Does a sitz bath shrink hemorrhoids?

No study has tested whether sitz baths alone shrink a hemorrhoid compared with doing nothing. One small study found a smaller hemorrhoid when a sitz bath was combined with a medicated ointment, but it can't say which part of that combination mattered.

Does a sitz bath help with bleeding hemorrhoids?

This hasn't been directly tested. The handful of studies that recorded bleeding gave a sitz bath to every participant and compared add-on treatments, so none of them can tell you whether the bath itself changes bleeding.

Does a sitz bath help with internal hemorrhoids?

The studies here didn't separate internal from external hemorrhoids in people who hadn't had surgery, so there's no direct evidence either way for internal hemorrhoids specifically.

How long, how often, and with what (salt, etc.) should I do a sitz bath for hemorrhoids?

The studies used different routines — plain warm water, salted water, herbal additions, 10-minute soaks, two or three times a day — but none of them compared these choices against each other for symptom relief, so there's no trial-backed "best" recipe, duration, or frequency.

Should I stop doing sitz baths for my hemorrhoids?

You don't need to stop. A warm sitz bath appears safe for most people and some find it comforting, but don't rely on it alone to treat the hemorrhoid — fiber, enough fluids, and not straining on the toilet are the measures with a stronger basis, and a doctor can offer in-office procedures if symptoms persist.

Do sitz baths help hemorrhoids?

Name: Do sitz baths help hemorrhoids?
Published: 2026-10-13
Keywords: sitz bath for hemorrhoids, sitz bath for bleeding hemorrhoids, sitz bath for internal hemorrhoids, does sitz bath shrink hemorrhoids, hemorrhoid sitz bath recipe, how long to soak in sitz bath for hemorrhoids, sitz bath for hemorrhoids how often, sitz bath salt for hemorrhoids

In patients with symptomatic hemorrhoids (including internal and bleeding hemorrhoids), does the use of sitz baths improve symptoms, reduce hemorrhoid size, or reduce bleeding compared with no sitz bath use?

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Evidence review in plain language · compiled 2026-10-13 · checked 2026-10-13 · next 2026-11-13 · automated review, how it works

Bottom line

No trial has shown that a sitz bath reduces hemorrhoid pain, bleeding, or size better than not doing one.

The only randomized trial that directly tested adding a warm sitz bath to standard care, versus standard care without one, found no difference in pain, pain-medicine use, or satisfaction — and that trial was done in people recovering from hemorrhoid surgery, not people with untreated hemorrhoids. Most other studies compared different ways of doing a sitz bath (hot vs cold water, plain vs herbal, bath vs bidet) or gave everyone a sitz bath as background care, so they cannot show whether sitz baths help at all compared with doing nothing.

How certain

Low

The randomised evidence here is small or at risk of bias (1 trial).

What it shows

No meaningful benefit

Most of the evidence found no meaningful difference.

studies found: 38studies found
randomised trials: 14randomised trials
people studied: 4,039people studied
reviews of trials: 2reviews of trials
years covered: 1986–2026years covered
finished, never published: 2finished, never published

What the research shows

Symptom score (pain, itching, discomfort)
In one trial, adding a sitz bath to standard post-surgery care (antibiotics and painkillers) made no difference in pain scores, pain-medicine use, or satisfaction compared with the same care without a sitz bath. Trials comparing a sitz bath against other approaches mostly found no consistent difference in pain either: no difference versus an electronic bidet, no difference between cold-water and hot-water sitz baths, and no difference versus a warm water spray (though the spray group reported more convenience and satisfaction). One trial found that ice packing gave lower pain scores and less pain-medicine use than a warm sitz bath after hemorrhoid surgery.[1,2,3,4,5]
No improvement shown
Bleeding frequency or severity
No study has compared sitz baths with no treatment for hemorrhoid bleeding. A couple of post-surgery trials measured bleeding, but every patient in those trials got a sitz bath, so the bath's own effect on bleeding can't be judged from them.[1,2]
Not studied
Hemorrhoid size or grade on examination
No study measured whether a sitz bath alone shrinks a hemorrhoid compared with no treatment. One small study found a smaller hemorrhoid diameter when a sitz bath was combined with a medicated ointment, but the ointment's own contribution can't be separated out.[1]
Not studied
Time to symptom resolution
One case series of people with painful thrombosed hemorrhoids found pain was mostly gone by day 5 and fully gone by day 10 using sitz baths plus pain medicine, but there was no comparison group, so it can't say the sitz bath was what resolved it.[1]
Insufficient evidence
Need for further medical or surgical treatment
No study has tracked whether using sitz baths changes the chance that someone later needs a procedure or surgery for their hemorrhoids.
Not studied
Recurrence of symptoms
A case series reported about 6 in 100 people had symptoms come back after conservative treatment that included sitz baths, but with no comparison group this can't show the bath itself affected recurrence.[1]
Insufficient evidence

Important limitations

Most studies were done in people recovering from hemorrhoid surgery, not people with ordinary, untreated hemorrhoids — so the findings may not carry over to everyday hemorrhoid symptoms.[1,2,3,4]
Many trials compared one version of a sitz bath against another — hot water versus cold, plain water versus ozonated or herbal water — rather than comparing a sitz bath with no sitz bath at all.[1,2,3,4]
In several studies everyone in the trial received a sitz bath as routine background care, so the specific effect of the bath could not be pulled apart from the other treatment being tested.[1,2,3,4,5,6]
Only one randomized trial directly tested adding a sitz bath versus not adding one, and it was small — 50 people — and limited to post-surgery patients.[1]

Why people try it

Warm water feels immediately soothing on itchy, sore skin.
It's a remedy doctors and pharmacists have recommended for generations, so it feels like a trusted, established habit.
It's cheap, easy to do at home, and needs no prescription or appointment.
People hope soaking will reduce swelling the way warmth seems to help other sore or swollen body parts.

What the studies found

Found a benefit14 · 37%
Found no clear effect8 · 21%
Mixed or unclear16 · 42%

What kind of studies

Randomised trial14 · 37%
Retrospective7 · 18%
Narrative review7 · 18%
Case series4 · 11%
Prospective cohort3 · 8%
Systematic review2 · 5%
Guideline1 · 3%

The studies that decided it

Qureshi et al. 2026
AGA Clinical Practice Update on Diagnosis and Treatment of Hemorrhoids: Expert Review
Often advised, but evidence is thin.GuidelineVery low quality
size not given2026
sitz baths are often recommended for symptom relief but the evidence supporting them is limited
Who was studied
people with symptomatic hemorrhoids
What they received
sitz baths along with fiber and lifestyle changes
Compared with
no direct comparator specified
Main outcome
symptom improvement in hemorrhoids
Quality
This is an expert opinion guideline without a systematic review of evidence, and it explicitly states data on sitz baths is limited.
Limitations
No systematic review was performed; statements are based on expert opinion rather than graded evidence.
Taken word for word from the abstract
- population symptomatic hemorrhoids
- intervention The use of sitz baths for symptom improvement in symptomatic hemorrhoids is often advised, but scientific data is limited.
- result The use of sitz baths for symptom improvement in symptomatic hemorrhoids is often advised, but scientific data is limited.
- primaryOutcome symptom improvement
- comparator Dietary and lifestyle modifications, including increasing fiber intake and avoiding straining or prolonged time on the toilet, are reasonable first-line therapies
Clin Gastroenterol Hepatol · PMID 42067175 · Read it on PubMed ↗
Chen et al. 2025
Ice Packing Versus Warm Sitz Baths for Post-hemorrhoidectomy Pain Management: A Randomized Controlled Trial
Ice packs beat warm sitz baths after surgeryRandomised trialModerate qualityRelated question
166 people7 days
ice packing gave lower pain scores, less swelling, better wound healing, and less morphine use than warm sitz baths
Who was studied
patients who had surgery to remove hemorrhoids (Ferguson hemorrhoidectomy)
What they received
ice packing after surgery
Compared with
warm sitz baths after surgery
Main outcome
pain and swelling after surgery
Quality
it was a randomized trial but from only one hospital, with a short follow-up and no validated wound-scoring tool for hemorrhoids.
Limitations
Single-center design, short follow-up period, lack of validated hemorrhoid-specific wound assessment tools, and exclusion of ASA III patients limit the present study's generalizability.
Taken word for word from the abstract
- n A total of 166 patients undergoing Ferguson hemorrhoidectomy were included.
- population PATIENTS: A total of 166 patients undergoing Ferguson hemorrhoidectomy were included.
- intervention Patients were randomly assigned to receive either ice packing (n = 82) or warm sitz bath (n = 84) for initial postoperative care.
- comparator Patients were randomly assigned to receive either ice packing (n = 82) or warm sitz bath (n = 84) for initial postoperative care.
- primaryOutcome Primary outcomes were pain (visual analog scale) and swelling.
- result The ice packing group showed lower pain scores within 16 hours postsurgery ( p < 0.01), reduced swelling at 24 hours (76.8% vs 56.0% with no or mild swelling, p = 0.03), superior wound healing at 7 days (Redness, Edema, Ecchymosis, Discharge, Approximation score: 2.56 ± 1.89 vs 3.27 ± 2.12, p = 0.02), and lower 24-hour morphine consumption (4.58 ± 2.56 vs 6.39 ± 2.7 mg, p < 0.01).
Dis Colon Rectum · PMID 40145987 · Read it on PubMed ↗
Liao et al. 2024
Effects of early warm water sitz bath on urinary retention and pain after haemorrhoidectomy: A randomized controlled trial
Less pain, no change in retentionRandomised trialModerate qualityRelated question
64 peopleuntil hospital discharge
no difference in urinary retention, but lower pain scores with early sitz bath
Who was studied
patients who had surgery to remove hemorrhoids (grade III or IV)
What they received
warm water sitz bath started 6 hours after hemorrhoid surgery
Compared with
warm water sitz bath started the standard way, on day 1 after surgery
Main outcome
urinary retention and wound pain after surgery
Quality
it was a randomized trial but small and looked at post-surgical patients, not people with untreated hemorrhoids using sitz baths as a primary treatment
Limitations
small sample of 64 patients, single surgical ward, and the question studied was timing of sitz baths after surgery rather than sitz baths as treatment for hemorrhoids themselves
Taken word for word from the abstract
- population Patients who received haemorrhoidectomy for grade III or IV haemorrhoids from January to December 2020 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
- primaryOutcome To investigate the effect of early warm water sitz bath on the day of haemorrhoidectomy surgery on 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. A change in the wound pain index was noted; the study group had a statistically significant lower pain score than the control group (B = -0.81, 95 % CI: -1.44 to -0.18).
- n A total of 64 participants (32 each in the experimental and control groups) were enrolled.
Int J Nurs Stud · PMID 38642473 · Read it on PubMed ↗
Baig et al. 2022
Be Kind to Your Behind: A Systematic Review of the Habitual Use of Bidets in Benign Perianal Disease
No clear evidence sitz baths help hemorrhoids.Systematic reviewLow qualityRelated question
size not given2022
Bidet use did not reduce odds of hemorrhoids, was non-inferior to sitz baths for post-surgery pain, but was linked to more pruritus ani and some cases of burns or fissures
Who was studied
people with benign perianal conditions like hemorrhoids, anal fissures, and pruritus ani
What they received
habitual use of bidets (continuous stream of water) for perianal hygiene
Compared with
sitz baths and no bidet use
Main outcome
hemorrhoid symptoms, post-hemorrhoidectomy pain, and pruritus ani
Quality
The review combined only a few small, variable-quality studies and could not even perform a meta-analysis.
Limitations
Only a limited number of studies were available, and they were of variable quality; no meta-analysis was performed.
Taken word for word from the abstract
- population All studies on bidet use in pruritus ani, hemorrhoids, or anal fissures were included.
- intervention habitual use of bidets
- comparator One RCT concluded that using bidets was non-inferior to sitz bath for post-hemorrhoidectomy pain.
- primaryOutcome To critically analyze and systematically review the current evidence regarding the effect of habitual bidet use on symptoms of benign perianal disease.
- result Two prospective trials and 1 cross-sectional study found that habitual use of bidets had no impact on the odds of developing hemorrhoids or hemorrhoidal symptoms. One RCT concluded that using bidets was non-inferior to sitz bath for post-hemorrhoidectomy pain. Two prospective trials and 1 cross-sectional study determined that habitual bidet use may increase the odds of developing pruritus ani. Two case series found that habitual bidet use may cause perianal burns or anterior anal fissures.
- limitations A meta-analysis was not performed because only a limited number of studies were available, and they were of variable quality.
Evid Based Complement Alternat Med · PMID 35685735 · Read it on PubMed ↗
Shirah et al. 2018
Hemorrhoids during pregnancy: Sitz bath vs. ano-rectal cream: A comparative prospective study of two conservative treatment protocols
Better healing than cream.Prospective cohortLow quality
495 people2018
100% complete healing with Sitz bath versus 84.8% with cream, a statistically significant difference favoring Sitz bath
Who was studied
pregnant Saudi Arabian women with hemorrhoids
What they received
salty warm Sitz bath three times a day plus glycerin suppositories and fiber supplement
Compared with
ano-rectal cream twice daily plus glycerin suppositories and fiber supplement
Main outcome
complete healing of hemorrhoids
Quality
This was a non-randomized comparative study, so differences between groups could be due to factors other than the treatment itself.
Limitations
Not randomized; abstract does not describe blinding or how patients were assigned to each protocol.
Taken word for word from the abstract
- n A prospective comparative study of the results of two conservative treatment protocols of 495 pregnant females diagnosed to have hemorrhoids during pregnancy between January 2010 and December 2014 was done.
- population pregnant Saudi Arabian females
- intervention three times per day salty warm Sitz bath (using 20g of commercial salt) for 284 patients
- comparator topical cream twice daily for 211 patients
- primaryOutcome Complete healing was achieved in all patients 284 (100%) in the Sitz bath group, compared to 179 (84.8%) in the cream group.
- result Sitz bath was found to represent a statistically significant difference in achieving complete healing for hemorrhoids in pregnant Saudi Arabian females compared to an ano-rectal cream (p-value<0.05).
Women Birth · PMID 29055673 · Read it on PubMed ↗
Maestre et al. 2010
[Cold or hot sitz baths in the emergency treatment of acute anal pain due to anorectal disease? Results of a randomised clinical trial]
No difference between hot, cold baths.Randomised trialLow quality
24 people7 days
no significant difference in pain control between cold and hot sitz baths
Who was studied
people with acute anal pain from hemorrhoids or anal fissures
What they received
sitz baths with cold water (below 15°C)
Compared with
sitz baths with hot water (above 30°C)
Main outcome
pain level after 7 days
Quality
Very small trial with only 24 patients, which is too few to reliably detect a difference.
Limitations
Small sample size (only 24 of 27 eligible patients randomised); differences did not reach statistical significance.
Taken word for word from the abstract
- n 24 were randomised (Group 1: n=12 y Group 2: n=12)
- population patients with acute anal pain due to haemorrhoids or anal fissures
- intervention Group 1: Sitz baths with water at a temperature of less than 15 degrees C
- comparator Group 2: Baths with a water temperature above 30 degrees C
- primaryOutcome An analysis was made of the pain at 7 days (visual analogue scale)
- result There were no statistical differences in pain, but it remained stable in Group 1, but gradually decreased in the patients of Group 2
- result There were no statistically significant differences in pain control from day 1 to day 7 in the Group with sitz baths with hot water.
Cir Esp · PMID 20580349 · Read it on PubMed ↗
Hsu et al. 2009
Comparison of clinical effects between warm water spray and sitz bath in post-hemorrhoidectomy period
Spray as good as sitz bathRandomised trialModerate qualityRelated question
120 people4-week postoperative follow-up period
no significant difference in pain, irritation, hygiene, or wound healing; spray group reported more convenience and satisfaction
Who was studied
patients recovering after hemorrhoid surgery (hemorrhoidectomy)
What they received
warm water spray applied to the surgical area
Compared with
traditional warm water sitz bath
Main outcome
pain, irritation, hygiene, convenience, satisfaction, and wound healing after surgery
Quality
it was a randomized trial but studied post-surgical hemorrhoid patients, not people using sitz baths for ordinary hemorrhoid symptoms.
Limitations
studied only post-hemorrhoidectomy patients, not general hemorrhoid sufferers; short 4-week follow-up
Taken word for word from the abstract
- population post-hemorrhoidectomy period
- intervention water spray method
- comparator sitz bath
- primaryOutcome Clinical parameters including pain, irritation (burning or itching sensations), hygiene, convenience, and overall satisfaction were evaluated by a visual analog scale to assess treatment outcome in both groups.
- 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. However, the water spray group reported significantly greater convenience (p < 0.05) and higher overall satisfaction (p < 0.05) compared with the sitz bath group.
- n A total of 120 patients were randomly assigned to water spray or sitz bath groups.
- followUp At the end of the 4-week postoperative follow-up period
J Gastrointest Surg · PMID 19337777 · Read it on PubMed ↗
Gupta 2008
Warm sitz bath does not reduce symptoms in posthaemorrhoidectomy period: a randomized, controlled study
No benefit after hemorrhoid surgery.Randomised trialModerate qualityRelated question
50 people2008
no significant difference in pain, pain medication use, or satisfaction between groups
Who was studied
patients recovering after hemorrhoid surgery (hemorrhoidectomy)
What they received
warm sitz bath twice daily plus antibiotics and painkillers
Compared with
antibiotics and painkillers alone
Main outcome
weekly pain score, pain medication use, and patient satisfaction
Quality
it was a randomized trial but small, with only 50 patients, limiting confidence in the findings.
Limitations
small sample size; studied patients recovering from surgery rather than people with untreated hemorrhoids
Taken word for word from the abstract
- n Fifty patients were randomly assigned
- population after haemorrhoidectomy
- intervention a twice-daily sitz bath along with identical antibiotics and analgesics
- comparator antibiotics and analgesics alone
- primaryOutcome Weekly pain score and patient satisfaction score were evaluated on visual analogue scores. The number of analgesic tablets consumed in each week was also assessed.
- result No significant difference in postoperative mean pain score between groups (P = 0.234) was noticed. Likewise, no relevant differences in analgesic requirements between sitz bath and no sitz bath group (P = 0.435) were seen.
ANZ J Surg · PMID 18380741 · Read it on PubMed ↗

What actually helps, on this site

More about the condition:

All 38 studiesEvery study that answered the question, with its design, size and result.

The other 31 studiesEverything else the search returned, including anything retracted.

Liao et al. 2026
Evaluating the Timing of Sitz Baths After Laser Hemorrhoidoplasty: An Exploratory Study
Early sitz baths showed no pain benefit.RetrospectiveLow qualityRelated question
310 people2026
starting sitz baths earlier was linked to higher pain scores, while delayed sitz baths were linked to lower pain scores on day 1 and after discharge; complication rates were similar across groups
Who was studied
patients with grade I-IV hemorrhoids who had laser hemorrhoidoplasty surgery
What they received
starting sitz baths early (on operation day or day 1 after surgery)
Compared with
starting sitz baths later, after hospital discharge
Main outcome
pain scores (VAS) and change in pain scores after surgery
Quality
this was a retrospective study (not randomized), so timing of sitz baths was not controlled and other factors could explain the pain differences.
Limitations
Retrospective design; patients were not randomly assigned to sitz bath timing; studied only after a specific laser surgery, not for hemorrhoids in general.
Taken word for word from the abstract
- n Of 310 patients, 92 began sitz baths on operation day, 146 on postoperative day 1, and 72 after discharge.
- population patients with grade I-IV hemorrhoids who underwent LHP
- intervention Patients were grouped by sitz bath timing: operation day, postoperative day 1, or after discharge.
- comparator after discharge
- primaryOutcome Primary outcomes were maximum and mean visual analog scale (VAS) pain scores and change in VAS scores (ΔVAS) between operation day and postoperative day 1.
- result The operation-day group had significantly higher mean VAS pain score (1.31 ± 0.77 vs. 0.91 ± 0.57 vs. 0.93 ± 0.6, p = 0.0022) on the operation day and △VAS pain score (mean) (-0.27 ± 0.67 vs. 0.12 ± 0.63 vs. 0.14 ± 0.56, p = 0.0018) compared with other groups. Complication rates did not differ among groups.
- result Although this study failed to show advantages of early sitz baths, it does not exclude potential benefits for sitz baths after LHP.
Health Sci Rep · PMID 42746097 · Read it on PubMed ↗
Zhao et al. 2026
Traditional Chinese medicine fumigation combined with Musk hemorrhoid suppository for wound healing and inflammation control in patients with mixed hemorrhoids after Milligan-Morgan hemorrhoidectomy
Herbal combo beat sitz bath after surgeryRandomised trialLow qualityRelated question
160 people4 weeks postoperatively
the combined herbal treatment healed wounds faster and worked better than sitz bath alone
Who was studied
patients with mixed hemorrhoids after surgery to remove them
What they received
Chinese medicine herbal fumigation plus Musk hemorrhoid suppository
Compared with
potassium permanganate sitz bath alone
Main outcome
complete wound healing by day 14 after surgery
Quality
this is a postoperative healing study in surgery patients, not general hemorrhoid sufferers, so it does not directly answer whether sitz baths help hemorrhoids.
Limitations
the abstract does not describe blinding, and the sitz bath group used medicated (potassium permanganate) water rather than plain water, which differs from typical sitz bath use.
Taken word for word from the abstract
- n enrolled 160 patients
- population patients with mixed hemorrhoids undergoing Milligan-Morgan Hemorrhoidectomy (MMH)
- intervention combined (TCM fumigation + Musk suppository)
- comparator control (1:5,000 potassium permanganate sitz bath)
- primaryOutcome The primary endpoint was complete wound epithelialization rate at postoperative day (POD) 14
- result the shortest wound healing time (5.15 ± 0.60 days, a 2.30-day reduction vs. control group's 7.45 ± 0.75 days, P < 0.001) and the highest 4-week total effective rate (97.50% vs. control's 65.00%, P < 0.001)
Front Surg · PMID 42245301 · Read it on PubMed ↗
Alula et al. 2026
Assessment of the perceptions and practices of traditional hemorrhoid healers in the North Gondar Zone, Ethiopia
Healers say it helps mild cases.Case seriesVery low qualityRelated question
15 people2026
healers reported strong confidence in effectiveness for early-stage hemorrhoids but limited effectiveness for severe cases
Who was studied
traditional healers who treat hemorrhoids in North Gondar Zone, Ethiopia
What they received
traditional hemorrhoid treatments including herbal topical applications, fumigation, and sitz baths
Compared with
none reported
Main outcome
healers' perceived effectiveness of their treatments for hemorrhoids
Quality
this is a small qualitative interview study of healers' own beliefs, with no patients tested, no control group, and no objective measurement of whether sitz baths actually worked.
Limitations
qualitative design based on self-reported perceptions of healers rather than measured patient outcomes; no comparison group or objective diagnosis
Taken word for word from the abstract
- population In-depth semi-structured interviews were conducted with 15 purposively selected traditional healers.
- n 15 purposively selected traditional healers
- intervention Treatments mainly involved locally sourced medicinal plants, often combined with substances such as butter or honey, and administered through topical applications, herbal fumigation, or sitz baths.
- comparator Participants reported strong confidence in the effectiveness of these treatments for early-stage hemorrhoids, while acknowledging limited effectiveness in severe cases.
- primaryOutcome explore the diagnostic methods, treatment approaches, perceived effectiveness, and sustainability challenges of traditional hemorrhoid healers
- result Participants reported strong confidence in the effectiveness of these treatments for early-stage hemorrhoids, while acknowledging limited effectiveness in severe cases.
BMC Complement Med Ther · PMID 42163169 · Read it on PubMed ↗
Han et al. 2025
[Multicenter, randomized, open-label, and positive-controlled clinical trial of Pien Tze Huang Capsules combined with Compound Pien Tze Huang Hemorrhoid Ointment in postoperative management of mixed hemorrhoids]
Herbal add-on reduced wound oozing only.Randomised trialLow qualityRelated question
240 peoplepostoperative day 7
Less wound discharge with the herbal capsule-plus-ointment combination by day 7, but no significant difference in bleeding, tissue growth, swelling, or pain scores
Who was studied
patients who had surgery to remove mixed hemorrhoids
What they received
Pien Tze Huang Capsules taken orally plus Compound Pien Tze Huang Hemorrhoid Ointment applied topically, on top of sitz baths
Compared with
Mayinglong Shexiang Hemorrhoid Ointment applied topically, on top of sitz baths
Main outcome
wound fluid discharge, wound bleeding, and new tissue growth scores after surgery
Quality
This was an open-label trial without a placebo group, both arms got sitz baths, and most of the measured outcomes showed no significant difference.
Limitations
Open-label design, positive-control rather than placebo comparison, and the trial tested an added herbal medicine rather than sitz baths themselves since all patients received sitz baths as baseline care
Taken word for word from the abstract
- n A total of 240 patients who underwent Milligan-Morgan hemorrhoidectomy for mixed hemorrhoids were enrolled
- population patients undergoing surgery for mixed hemorrhoids
- intervention The treatment group additionally received Pien Tze Huang Capsules orally(2 capsules per dose, 3 times per day) and topical application of Compound Pien Tze Huang Hemorrhoid Ointment(2.5 g, twice per day)
- comparator the control group received topical Mayinglong Shexiang Hemorrhoid Ointment(2.5 g, twice per day)
- primaryOutcome Primary efficacy endpoints included wound exudation scores, wound bleeding scores, and wound granulation tissue formation scores
- result the wound exudation scores on postoperative day 7 was significantly lower in the treatment group compared to that in the control group(P<0.05)
- result No statistically significant differences were observed between the two groups in wound bleeding scores, wound granulation tissue formation scores, analgesic use rate or amount, or incidence of adverse reactions.
- directness Both groups received sitz baths with Compound Jingjie for Fumigation and Washing as basic treatment.
Zhongguo Zhong Yao Za Zhi · PMID 41508088 · Read it on PubMed ↗
Wang et al. 2025
Effects of Tongyangxiao lotion bidet therapy combined with Ziyu ointment on postpartum hemorrhoidal pain, oedema, anxiety, and depression
Herbal sitz bath eased swelling and painRetrospectiveLow qualityRelated question
268 people14 days
Hemorrhoid diameter and edema were smaller, comfort scores and treatment compliance were higher in the sitz bath group after 14 days
Who was studied
women with hemorrhoids after childbirth
What they received
Tongyangxiao lotion sitz bath therapy combined with Ziyu ointment
Compared with
magnesium sulfate wet compress combined with Ziyu ointment
Main outcome
hemorrhoid pain, swelling, comfort, compliance, and psychological state
Quality
This was a retrospective study comparing two combined treatments rather than a randomized trial of sitz baths alone, so it can't clearly isolate the effect of the sitz bath itself.
Limitations
Retrospective design; both groups received an ointment alongside their respective soak/compress, so the lotion's specific contribution versus the ointment is unclear.
Taken word for word from the abstract
- n n = 134 in each group
- population patients with hemorrhoids
- intervention Tongyangxiao lotion sitz bath therapy + Ziyu ointment
- comparator wet compress with magnesium sulfate + Ziyu ointment
- primaryOutcome Degree of pain, comfort level, compliance behavior with medical care, psychological state, therapeutic effect, hemorrhoid edema score, incidence of adverse reactions, and hemorrhoid diameter were compared.
- result Hemorrhoid diameter and degree of edema were significantly smaller in the observation group than those in the control group 14 days post treatment.
World J Psychiatry · PMID 41357914 · Read it on PubMed ↗
Kwon et al. 2025
Comparison of warm sitz bath and electronic bidet with a lower-force water flow for postoperative management after hemorrhoidectomy (BIDLOW)
No difference in pain after surgery.Randomised trialLow qualityRelated question
75 people7 days
no significant difference in pain scores between electronic bidet and sitz bath groups
Who was studied
patients who had surgery to remove hemorrhoids
What they received
electronic bidet with lower-force water flow
Compared with
warm sitz bath
Main outcome
anal pain score over 7 days after surgery
Quality
small trial with many dropouts after randomization and failed to prove the alternative device was as good as sitz baths.
Limitations
Twenty-six patients dropped out after randomization; noninferiority of electronic bidet not verified.
Taken word for word from the abstract
- n the final analysis included 34 patients in the electronic bidet group and 41 in the sitz bath group
- population Patients who underwent hemorrhoidectomy
- intervention use the electronic bidet
- comparator warm sitz baths for 7 days after 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 (38.3 ± 21.9 vs. 42.0 ± 21.1, p = 0.453).
BMC Surg · PMID 39757160 · Read it on PubMed ↗
Al Amri 2024
Myrrh sitz bath for wound healing after hemorrhoidectomy: A retrospective study of adverse effects and treatment outcomes
Faster healing but more complicationsRetrospectiveLow qualityRelated question
67 people2024
Myrrh group had more higher-grade healing but also more complications than standard care
Who was studied
patients who had surgery to remove hemorrhoids
What they received
Myrrh-based sitz bath used as self-treatment for wound care after hemorrhoid surgery
Compared with
standard wound care after hemorrhoid surgery
Main outcome
wound healing grade and complication rate after hemorrhoidectomy
Quality
This was a small retrospective study where patients chose their own treatment, so differences could be due to the older, sicker patients in the Myrrh group rather than the Myrrh itself.
Limitations
Retrospective design, self-selected treatment without medical advice, Myrrh group was significantly older with more comorbidities, small sample size in Myrrh group (15 patients)
Taken word for word from the abstract
- n The study included 67 patients who underwent hemorrhoidectomy.
- population The data of patients who underwent hemorrhoidectomy were collected
- intervention Group A for Myrrh-based wound care as a self-medication
- comparator Group B for standard wound care
- primaryOutcome compare the safety, efficacy, and treatment outcomes of Myrrh sitz baths with standard clinical care in promoting wound healing after hemorrhoidectomy
- result The Myrrh group had significant Grade III wound healing outcomes 9/15 (60%) compared to the standard care group 2/52 (3.8%) (p < 0.001). However, despite the better healing outcomes, the Myrrh group had a significantly higher complication rate 7/15(46.7%) than the standard care group 1/52 (1.9%) (p < 0.001).
Health Sci Rep · PMID 38868538 · Read it on PubMed ↗
Medkova et al. 2024
Efficacy of Micronized Purified Flavonoid Fraction in the Posthemorrhoidectomy Period Trial: Open-Label Randomized Controlled Trial
Added flavonoid drug reduced swelling, no extra pain relief; doesn't test sitz baths.Randomised trialLow qualityRelated question
50 people60 days
the flavonoid drug reduced swelling/clotting and skin tag formation and patients rated it better, but there was no difference in pain scores between groups
Who was studied
adults who had surgery to remove hemorrhoids (grade III-IV)
What they received
standard post-surgery care (pain relievers, topical steroids, fiber, warm sitz baths, nifedipine gel) plus a flavonoid drug (micronized purified flavonoid fraction)
Compared with
standard post-surgery care alone, which already included warm sitz baths
Main outcome
swelling or clotting of the skin bridges left after surgery, pain levels, quality of life, and patient-rated treatment effect
Quality
This was a small, single-center, open-label trial that tested an add-on drug, not sitz baths themselves, since both groups already received sitz baths as part of standard care.
Limitations
Unicenter open-label design.
Taken word for word from the abstract
- n The data from 50 patients were analyzed (25 in each group).
- population Patients who underwent hemorrhoidectomy for grade III and IV hemorrhoids.
- intervention standard treatment with micronized purified flavonoid fraction, referred to as the study group
- comparator standard treatment (peroral nonsteroid anti-inflammatory drugs and local anesthetics, topical steroids, psyllium, warm sitz baths, and nifedipine gel), referred to as the control group
- primaryOutcome Thrombosis or edema of mucocutaneous bridges and pain intensity on a visual analog scale оn postoperative days 1-7, 14, 21, and 30; quality of life and patient-assessed treatment effect оn postoperative days 1, 3, 7, 21, and 30; and perianal skin tags оn postoperative day 60.
- result The visual analog scale demonstrated no differences between groups in each follow-up point. Compared to the control group, the patients in the study group had a significantly higher patient-assessed treatment effect оn postoperative days 1, 3, 7, 21, and 30 and a significantly lower rate of thrombosis or edema of mucocutaneous bridges оn postoperative days 1-7 and 14.
Dis Colon Rectum · PMID 38380823 · Read it on PubMed ↗
Sha et al. 2022
Effects of Huhuang Burn Liniment on wound healing and changes in IL-10 and MMP-9 levels in patients with mixed hemorrhoids
Herbal liniment healed better than sitz bath.RetrospectiveLow qualityRelated question
113 people2022
the liniment group healed faster, had less pain, swelling and leaking, and fewer complications than the sitz bath group
Who was studied
patients with mixed hemorrhoids who had surgery to remove them
What they received
Huhuang Burn Liniment applied after surgery
Compared with
potassium permanganate sitz bath after surgery
Main outcome
wound healing time and overall treatment effectiveness
Quality
this was a retrospective, non-randomized single-center study, so differences between groups could be due to factors other than the treatment itself
Limitations
retrospective design, single hospital, no randomization mentioned, and sitz bath is only used as a comparison treatment rather than being the main therapy studied
Taken word for word from the abstract
- population patients with mixed hemorrhoids
- intervention group B was treated with Huhuang Burn Liniment
- comparator Group A was treated with 1/5000 potassium permanganate sitz bath after surgery
- n The clinical data of 113 patients with mixed hemorrhoids
- primaryOutcome The treatment efficacy, wound healing time, level of pain, exudation, edema, granulation scores
- result The effective rate of group B (94.74%) was higher than that of group A (60.71%) (P < 0.05)
- result group B had shorter wound healing time and higher quality of life score than group A (P < 0.05)
Am J Transl Res · PMID 36398208 · Read it on PubMed ↗
Alldinger et al. 2022
Perianal thrombosis: no need for surgery
Healed well without surgery.Case seriesLow qualityRelated question
619 people10 days
pain was largely resolved after 5 days and completely gone after 10 days, with a 6.3% recurrence rate
Who was studied
patients with thrombosis of internal or external hemorrhoids (perianal thrombosis or thrombosed hemorrhoids)
What they received
conservative treatment with sitz baths and oral pain medication if needed
Compared with
no surgery was performed; no separate control group
Main outcome
pain resolution and recurrence after conservative treatment
Quality
This was a retrospective analysis of a single treatment group with no surgical comparison arm, so it cannot show whether sitz baths work better than doing nothing.
Limitations
Retrospective data analysis, no control or comparator group, no randomization, and sitz baths were combined with pain medication so their individual effect cannot be isolated.
Taken word for word from the abstract
- n Six hundred nineteen patients with thrombosis of internal or external hemorrhoids
- population Six hundred nineteen patients with thrombosis of internal or external hemorrhoids who presented in our clinic between March 2017 and August 2018 were enrolled in the study.
- intervention All patients were treated conservatively, with sitz baths and oral pain medication, if needed.
- comparator No surgery was performed.
- primaryOutcome On follow-up, patients stated that their pain had largely resolved after 5 days and completely disappeared after 10 days.
- result On follow-up, patients stated that their pain had largely resolved after 5 days and completely disappeared after 10 days. Local recurrence rate after perianal thrombosis was 6.3%.
Langenbecks Arch Surg · PMID 35064300 · Read it on PubMed ↗
Retracted by the journal — not counted
Zeng et al. 2021
Effect of Kangfuxin Solution Fumigation Bath on Postoperative Patients with Hemorrhoid PPH and Influence on the Postoperative Complications
Herbal fumigation bath beat plain sitz bath, but study retractedRandomised trialVery low qualityRelated question
106 people2021
the fumigation bath group had a higher treatment success rate and faster healing than the warm water sitz bath group
Who was studied
patients having surgery for hemorrhoids (PPH procedure)
What they received
Kangfuxin solution fumigation bath after surgery
Compared with
warm water sitz bath after surgery
Main outcome
overall treatment success and postoperative wound healing, pain, bleeding, swelling
Quality
This article was later retracted, so its findings cannot be trusted regardless of its design.
Limitations
The paper is a retracted publication, studied post-surgical patients rather than hemorrhoids in general, and compared two bath types rather than testing sitz baths against no treatment.
Taken word for word from the abstract
- n A total of 106 patients with hemorrhoids were included in this study
- population all of whom were treated with PHH surgery
- intervention an observation group treated with Kangfuxin solution fumigation bath
- comparator a control group treated with warm water sitz bath
- primaryOutcome The results of the evaluation of the efficacy of patients after the treatment period
- 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 ↗
Kim et al. 2020
Pain control and early wound healing effect using sitz bath with ozonised water after haemorrhoidectomy
Ozone water bath eased pain fasterRandomised trialLow qualityRelated question
80 people2020
patients using ozonised water sitz baths had lower pain scores and healed faster than those using tap water sitz baths
Who was studied
patients who had surgery to remove hemorrhoids (haemorrhoidectomy)
What they received
sitz bath using ozonised water after surgery
Compared with
sitz bath using ordinary tap water after surgery
Main outcome
pain level and time for wound to heal
Quality
this was a small single study where the data were analysed retrospectively from a randomised trial, so there is limited confidence in the result.
Limitations
small sample size, retrospective analysis of prospectively collected data, and it compares two types of sitz bath rather than sitz bath versus no sitz bath
Taken word for word from the abstract
- n A total of 80 patients participated in the study.
- population patients who have had a haemorrhoidectomy
- intervention Group O used a sitz bath with ozonised water after haemorrhoidectomy
- comparator patients in Group T used a sitz bath with ordinary tap water
- primaryOutcome compare the pain control effect, based on the time to wound healing
- result patients in Group O showed a significantly lower pain level than those in Group T (1.35±0.48 versus 2.40±0.9; p<0.001). The time needed for anus scars to be completely healed was significantly shorter for Group O than that for Group T (2.75±0.63 weeks versus 3.85±0.80 weeks; p<0.001).
J Wound Care · PMID 32421480 · Read it on PubMed ↗
Freymond et al. 2018
[Proctological emergencies in pregnant women]
No outcome data reportedNarrative reviewVery low qualityRelated question
size not given2018
Abstract lists sitz baths among conservative measures but reports no outcome data
Who was studied
Pregnant women with hemorrhoids or anal fissures
What they received
Sitz baths as part of conservative treatment
Quality
This is a general review of proctological emergencies in pregnancy with no study data or outcomes tested for sitz baths.
Limitations
No original data, no comparison group, no effect size reported; focuses on pregnant population only.
Taken word for word from the abstract
- population Hemorrhoids affect up to 85 % of pregnant women during the last two trimesters.
- intervention conservative measures (local anesthetics, sitz baths)
- result The treatment includes above all hygiene and dietary measures to prevent constipation and conservative measures (local anesthetics, sitz baths).
Rev Med Suisse · PMID 30091329 · Read it on PubMed ↗
Mott et al. 2018
Hemorrhoids: Diagnosis and Treatment Options
Recommended, but no evidence given.Narrative reviewLow quality
size not given2018
Not separately reported; sitz baths listed as part of initial therapy without specific outcome data
Who was studied
adults with hemorrhoids
What they received
sitz baths (along with stool softeners, dietary changes, topical treatments)
Quality
This is a general review article that lists sitz baths as a standard recommendation without citing specific studies or outcome data for this treatment.
Limitations
No specific data, trial results, or comparison given for sitz baths alone; it is grouped with other initial therapies.
Taken word for word from the abstract
- intervention behavioral therapies (sitz baths) are the mainstays of initial therapy
- population Many Americans between 45 and 65 years of age experience hemorrhoids.
- result Medical management (e.g., stool softeners, topical over-the-counter preparations, topical nitroglycerine), dietary modifications (e.g., increased fiber and water intake), and behavioral therapies (sitz baths) are the mainstays of initial therapy.
Am Fam Physician · PMID 29431977 · Read it on PubMed ↗
Shen et al. 2017
Xiaozhi decoction reduced posthemorrhoidectomy pain and analgesic medication consumption: a prospective study
Herbal sitz bath eased post-surgery pain moreRandomised trialModerate qualityRelated question
315 peoplepostoperative day 28
the herbal sitz bath group had lower pain scores and used less pain medicine on days 2, 7 and 14 after surgery than the warm water sitz bath group
Who was studied
patients who had surgery to remove hemorrhoids (open hemorrhoidectomy)
What they received
sitz bath (warm soak) using a herbal medicine mixture called Xiaozhi decoction
Compared with
sitz bath with plain warm water
Main outcome
pain after surgery and amount of pain medicine used
Quality
it was a randomized trial with a reasonable number of patients, but it only compared two types of sitz bath (herbal vs plain water) rather than testing sitz baths against no soaking at all, and it was done at a single hospital.
Limitations
this compares two sitz bath variations in patients recovering from hemorrhoid surgery, not whether sitz bathing itself helps hemorrhoids compared with no sitz bath, and it was conducted at one center
Taken word for word from the abstract
- n 315 patients who underwent open hemorrhoidectomy in our hospital were enrolled in this study
- population patients who underwent open hemorrhoidectomy in our hospital
- intervention 155 patients were randomly assigned to accept sitz bath with XZD (XZD group) after hemorrhoidectomy
- comparator 160 patients were randomly assigned to accept sitz bath with warm water after hemorrhoidectomy (control group)
- primaryOutcome to investigate the effect of Xiaozhi decoction (XZD) on posthemorrhoidectomy pain and analgesic medication consumption
- result Postoperative pain score of the XZD group was significantly lower on POD 2 (6.04±1.11 vs 6.33±1.14, P=0.0229), POD 7 (3.35±0.75 vs 4.22±0.87, P=0.0000) and POD 14 (2.87±0.64 vs 3.64±0.77, P=0.0000) than that of the control group.
J Pain Res · PMID 28176917 · Read it on PubMed ↗
Wang et al. 2015
[Observation of curative effect of hemorrhoids lotion on pain, edema and bleeding after anorectal surgery]
Herbal soak beat plain sitz bath.Randomised trialLow qualityRelated question
348 people7 days
herbal lotion group had lower pain, edema and bleeding scores and healed faster than the sitz bath group
Who was studied
patients recovering after anorectal (hemorrhoid) surgery
What they received
Chinese herbal medicine lotion fumigation and wash
Compared with
potassium permanganate solution sitz bath
Main outcome
pain, swelling, bleeding scores and wound healing time after surgery
Quality
it is a randomized trial with a fair number of patients, but it only reports score outcomes without clear blinding details and studies people after surgery rather than everyday hemorrhoid sufferers using sitz baths alone.
Limitations
abstract does not describe blinding, dropout, or how scores were measured; population is post-surgical rather than general hemorrhoid patients, and sitz bath here is combined with potassium permanganate rather than plain water.
Taken word for word from the abstract
- population evaluate the value of Chinese herbal fumigation in the postoperative anal disease
- n randomly divided 348 patients into treatment group and control group with 174 cases in each group
- intervention The treatment group was given to the Chinese herbal medicine hemorrhoids lotion for fumigation
- comparator The control group was given to 1 000 mL 1: 5 000 potassium permanganate solution for sitz bath, fumigation
- primaryOutcome The pain score, edema score, bleeding score, granulation tissue growth score and wound healing time of two groups were compared after operation
- result postoperative 3,5,7 d pain scores in the treatment group were significantly lower than those in the control group (P < 0.05)
- result anal margin of edema score and blood in the stool score in the treatment group were lower than those in control group, meat medicine growth score was higher than that of the control group
- followUp 7 days after operation
Zhongguo Zhong Yao Za Zhi · PMID 27097430 · Read it on PubMed ↗
Fox et al. 2014
Anorectal conditions: hemorrhoids
No outcome data given.Narrative reviewVery low quality
size not given2014
listed as one of several nonsurgical treatment options, no specific outcome data given
Who was studied
people with hemorrhoids
What they received
sitz baths
Compared with
no specific comparator mentioned
Main outcome
treatment of nonthrombosed hemorrhoids
Quality
this is a narrative review that only lists sitz baths as an option without presenting any study data or outcomes for it.
Limitations
no data, statistics, or evidence source provided for sitz baths specifically; general review article without original research findings
Taken word for word from the abstract
- intervention sitz baths
- population Nonsurgical treatment for nonthrombosed hemorrhoids includes increased fiber intake, sitz baths, and drugs.
- primaryOutcome Nonsurgical treatment for nonthrombosed hemorrhoids includes increased fiber intake, sitz baths, and drugs.
- result Nonsurgical treatment for nonthrombosed hemorrhoids includes increased fiber intake, sitz baths, and drugs.
- comparator Nonsurgical treatment for nonthrombosed hemorrhoids includes increased fiber intake, sitz baths, and drugs.
FP Essent · PMID 24742083 · Read it on PubMed ↗
Fargo et al. 2012
Evaluation and management of common anorectal conditions
Sitz baths mentioned only for fistulas, not hemorrhoids.Narrative reviewLow qualityRelated question
size not given2012
abstract states sitz baths are used for simple anorectal fistulas, not for hemorrhoids
Who was studied
patients with anorectal conditions
What they received
sitz baths
Main outcome
management/symptom resolution of anorectal fistulas
Quality
This is a general narrative review of anorectal conditions, not a study designed to test sitz baths for hemorrhoids, so it offers no controlled evidence on that specific question.
Limitations
The abstract does not describe study methods, does not mention sitz baths in relation to hemorrhoids, and provides no original data or comparison group for this question.
Taken word for word from the abstract
- intervention Simple anorectal fistulas can be treated conservatively with sitz baths and analgesics
- primaryOutcome Simple anorectal fistulas can be treated conservatively with sitz baths and analgesics, whereas complex or nonhealing fistulas may require surgery.
- population Symptomatic external hemorrhoids are managed with dietary modifications, topical steroids, and analgesics.
- result Simple anorectal fistulas can be treated conservatively with sitz baths and analgesics
Am Fam Physician · PMID 22534276 · Read it on PubMed ↗
Song et al. 2011
Optimal treatment of symptomatic hemorrhoids
No evidence reported either way.Narrative reviewVery low qualityRelated question
size not given2011
the abstract does not report specific results or effectiveness data for sitz baths
Who was studied
people with symptomatic hemorrhoids
What they received
sitz baths (along with other non-surgical treatments like fiber and suppositories)
Main outcome
relief of hemorrhoid symptoms
Quality
this is a general overview of treatment options without any study data, numbers, or outcomes reported for sitz baths specifically.
Limitations
abstract provides no study design, no participant numbers, no outcome measures, and no results comparing treatments - it is a narrative description of available treatment options.
Taken word for word from the abstract
- population patients with symptomatic hemorrhoids
- intervention oral treatments, such as fiber, suppositories and Sitz baths have been applied to patients
- primaryOutcome To alleviate symptoms caused by hemorrhoids
- result To alleviate symptoms caused by hemorrhoids, oral treatments, such as fiber, suppositories and Sitz baths have been applied to patients.
J Korean Soc Coloproctol · PMID 22259741 · Read it on PubMed ↗
Man et al. 2013
A randomized, double-blind, placebo-controlled trial of a Chinese herbal Sophora flower formula in patients with symptomatic haemorrhoids: a preliminary study
Sitz baths linked to symptom relief, not formally testedRandomised trialLow qualityRelated question
size not given14 days
No statistically significant difference between the herbal formula and placebo groups in symptom improvement
Who was studied
patients with symptomatic haemorrhoids
What they received
Sophora flower herbal formula
Compared with
placebo
Main outcome
improvement in major hemorrhoid symptoms
Quality
This was a small preliminary trial with no reported number of participants and no significant difference found between treatment and placebo.
Limitations
Preliminary study; sample size not reported; authors state effects need to be studied in a larger sample size and with different dosages
Taken word for word from the abstract
- population patients with symptomatic haemorrhoids
- intervention This study compared the clinical safety and efficacy of a Sophora flower formula with a placebo for the conservative treatment of symptomatic haemorrhoids.
- comparator This study compared the clinical safety and efficacy of a Sophora flower formula with a placebo for the conservative treatment of symptomatic haemorrhoids.
- primaryOutcome The clinical effective rate, symptom score and the incidence of important clinical events were used as observation indices to evaluate the effect of the Sophora flower formula.
- result However, the difference between both groups was not statistically significant.
- result As the bowel habits of the patients improved and as the patients took sitz baths, their symptoms improved drastically, regardless of the use of the Sophora flower formula.
- limitations its effects on haemorrhoids need to be studied in a larger sample size and with different dosages
Afr J Tradit Complement Altern Med · PMID 24146460 · Read it on PubMed ↗
Gupta 2010
Supportive therapies in ano-rectal diseases--are they really useful?
No clear evidence given.Narrative reviewVery low qualityRelated question
size not given2010
the paper discusses advantages and pitfalls of these treatments without giving a clear verdict on their benefit
Who was studied
people with anal and rectal conditions like hemorrhoids, anal fissure and fistula
What they received
supportive therapies such as sitz baths, local applications, diet and lifestyle changes
Main outcome
whether these supportive therapies are actually beneficial
Quality
this is a narrative discussion paper, not a study with data, so it cannot show whether sitz baths actually help.
Limitations
no original data, numbers, or outcomes reported; it is a general discussion of supportive therapies across multiple anal conditions, not a focused study on sitz baths for hemorrhoids.
Taken word for word from the abstract
- population common anal disorders like hemorrhoids, anal fissure and fistula
- intervention various additional or supportive therapies are being advised both by the family physicians and surgeons. These include local applications, sitz baths, modification in the diet and life style
- primaryOutcome are these supportive therapies really beneficial or they are just empirical?
- result summarizes the advantages and pitfalls of these treatment additives
Acta Chir Iugosl · PMID 21066990 · Read it on PubMed ↗
Gebbensleben et al. 2009
Do we at all need surgery to treat thrombosed external hemorrhoids? Results of a prospective cohort study
Improved without surgery or sitz bathsProspective cohortLow qualityRelated question
72 peoplesix months
about 63% of patients said they were healed or improved after six months without surgery or sitz baths
Who was studied
adults with thrombosed external hemorrhoids
What they received
no surgery and no sitz baths, just gentle dry cleaning with soft toilet paper after bowel movements
Compared with
no separate comparison group; single group followed over time
Main outcome
patients' self-reported healing or improvement at six months
Quality
This was a single group with no comparison arm and relied on patients' own reports, and it specifically avoided sitz baths, so it cannot show whether sitz baths help.
Limitations
No control group, self-reported outcomes by questionnaire, and only 48 of 72 patients responded for symptom follow-up.
Taken word for word from the abstract
- n A prospective cohort study of 72 adults with TEH was conducted
- population 72 adults with TEH
- intervention no surgery, no sitz baths but gentle dry cleaning with smooth toilet paper after defecation
- comparator no surgery, no sitz baths but gentle dry cleaning with smooth toilet paper after defecation
- primaryOutcome Follow-up information was collected six months after admission by questionnaire.
- result 62.5% (45/72) of patients (95% confidence interval [CI]: 51.0-74.0) described themselves as "healed" or "ameliorated"
- followUp Follow-up information was collected six months after admission by questionnaire.
Clin Exp Gastroenterol · PMID 21694829 · Read it on PubMed ↗
Piccinni et al. 2009
Botox for chronic anal fissure: is it useful? A clinical experience with mid-term follow-up
Botox healed most anal fissures.Case seriesLow qualityRelated question
60 people24 months
48.33% of patients healed after the first injection; 51.6% were re-treated and 20 of those healed after a second injection; 11 patients needed surgery
Who was studied
patients with chronic anal fissure
What they received
botulinum toxin A injection into the anal sphincter (with sitz baths, Vaseline oil and water intake as adjunct hygiene measures)
Compared with
no comparison group; all patients received the same treatment
Main outcome
healing of the anal fissure without relapse
Quality
This was a small, single-group study with no comparison group, so it cannot show whether sitz baths themselves made a difference.
Limitations
Open label, non-comparative design with no control group; sitz baths were only one part of combined aftercare, not studied on its own.
Taken word for word from the abstract
- n sixty patients were enrolled in our Unit of Coloproctology
- population Sphincterotomy has been the most commonly used treatment for chronic anal fissures.
- intervention Intrasphincteric Botulinum Toxin A injection seems to be a reliable option.
- intervention After inoculation hygiene measures (sitz baths, Vaseline oil and water intake) were recommended.
- comparator The study design was an open label non-comparative prospective trial
- primaryOutcome to verify the effectiveness of this treatment in relieving symptoms and healing fissures without relapse
- result In 29 pts the fissure was healed (48.33%) after the first injection; 31 patients (51.6%) were re-treated; 20 pts presented a complete healing of the fissure in a period ranging between 4-5 weeks from the second injection and 11 patients were introduced to surgery.
Acta Biomed · PMID 20578418 · Read it on PubMed ↗
Vazquez 2008
Constipation, haemorrhoids, and heartburn in pregnancy
No specific findings reportedSystematic reviewVery low qualityRelated question
size not given2008
not stated for sitz baths specifically in the abstract
Who was studied
pregnant women with haemorrhoids
What they received
sitz baths
Main outcome
effectiveness and safety of treatments for haemorrhoids in pregnancy
Quality
The abstract only lists sitz baths as one of many interventions reviewed and gives no specific data, outcomes, or statistics for it.
Limitations
Abstract provides no specific results, effect sizes, or study details for sitz baths; population is limited to pregnant women rather than the general hemorrhoid population.
Taken word for word from the abstract
- population the prevalence of symptomatic haemorrhoids in pregnant women is higher than in non-pregnant women
- intervention sitz baths
- primaryOutcome What are the effects of interventions to prevent or treat haemorrhoids in pregnancy?
- result In this systematic review we present information relating to the effectiveness and safety of the following interventions: Acid-suppressing drugs, anaesthetic agents (topical), antacids with or without alginates, bulk-forming laxatives, compound corticosteroid and anaesthetic agents (topical), corticosteroid agents (topical), increased fibre intake, increased fluid intake, osmotic laxatives, raising the head of the bed, reducing caffeine intake, intake of fatty foods, and the size and frequency of meals, rutosides, sitz baths, and stimulant laxatives.
BMJ Clin Evid · PMID 19450328 · Read it on PubMed ↗
Gupta 2002
Use of enzyme and heparin paste in acute haemorrhoids
Tests a paste, not sitz baths alone.RetrospectiveVery low qualityRelated question
89 people2002
adding the heparin-enzyme paste reduced pain, swelling, pile size and tenderness significantly compared with conventional treatment alone
Who was studied
patients with acute, inflamed hemorrhoids (piles)
What they received
a heparin-enzyme paste (trypsin, chymotrypsin, and heparin ointment) applied to the piles, added on top of standard conservative care
Compared with
standard conservative care alone (bed rest, liquid diet, stool softeners, antibiotics, anti-inflammatory drugs, warm sitz baths, and glycerin-magnesium sulphate paste)
Main outcome
pain, pile size, swelling, and tenderness around the anus
Quality
this was a small, non-randomized comparison of two groups with no mention of blinding, so it cannot reliably show cause and effect.
Limitations
not described as randomized, no blinding mentioned, small sample size, and sitz baths were used identically in both groups so their individual effect cannot be judged from this study
Taken word for word from the abstract
- population treating acutely inflammed piles
- intervention Ten tablets of trypsin and chymotrypsin (Chymoral forte, Elder Pharmaceuticals India) were powdered and were mixed with 30 grams of heparin (Thrombophobe, German Remedies Ltd, Germany) ointment. This paste was applied to the inflammed pile mass.
- comparator bed rest in a Trendelenburg's or jack-knife position, administration of liquid diet, stool softeners, antibiotics, and anti-inflammatory drugs along with warm Sitz baths and local application of glycerin and magnesium sulphate paste
- comparator similarly placed 22 patients who were treated with the conventional method only
- n In all, 67 received this in patient treatment with an average hospital stay of 2 days.
- n compared using chi2 test with similarly placed 22 patients
- primaryOutcome local pain was reduced to a great extent, the defecation was comfortable, there was negligible local pruritus, and the routine body movements of the patient were painless. Local signs observed in the form of the size of the piles, perianal edema, and tenderness, were also found to be significantly reduced.
- result the additional use of a heparin-enzyme paste applied directly over the pile masses significantly improves the healing and resolution of acutely inflammed hemorrhoids
Rom J Gastroenterol · PMID 12368938 · Read it on PubMed ↗
Janicke et al. 1996
Anorectal disorders
No evidence given either way.Narrative reviewVery low quality
size not given1996
abstract states sitz baths are part of conservative treatment that can treat most cases, but no outcome data given
Who was studied
people with anorectal disorders including hemorrhoids, seen in emergency department
What they received
sitz baths along with dietary changes, as conservative treatment
Main outcome
treatment of hemorrhoid symptoms
Quality
This is a general review article that only mentions sitz baths as a common treatment without presenting any study data or outcomes.
Limitations
No study design, patient numbers, or outcome measures are reported; this is a narrative overview statement, not a study finding.
Taken word for word from the abstract
- population Hemorrhoids are the most prevalent anorectal disorder and are the most common cause of hematochezia.
- intervention Most cases can be treated by conservative medical treatment (e.g., dietary changes, sitz baths) or nonsurgical procedures (e.g., rubber band liagation, infrared coagulation).
- result Most cases can be treated by conservative medical treatment (e.g., dietary changes, sitz baths) or nonsurgical procedures (e.g., rubber band liagation, infrared coagulation).
- primaryOutcome Treatment is dependent on the degree of hemorrhoid prolapse and symptoms.
Emerg Med Clin North Am · PMID 8921768 · Read it on PubMed ↗
North et al. 1996
The management of infectious and noninfectious anorectal complications in patients with leukemia
Most anorectal problems resolved nonoperatively.RetrospectiveLow qualityRelated question
83 people12-year period
86% of anorectal complications resolved without surgery; sitz baths were part of successful nonoperative treatment for infectious complications
Who was studied
patients with leukemia who developed anorectal problems during treatment
What they received
nonoperative care including systemic antibiotics and sitz baths
Compared with
surgical treatment (incision and drainage)
Main outcome
whether anorectal complications resolved without surgery
Quality
This was a retrospective chart review in a very specific group (leukemia patients) with no control group and no separate results for hemorrhoids alone.
Limitations
Retrospective design, mixed conditions (abscesses, fissures, ulcers, hemorrhoids, fistulas) analyzed together without hemorrhoid-specific outcomes, and sitz baths combined with antibiotics rather than tested alone.
Taken word for word from the abstract
- population 83 patients with acute or chronic leukemia in whom anorectal disease developed during inpatient therapy for leukemia
- n 83 patients with acute or chronic leukemia
- intervention Nonoperative intervention in the form of systemic antibiotics and sitz baths is successful in the treatment of infectious anorectal complications.
- comparator Thirteen patients (16 percent) required surgical intervention
- primaryOutcome Overall, 79 (86 percent) of the 92 anorectal complications resolved in 68 of the 83 patients.
- result Nonoperative intervention in the form of systemic antibiotics and sitz baths is successful in the treatment of infectious anorectal complications.
J Am Coll Surg · PMID 8843260 · Read it on PubMed ↗
Shafik 1993
Role of warm-water bath in anorectal conditions. The "thermosphincteric reflex"
Warm baths eased anorectal pain briefly.Case seriesVery low qualityRelated question
46 people1993
pain relief was greater and lasted longer at higher bath temperatures, linked to a drop in internal sphincter pressure and muscle activity
Who was studied
healthy volunteers and patients with painful anorectal disease (fissures or hemorrhoids)
What they received
warm-water sitz baths at 40, 45, and 50 degrees C for 10 minutes each
Compared with
measurements taken before the bath compared with after, no separate control group
Main outcome
pain relief and changes in anal sphincter pressure/muscle activity
Quality
this was a small, uncontrolled physiology study mixing healthy people with both fissure and hemorrhoid patients, not a controlled trial testing hemorrhoid treatment.
Limitations
small sample, no randomization, no control group, combined different anorectal conditions (fissures and hemorrhoids) rather than studying hemorrhoids alone
Taken word for word from the abstract
- n 18 healthy volunteers and 28 patients with painful anorectal disease (18 patients with fissures and 10 with hemorrhoids)
- population 18 healthy volunteers and 28 patients with painful anorectal disease (18 patients with fissures and 10 with hemorrhoids)
- intervention sat in a warm-water bath at temperatures of 40, 45, and 50 degrees C for 10 min each time
- comparator before and after the subjects sat in a warm-water bath
- primaryOutcome Pain relief was more evident and lasted longer at higher bath temperatures.
- result Pain relief after Sitz bath seems to be the result of internal anal-sphincter relaxation with a resulting diminution of the rectal neck pressure.
J Clin Gastroenterol · PMID 8331263 · Read it on PubMed ↗
Pinho et al. 1993
Do hot baths promote anal sphincter relaxation?
No sphincter relaxation from hot baths.Prospective cohortLow qualityRelated question
40 people1993
no significant difference in anal pressure before versus after the hot bath
Who was studied
healthy adults with no anal or rectal problems
What they received
a hot perineal (sitz) bath
Compared with
same person's anal pressure measurements before the bath
Main outcome
anal sphincter pressure at rest and during squeezing
Quality
it measured sphincter pressure in healthy people without hemorrhoids, not actual symptom relief in patients with anorectal disease
Limitations
studied normal subjects without anorectal complaints rather than patients with hemorrhoids, and measured sphincter pressure rather than symptoms
Taken word for word from the abstract
- n Anorectal manometry was performed in 40 control subjects with no anorectal complaints before and after a hot perineal bath.
- population 40 control subjects with no anorectal complaints
- intervention a hot perineal bath
- comparator before and after a hot perineal bath
- primaryOutcome anal pressures at rest or during voluntary contraction
- result No significant difference was found between anal pressures at rest or during voluntary contraction before and after the bath.
Dis Colon Rectum · PMID 8449132 · Read it on PubMed ↗
Wright et al. 1991
A prospective crossover trial of direct current electrotherapy in symptomatic hemorrhoidal disease
No difference between electrotherapy and sham.Randomised trialVery low qualityRelated question
16 people16-week treatment protocol
no significant difference in symptom improvement between electrotherapy and sham treatment groups
Who was studied
patients referred for treatment of symptomatic hemorrhoids
What they received
direct current electrotherapy added to standard medical therapy (including sitz baths)
Compared with
sham electrotherapy added to standard medical therapy (including sitz baths)
Main outcome
improvement in hemorrhoid symptoms
Quality
Very small study (16 patients) that tested an electrotherapy device, not sitz baths alone, since all patients received sitz baths as part of background therapy.
Limitations
Small sample size, crossover design, and sitz baths were given to all patients as part of combined medical therapy so their individual effect cannot be separated out.
Taken word for word from the abstract
- n Sixteen patients referred for treatment of symptomatic hemorrhoids underwent a 16-week treatment protocol.
- population Sixteen patients referred for treatment of symptomatic hemorrhoids
- intervention active direct current electrotherapy
- comparator sham therapy
- primaryOutcome Improvement in symptoms, or lack thereof, was not statistically different between the two treatment groups.
- result Improvement in symptoms, or lack thereof, was not statistically different between the two treatment groups.
- followUp 16-week treatment protocol
- intervention All patients were instructed in medical therapy including sitz baths, hydrocortisone suppositories, topical preparations, and a high fiber diet with an educational booklet.
Gastrointest Endosc · PMID 1661696 · Read it on PubMed ↗
Boddie et al. 1986
Management of acute rectal problems in leukemic patients
No isolated effect of sitz baths reported.RetrospectiveVery low qualityRelated question
54 people1986
most patients were treated with sitz baths and other conservative measures, with poor healing documented in only one case after surgical or spontaneous drainage
Who was studied
leukemia patients with acute rectal problems including hemorrhoids, abscesses, and fissures
What they received
combined conservative treatment: sitz baths, suppositories, stool softeners, and/or antibiotics
Compared with
surgical drainage or spontaneous drainage
Main outcome
healing and need for surgical intervention
Quality
this is a small, decades-long retrospective review of leukemia patients where sitz baths were combined with other treatments, so no isolated effect of sitz baths alone can be determined.
Limitations
retrospective data spanning 1944-1983, no control group, sitz baths combined with suppositories/stool softeners/antibiotics so individual effect unclear, and population is leukemia patients rather than general hemorrhoid patients
Taken word for word from the abstract
- n 54 patients with leukemia and acute rectal pathology
- population 54 patients with leukemia and acute rectal pathology were seen at our institution, including: 25 patients with perirectal abscesses and/or fistulas (PF/F), 16 patients with acutely prolapsed or thrombosed hemorrhoids
- intervention Most (42/54) patients were treated initially by sitz baths, suppositories, and stool softeners and/or antibiotics.
- comparator Eleven patients required surgical intervention for thrombosed hemorrhoids and perirectal abscess and/or fistulas.
- primaryOutcome Poor healing after surgical or spontaneous drainage was documented in only one case.
- result Poor healing after surgical or spontaneous drainage was documented in only one case.
J Surg Oncol · PMID 3463834 · 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 2026-10-13
The exact search — paste this into PubMed to repeat it: ("Hemorrhoids"[Mesh] OR hemorrhoid*[tiab] OR haemorrhoid*[tiab] OR piles[tiab]) AND ("Baths"[Mesh] OR "sitz bath"[tiab] OR "sitz baths"[tiab]); PubMed expanded that to: ("Hemorrhoids"[MeSH Terms] OR "hemorrhoid*"[Title/Abstract] OR "haemorrhoid*"[Title/Abstract] OR "piles"[Title/Abstract]) AND ("Baths"[MeSH Terms] OR "sitz bath"[Title/Abstract] OR "sitz baths"[Title/Abstract])
What came back: 57 records found · 57 read · 38 answered the question
Included: Human, animal or laboratory studies reporting an outcome relevant to the question
Excluded: Records about a different condition or intervention
Records reporting no outcome
Retracted publications, which are listed but excluded from every count
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.
Evidence strength is adapted from the GRADE framework. It is not a GRADE assessment and was not produced by a GRADE panel.

57records came back from the search
57were read
38actually answered the question

Common questionsShort answers, drawn from the same studies.

Does a sitz bath shrink hemorrhoids?: No study has tested whether sitz baths alone shrink a hemorrhoid compared with doing nothing. One small study found a smaller hemorrhoid when a sitz bath was combined with a medicated ointment, but it can't say which part of that combination mattered.
Does a sitz bath help with bleeding hemorrhoids?: This hasn't been directly tested. The handful of studies that recorded bleeding gave a sitz bath to every participant and compared add-on treatments, so none of them can tell you whether the bath itself changes bleeding.
Does a sitz bath help with internal hemorrhoids?: The studies here didn't separate internal from external hemorrhoids in people who hadn't had surgery, so there's no direct evidence either way for internal hemorrhoids specifically.
How long, how often, and with what (salt, etc.) should I do a sitz bath for hemorrhoids?: The studies used different routines — plain warm water, salted water, herbal additions, 10-minute soaks, two or three times a day — but none of them compared these choices against each other for symptom relief, so there's no trial-backed "best" recipe, duration, or frequency.
Should I stop doing sitz baths for my hemorrhoids?: You don't need to stop. A warm sitz bath appears safe for most people and some find it comforting, but don't rely on it alone to treat the hemorrhoid — fiber, enough fluids, and not straining on the toilet are the measures with a stronger basis, and a doctor can offer in-office procedures if symptoms persist.

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 office

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.

Allen Kamrava, MD, MBA, FACS, FASCRS · 435 N. Bedford Dr., Suite 308, Beverly Hills, CA 90210 · 424.279.8222

Educational information — not medical advice.