternat Med · PMID 34539803 · Read it on PubMed ↗
How we searchedThe exact query, the date it ran, and what came back — so you can run it yourself.
- Searched
- PubMed · ClinicalTrials.gov · Crossref on 2026-10-04
- The exact search — paste this into PubMed to repeat it
(sitz bath[tiab] OR "warm water bath"[tiab] OR epsom[tiab] OR "magnesium sulfate"[tiab]) AND (hemorrhoid*[tiab] OR haemorrhoid*[tiab] OR "Hemorrhoids"[MeSH Terms])(epsom[tiab]) AND (hemorrhoid*[tiab] OR anal[tiab] OR fissure[tiab])- PubMed expanded that to:
("sitz bath"[Title/Abstract] OR "warm water bath"[Title/Abstract] OR "epsom"[Title/Abstract] OR "magnesium sulfate"[Title/Abstract]) AND ("hemorrhoid*"[Title/Abstract] OR "haemorrhoid*"[Title/Abstract] OR "Hemorrhoids"[MeSH Terms]) - What came back
- 23 records found · 23 read · 5 answered the question
- Included
- Human studies reporting a clinical outcome
- Any study of a warm water or salt bath for hemorrhoidal disease or after hemorrhoid surgery
- Excluded
- Studies of herbal or medicated baths where the bath itself was the comparator, not the question
- Retracted publications, which are listed but excluded from every count
- Studies not reporting an outcome relevant to the question
- Limits
- Details were read from abstracts, not full papers, so anything reported only in a paper's methods section is not captured here.
- Fields were read from abstracts, not full text, so detail reported only in a paper's methods section is not captured.
- The epsom-specific search returned zero records, which is the basis for saying Epsom salt itself is untested.
- Evidence strength is adapted from the GRADE framework. It is not a GRADE assessment and was not produced by a GRADE panel.
Automated evidence review — PubMed, ClinicalTrials.gov, Crossref. Search strategy, grading rules and the checks that must pass before anything publishes were written by Allen Kamrava, MD, MBA, FACS, FASCRS, colon & rectal surgery, Beverly Hills. The pages themselves are compiled by software running that method and are not read one by one before publication — saying otherwise would be the one claim here that could not be checked.
- 23records came back from the search
- 23were read
- 5actually answered the question
Risks and safetyReported side effects and who should be careful.
- No trial reported harm from warm water baths. Water hot enough to burn is the practical risk, particularly for anyone with reduced sensation.
Why people try thisThe reasoning behind the question — not a claim that it works.
- It is cheap, available in any supermarket, and has been recommended by doctors and nurses for generations.
- Warm water genuinely feels better on a sore area, which is easy to mistake for healing.
- Epsom salt is widely marketed for aches and swelling, so people assume it draws down swollen tissue.
Common questionsShort answers, drawn from the same studies.
- So should I stop taking sitz baths?
- Not necessarily. There is no evidence they treat hemorrhoids, and no evidence they do harm. If a warm bath makes you more comfortable, that is a reasonable thing to do for comfort — just do not expect it to shrink a hemorrhoid or stop bleeding.
- Does adding Epsom salt do anything?
- Nobody has tested it for this. We searched PubMed for any study mentioning Epsom salt together with hemorrhoids or anal conditions and found none. Claims about Epsom salt drawing out swelling come from tradition and marketing, not from trials.
- Why has my doctor recommended one?
- Sitz baths have been standard advice for decades, mainly for comfort and hygiene after anal surgery. That is a reasonable use. It is different from saying a bath treats hemorrhoids.
- What does have evidence?
- For hemorrhoid symptoms the better-studied measures are fiber and fluid to soften stool, avoiding straining and long periods on the toilet, and office procedures or surgery when symptoms persist. Bleeding should always be examined rather than assumed to be hemorrhoids.
This is information, not advice
This page summarises published research. It cannot tell you what is happening in your own body, and evidence changes. If something is bleeding, painful, or new, it is worth being looked at — that is a different question from the one on this page, and a better one to bring to a consultation.
Contact the officeAutomated evidence review — PubMed, ClinicalTrials.gov, Crossref. Search strategy, grading rules and the checks that must pass before anything publishes were written by Allen Kamrava, MD, MBA, FACS, FASCRS, colon & rectal surgery, Beverly Hills. The pages themselves are compiled by software running that method and are not read one by one before publication — saying otherwise would be the one claim here that could not be checked.