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Allen KamravaMD · MBA · FACS · FASCRS

Do sitz baths help hemorrhoids?

In patients with symptomatic hemorrhoids (including bleeding, internal, or thrombosed hemorrhoids), does the use of sitz baths (warm water soaks) improve symptom relief, reduce bleeding, shrink hemorrhoid size, or speed resolution compared with no sitz bath or usual care?

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Evidence review in plain language · compiled 2026-10-26 · checked 2026-10-26 · next 2026-11-26 · automated review, how it works

What the evidence says

Bottom line

No study has directly tested whether sitz baths help people with hemorrhoids — most of the research looks at something else, like recovery after hemorrhoid surgery.

Of the 9 trials and other studies found, none compared a plain warm water soak with no soak in people who simply have untreated, symptomatic hemorrhoids. Almost all were done after hemorrhoid surgery, or compared one kind of soak against another soak, a bidet, or an ointment — so they can't say whether soaking itself treats a hemorrhoid.

How certain

Very low

The 20 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 in people with this condition.

answer it directly
0answer it directly
studies found
28studies found
randomised trials
9randomised trials
people studied
2,830people 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)

    Studied mostly in people recovering from hemorrhoid surgery, not in people with untreated hemorrhoids. Results are mixed: some soaks did better than an alternative, some showed no difference, and one showed a sitz bath did worse than another option.[1,2,3,4,5,6,7,8]

    Insufficient evidence

  • Bleeding frequency or severity

    The only study that measured bleeding found a sitz bath worked less well, with more bleeding, than an herbal wash after anal surgery. No study measured bleeding in people with untreated hemorrhoids.[1]

    Insufficient evidence

  • Hemorrhoid size or grade on exam

    Two studies measured hemorrhoid size or complete healing after a soak. One found significantly smaller hemorrhoid diameter and less swelling with a herbal sitz-bath lotion than with a magnesium-sulfate compress, but both groups also received the same ointment, so the soak's own effect can't be separated out. The other found 100% of pregnant women healed completely with a salty sitz bath versus 84.8% with an ano-rectal cream, a statistically significant difference, but the study wasn't randomized and didn't describe how healing was assessed, so it can't isolate the soak's effect either.[1,2]

    Insufficient evidence

  • Time to symptom resolution

    One study of a painful blood clot in a hemorrhoid found pain mostly gone by day 5 and fully gone by day 10 with sitz baths plus pain medication, but there was no comparison group, so it can't show the soak caused the improvement.[1]

    Insufficient evidence

  • Need for further medical or surgical intervention

    In small studies of leukemia patients with anal problems, most resolved without surgery when treated with soaks plus other measures, but the soak's effect alone wasn't isolated, and this population is not typical of people with ordinary hemorrhoids.[1,2]

    Insufficient evidence

  • Recurrence rate

    One study reported a 6.3% recurrence rate after a blood clot in a hemorrhoid treated with soaks and pain medicine, but with no comparison group, it can't show whether soaking changed how often it came back.[1]

    Insufficient evidence

What it may help with

  • In laboratory studies, warm water (40°C or hotter) relaxed the internal anal sphincter muscle and lowered pressure inside the anal canal for 15 to 70 minutes. This is a muscle-pressure finding, not proof that it relieves hemorrhoid symptoms.[1,2]
  • In one trial of people recovering from hemorrhoid surgery, starting a warm sitz bath early (6 hours after surgery) was linked to lower pain scores than starting it the next day — but this only tested timing after surgery, not whether soaking helps hemorrhoids in general.[1]
  • In one study of a painful blood clot in a hemorrhoid, most people's pain had eased by day 5 while using sitz baths and pain medication together, though without a comparison group this can't prove the soak was the reason.[1]

Important limitations

  • None of the 9 trials compared a sitz bath with doing nothing in people who simply have untreated, symptomatic hemorrhoids. Nearly all were done in patients recovering from hemorrhoid surgery, where wounds heal over time regardless of soaking.[1,2,3,4,5,6,7,8,9]
  • Several studies tested a sitz bath against another soak or device — an electronic bidet, ozonated water, or an herbal lotion — so at best they show one soak compares with another, not whether soaking itself works.[1,2,3,4,5]
  • Many of the sources are narrative reviews or guidelines that list sitz baths as a common recommendation without citing any actual study data on how well they work.[1,2,3,4,5,6,7]

What the studies found

  • Found a benefit6 · 21%
  • Found no clear effect4 · 14%
  • Mixed or unclear16 · 57%

What kind of studies

  • Randomised trial9 · 32%
  • Narrative review6 · 21%
  • Retrospective5 · 18%
  • Prospective cohort3 · 11%
  • Systematic review2 · 7%
  • Guideline1 · 4%
  • Case series1 · 4%
  • Laboratory study1 · 4%

The studies that decided it

  • Qureshi et al. 2026

    AGA Clinical Practice Update on Diagnosis and Treatment of Hemorrhoids: Expert Review

    Often advised, evidence limited.GuidelineVery low quality

    size not given2026

    Sitz baths are often recommended for symptom relief, but the abstract states scientific data supporting this is limited

    Who was studied
    Adults with symptomatic hemorrhoids
    What they received
    Sitz baths (warm water soaks)
    Main outcome
    Symptom improvement in hemorrhoids
    Quality
    This is an expert opinion statement from a clinical practice update, not based on a systematic review, and the authors explicitly say these statements carry no formal evidence rating.
    Limitations
    No systematic review was performed; statement is based on expert opinion and literature review without formal evidence grading; no study data, sample size, or comparator trial reported.

    Taken word for word from the abstract

    • population symptomatic hemorrhoids
    • intervention The use of sitz baths for symptom improvement in symptomatic hemorrhoids
    • primaryOutcome symptom improvement in symptomatic hemorrhoids
    • result The use of sitz baths for symptom improvement in symptomatic hemorrhoids is often advised, but scientific data is limited.
    • qualityWhy Because systematic reviews were not performed, these BPA statements do not carry formal ratings regarding the quality of evidence or strength of the presented considerations.

    Clin Gastroenterol Hepatol · PMID 42067175 · Read it on PubMed ↗

  • Alldinger et al. 2022

    Perianal thrombosis: no need for surgery

    Healed well without surgeryProspective cohortVery low qualityRelated question

    619 people10 days

    Pain mostly resolved by 5 days and fully gone by 10 days, with a 6.3% recurrence rate after perianal thrombosis

    Who was studied
    Adults with thrombosed external hemorrhoids (perianal thrombosis) or thrombosed internal hemorrhoids
    What they received
    Sitz baths plus oral pain medication, no surgery
    Compared with
    No comparison group (all patients treated the same way; surgery not performed in anyone)
    Main outcome
    Pain resolution and recurrence without surgery
    Quality
    This is a single-arm study with no comparison group, so it cannot show whether sitz baths themselves made a difference, and the data analysis was retrospective.
    Limitations
    No control or comparator group, sitz baths were combined with pain medication so their separate effect is unclear, and data analysis was retrospective despite prospective collection.

    Taken word for word from the abstract

    • population Six hundred nineteen patients with thrombosis of internal or external hemorrhoids who presented in our clinic
    • intervention All patients were treated conservatively, with sitz baths and oral pain medication, if needed.
    • comparator No surgery was performed.
    • primaryOutcome Follow-up data was obtained by personal examination.
    • result 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%.
    • n Six hundred nineteen patients with thrombosis of internal or external hemorrhoids

    Langenbecks Arch Surg · PMID 35064300 · 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 qualityRelated question

    495 people2018

    Counted as a related question: The study compares sitz bath plus suppositories and fiber to cream plus suppositories and fiber, so it cannot isolate whether sitz baths themselves work since both groups received the same additional treatments; moreover, it studies only pregnant women, not the general adult population with symptomatic hemorrhoids.

    100% of sitz bath patients healed completely versus 84.8% of cream patients, a statistically significant difference

    Who was studied
    Pregnant women with hemorrhoids
    What they received
    Warm salty sitz bath three times daily (plus suppositories and fiber supplement)
    Compared with
    Ano-rectal cream twice daily (plus suppositories and fiber supplement)
    Main outcome
    Complete healing of hemorrhoids
    Quality
    The study compared two treatment protocols without mentioning randomization or blinding, so other differences between groups could explain the result.
    Limitations
    Not randomized or blinded; both groups also received suppositories and fiber supplements, and the abstract doesn't describe how healing was assessed.

    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 females diagnosed to have hemorrhoids during pregnancy
    • intervention The first conservative protocol consisted of three times per day salty warm Sitz bath (using 20g of commercial salt) for 284 patients.
    • comparator The second protocol consisted of 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 ↗

  • Wang et al. 2015

    [Observation of curative effect of hemorrhoids lotion on pain, edema and bleeding after anorectal surgery]

    Healed slower than herbal washRandomised trialLow qualityRelated question

    348 people7 days

    At 7 days the sitz-bath group had higher pain, edema and bleeding scores, slower granulation tissue growth, and took longer to heal (about 18.5 days) than the herbal-wash group (about 13.9 days).

    Who was studied
    adults recovering from anal/anorectal surgery for hemorrhoids and related anal disease
    What they received
    potassium permanganate sitz bath (warm water soak) added to routine postoperative wound care
    Compared with
    Chinese herbal medicine lotion fumigation added to the same routine postoperative wound care
    Main outcome
    postoperative pain, swelling, bleeding, tissue healing and time to wound healing after anal surgery
    Quality
    It is a randomized trial, but it compares sitz bathing against an active herbal treatment rather than against no treatment, with no blinding described and subjective symptom scoring, so it mainly shows sitz bath did less well than the herbal wash, not whether sitz bathing itself helps.
    Limitations
    No placebo or no-treatment arm, no blinding mentioned, single small postoperative population, and sitz bath is only the control condition rather than the treatment being tested.

    Taken word for word from the abstract

    • n The authors randomly divided 348 patients into treatment group and control group with 174 cases in each group.
    • population The purpose of this study was to evaluate the value of Chinese herbal fumigation in the postoperative anal disease.
    • intervention The control group was given to 1 000 mL 1: 5 000 potassium permanganate solution for sitz bath, fumigation based on conventional anti infective therapy, routine dressing change and relaxing bowel.
    • comparator The treatment group was given to the Chinese herbal medicine hemorrhoids lotion for fumigation based on conventional anti infective therapy, routine dressing change and relaxing bowel.
    • primaryOutcome The pain score, edema score, bleeding score, granulation tissue growth score and wound healing time of two groups were compared after operation.
    • result 7 days after operation, 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, the difference had statistical meaning (P < 0.05).
    • result The healing time of two groups was respectively (13.89 + 2.78), (18.45 + 1.65) d (P < 0.05).

    Zhongguo Zhong Yao Za Zhi · PMID 27097430 · Read it on PubMed ↗

  • Gupta 2008

    Warm sitz bath does not reduce symptoms in posthaemorrhoidectomy period: a randomized, controlled study

    No pain relief after hemorrhoid surgery.Randomised trialModerate qualityRelated question

    50 people2008

    no significant difference in pain scores or painkiller use between groups; satisfaction was higher with sitz bath but not statistically significant

    Who was studied
    adults recovering from hemorrhoid removal surgery
    What they received
    twice-daily warm sitz bath plus antibiotics and painkillers
    Compared with
    antibiotics and painkillers alone, no sitz bath
    Main outcome
    pain score, amount of painkillers used, and patient satisfaction after surgery
    Quality
    it was a randomized trial but small (50 people) and looked only at recovery after surgery, not at hemorrhoids on their own.
    Limitations
    small sample size of 50 patients from a single study; population was post-surgical rather than people with untreated symptomatic hemorrhoids

    Taken word for word from the abstract

    • population to determine the influence of sitz bath with regards to pain scores, analgesic requirements and patient satisfaction ratings after haemorrhoidectomy
    • intervention a twice-daily sitz bath along with identical antibiotics and analgesics (sitz bath group)
    • comparator antibiotics and analgesics alone (control patients)
    • 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. The satisfaction score was higher in the sitz bath group when compared with the control group; however, it did not reach a statistically significant level.
    • n Fifty patients were randomly assigned

    ANZ J Surg · PMID 18380741 · Read it on PubMed ↗

  • Shafik 1993

    Role of warm-water bath in anorectal conditions. The "thermosphincteric reflex"

    Warm baths eased pain via sphincter relaxation.Case seriesVery low qualityRelated question

    10 people1993

    Pain relief was greater and longer-lasting with hotter baths, linked to relaxation of the internal anal sphincter and a drop in rectal neck pressure that gradually returned to baseline over 25-70 minutes

    Who was studied
    Adults with painful anorectal conditions, including some with hemorrhoids
    What they received
    Warm-water sitz bath at 40, 45, or 50°C for 10 minutes
    Compared with
    Measurements before versus after the warm-water bath (no separate control group)
    Main outcome
    Relief of anorectal pain and changes in anal sphincter pressure/activity after sitz bathing
    Quality
    This was a small mechanistic study mixing fissure and hemorrhoid patients with no control treatment, so it can't reliably show whether sitz baths help hemorrhoids specifically.
    Limitations
    Small number of hemorrhoid patients (10), combined with fissure patients in reported results, no control group, and focus on physiological mechanism rather than clinical outcome.

    Taken word for word from the abstract

    • population 18 patients with fissures and 10 with hemorrhoids
    • n 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 Why anorectal pain is relieved by sitting in a warm-water bath was investigated
    • result Pain relief was more evident and lasted longer at higher bath temperatures.
    • result The rectal neck pressure and internal and sphincter electromyographic activity dropped significantly in the bath, but increased gradually to pretest levels 25-70 min after exiting the bath.

    J Clin Gastroenterol · PMID 8331263 · Read it on PubMed ↗

What actually helps, on this site

More about the condition:

All 28 studiesEvery study that answered the question, with its design, size and result.
The other 22 studiesEverything else the search returned, including anything retracted.

  • Alula et al. 2026

    Assessment of the perceptions and practices of traditional hemorrhoid healers in the North Gondar Zone, Ethiopia

    Healers believe it helps, not testedRetrospectiveVery low qualityRelated question

    15 people2026

    healers said their treatments (including sitz baths) worked well for early-stage hemorrhoids but not for severe cases; no measured patient outcomes reported

    Who was studied
    traditional healers in Ethiopia who treat hemorrhoid patients
    What they received
    sitz baths (among other traditional treatments like herbal plants, butter, honey, fumigation)
    Main outcome
    healers' perceptions of how well their treatments work
    Quality
    this is a qualitative interview study of healers' opinions and practices, not a trial testing sitz baths on patients, so it cannot show whether sitz baths actually help.
    Limitations
    qualitative interviews with 15 healers only, no patient outcome measurement, sitz bath is just one of several combined treatments, relies on healers' self-reported confidence rather than objective assessment

    Taken word for word from the abstract

    • population In-depth semi-structured interviews were conducted with 15 purposively selected traditional healers.
    • intervention administered through topical applications, herbal fumigation, or sitz baths
    • n In-depth semi-structured interviews were conducted with 15 purposively selected traditional healers.
    • result 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

    BMC Complement Med Ther · PMID 42163169 · 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 soak reduced swelling, pain better than compressRetrospectiveLow qualityRelated question

    268 people14 days

    Hemorrhoid diameter and edema were significantly smaller and comfort and compliance scores were significantly higher in the herbal sitz-bath group than in the magnesium sulfate compress group, with no difference in adverse reactions

    Who was studied
    women with hemorrhoids after childbirth
    What they received
    warm soak with Tongyangxiao herbal lotion (sitz bath) plus Ziyu ointment
    Compared with
    wet compress with magnesium sulfate plus Ziyu ointment
    Main outcome
    hemorrhoid pain, swelling, comfort and psychological state after treatment
    Quality
    This was a retrospective, non-randomized comparison of two different soak/compress products (not plain water sitz bathing) in postpartum women only, so it carries little weight for the general question.
    Limitations
    Retrospective design without randomization, both groups also received the same ointment, and the soak used was a specific herbal lotion rather than plain water, in a postpartum-only population.

    Taken word for word from the abstract

    • population 268 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
    • result All GCQ dimension scores were significantly higher in the observation group than those in the control group 7 and 14 days post treatment
    • n 268 patients with hemorrhoids

    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 vs bidet, post-surgery.Randomised trialLow qualityRelated question

    75 people7 days

    no significant difference in pain scores between sitz bath and electronic bidet groups, and the bidet could not be confirmed as noninferior to sitz baths

    Who was studied
    adults recovering from hemorrhoid removal surgery (hemorrhoidectomy)
    What they received
    warm sitz bath for 7 days after surgery
    Compared with
    electronic bidet with lower-force water flow for 7 days after surgery
    Main outcome
    anal pain score (VAS) over 7 days after surgery
    Quality
    over a quarter of patients dropped out after randomization and the trial could not even confirm the comparator was as good as sitz baths, so the result is not very solid.
    Limitations
    high dropout after randomization (26 of 101 patients), small final sample size, and this trial tested sitz baths only against an electronic bidet in post-surgical patients, not against no treatment in people with untreated hemorrhoids.

    Taken word for word from the abstract

    • population Patients who underwent hemorrhoidectomy were randomly assigned
    • intervention use the electronic bidet or warm sitz baths for 7 days after hemorrhoidectomy
    • comparator Electronic bidets can be a substitute for sitz baths
    • 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).
    • result the noninferiority of the electronic bidet to sitz baths for anal pain 7 days posthemorrhoidectomy was not verified
    • n the final analysis included 34 patients in the electronic bidet group and 41 in the sitz bath group

    BMC Surg · PMID 39757160 · 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 after surgery; no change in urinary retentionRandomised trialModerate qualityRelated question

    64 peopleUntil hospital discharge

    No significant difference in urinary retention between groups, but the early sitz bath group had significantly lower pain scores than the usual-timing group

    Who was studied
    Adults who had surgery for advanced (grade III or IV) hemorrhoids
    What they received
    Warm water sitz bath started early, 6 hours after hemorrhoid surgery
    Compared with
    Warm water sitz bath started later, on day 1 after surgery (usual timing)
    Main outcome
    Urinary retention and wound pain after hemorrhoid surgery
    Quality
    It was a randomized, double-blind trial, but it was small (64 people) and done at a single center, so the results may not generalize.
    Limitations
    Small sample size from a single surgical ward; studies only timing of sitz bath after surgery, not whether sitz bathing itself helps hemorrhoid symptoms in general.

    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 ↗

  • 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

    Healed worse than liniment treatment.RetrospectiveVery low qualityRelated question

    113 people2022

    Patients who got the sitz bath had a lower treatment success rate, more complications, and slower wound healing than those who got the liniment

    Who was studied
    adults who had surgery for mixed hemorrhoids (hemorrhoidectomy)
    What they received
    warm sitz bath with potassium permanganate solution after surgery
    Compared with
    Huhuang Burn Liniment applied after surgery
    Main outcome
    treatment effectiveness, wound healing time, pain, swelling and complications after surgery
    Quality
    This was a retrospective chart review, not a randomized trial, so differences between groups could be due to factors other than the sitz bath itself.
    Limitations
    Retrospective design, no randomization or blinding mentioned, and patients were post-surgical rather than people with untreated symptomatic hemorrhoids.

    Taken word for word from the abstract

    • population 113 patients with mixed hemorrhoids admitted to Chongqing Sanxia Central Hospital
    • intervention Group A was treated with 1/5000 potassium permanganate sitz bath after surgery
    • comparator while group B was treated with Huhuang Burn Liniment
    • primaryOutcome The treatment efficacy, wound healing time, level of pain, exudation, edema, granulation scores, anal function index, levels of IL-10 and MMP-9, quality of life scores, and complications were compared between the two groups.
    • result The effective rate of group B (94.74%) was higher than that of group A (60.71%) (P < 0.05).
    • result The complication rate of group B (8.77%) was lower than that in group A (23.21%) (P < 0.05).
    • n 113 patients with mixed hemorrhoids admitted to Chongqing Sanxia Central Hospital

    Am J Transl Res · PMID 36398208 · 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

    Studied bidets, not sitz baths directlySystematic reviewLow qualityRelated question

    size not given2022

    Bidet use did not change the odds of developing hemorrhoids; in one trial it worked about as well as a sitz bath for pain after hemorrhoid surgery, but bidet use was linked to more itching (pruritus ani) and some case reports of burns or fissures

    Who was studied
    Adults with perianal conditions such as hemorrhoids, pruritus ani, or anal fissures, including some patients recovering from hemorrhoid surgery
    What they received
    Regular use of a bidet (stream of water for hygiene)
    Compared with
    No bidet use, or sitz bath in one surgical trial
    Main outcome
    Whether bidet use affected hemorrhoid risk, hemorrhoid symptoms, pruritus ani, or post-surgery pain
    Quality
    This review combines a small number of varied, low-quality studies about bidets, not sitz baths themselves, so it cannot really judge whether sitz baths help hemorrhoids.
    Limitations
    No meta-analysis performed due to limited and variable-quality studies; focus is on bidet use rather than directly testing sitz baths for hemorrhoids

    Taken word for word from the abstract

    • population All studies on bidet use in pruritus ani, hemorrhoids, or anal fissures were included.
    • intervention habitual bidet use
    • 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.
    • result One RCT concluded that using bidets was non-inferior to sitz bath for post-hemorrhoidectomy pain.
    • result Two prospective trials and 1 cross-sectional study determined that habitual bidet use may increase the odds of developing pruritus ani.
    • result Two case series found that habitual bidet use may cause perianal burns or anterior anal fissures.

    Evid Based Complement Alternat Med · PMID 35685735 · Read it on PubMed ↗

  • Kim et al. 2020

    Pain control and early wound healing effect using sitz bath with ozonised water after haemorrhoidectomy

    Found a benefitRandomised trialLow qualityRelated question

    80 people7 days (pain); up to healing completion

    Patients using ozonised water had less pain on day seven and healed about a week faster than those using tap water

    Who was studied
    Adults recovering from hemorrhoid removal surgery
    What they received
    Sitz bath using ozonised water
    Compared with
    Sitz bath using ordinary tap water
    Main outcome
    Pain level and time for the surgical wound to heal
    Quality
    Small single study of post-surgery patients with unclear randomisation process (described as 'retrospectively performed on prospectively randomised data'), so it's hard to be fully confident in the result.
    Limitations
    Small sample of 80 patients, population was post-surgical (not general hemorrhoid sufferers), and the analysis method (retrospective review of randomised data) raises questions about how rigorously it was run.

    Taken word for word from the abstract

    • 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 Pain levels were measured using the Visual Analogue Scale (ranging from 0-10 where 0 is 'no pain' and 10 is 'unbearable pain'), on days two, three and seven
    • result On postoperative day seven, 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).
    • n A total of 80 patients participated in the study.

    J Wound Care · PMID 32421480 · Read it on PubMed ↗

  • Mott et al. 2018

    Hemorrhoids: Diagnosis and Treatment Options

    No specific evidence given.Narrative reviewVery low qualityRelated question

    size not given2018

    The abstract lists sitz baths as one of several initial therapies without reporting any specific outcome data, success rate, or comparison for sitz baths alone

    Who was studied
    Adults with hemorrhoids
    What they received
    Sitz baths (warm water soaks)
    Quality
    This is a general narrative review that mentions sitz baths only as part of a list of initial treatments, without presenting any study data, outcomes, or evidence specifically about how well sitz baths work.
    Limitations
    No specific study design, sample size, or outcome data for sitz baths is given; it is grouped with other behavioral and medical therapies without isolation of its effect.

    Taken word for word from the abstract

    • population Many Americans between 45 and 65 years of age experience hemorrhoids.
    • intervention behavioral therapies (sitz baths)
    • 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 surgery pain more than plain waterRandomised trialModerate qualityRelated question

    315 people28 days

    The herbal decoction sitz bath group had lower pain scores and used less pain medicine than the plain warm water sitz bath group at several time points after surgery

    Who was studied
    Adults who had surgery to remove hemorrhoids (open hemorrhoidectomy)
    What they received
    Sitz bath using a herbal remedy called Xiaozhi decoction after surgery
    Compared with
    Sitz bath using plain warm water after surgery
    Main outcome
    Pain after surgery and how much pain medicine was used
    Quality
    It was a randomized trial with a reasonable number of patients, but it only compared two types of sitz bath after surgery, not sitz bathing versus no sitz bathing, and was done at a single hospital.
    Limitations
    Single-center study; compares herbal vs plain water sitz bath rather than sitz bath vs no sitz bath; population is post-surgical patients, not general hemorrhoid sufferers

    Taken word for word from the abstract

    • population 315 patients who underwent open hemorrhoidectomy in our hospital were enrolled in this study
    • 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 Postoperative pain at 12 hours after surgery and on postoperative days (PODs) 1, 2, 7, 14 and 28 was evaluated by Visual Analog Scale (VAS).
    • 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.
    • n 315 patients who underwent open hemorrhoidectomy in our hospital were enrolled in this study

    J Pain Res · PMID 28176917 · Read it on PubMed ↗

  • Fargo et al. 2012

    Evaluation and management of common anorectal conditions

    Not studied for hemorrhoids hereNarrative reviewVery low qualityRelated question

    size not given2012

    The abstract does not report on sitz baths as a treatment for hemorrhoids; sitz baths are mentioned only for anorectal fistulas, while hemorrhoids are said to be managed with dietary changes, topical steroids, and analgesics

    Who was studied
    Adults with common anorectal conditions including hemorrhoids
    What they received
    Sitz baths
    Compared with
    Not compared for hemorrhoids specifically
    Main outcome
    Not stated for sitz baths and hemorrhoids
    Quality
    This is a general narrative review of anorectal conditions with no study methodology, and it does not actually test or report on sitz baths for hemorrhoids.
    Limitations
    No study design, data, or outcomes are given; this is a summary of general practice recommendations, and sitz baths are only linked to fistulas, not hemorrhoids.

    Taken word for word from the abstract

    • population Symptomatic external hemorrhoids are managed with dietary modifications, topical steroids, and analgesics.
    • intervention Simple anorectal fistulas can be treated conservatively with sitz baths and analgesics
    • comparator Symptomatic external hemorrhoids are managed with dietary modifications, topical steroids, and analgesics.
    • primaryOutcome Simple anorectal fistulas can be treated conservatively with sitz baths and analgesics, whereas complex or nonhealing fistulas may require surgery.
    • result Symptomatic external hemorrhoids are managed with dietary modifications, topical steroids, and analgesics.

    Am Fam Physician · PMID 22534276 · Read it on PubMed ↗

  • Song et al. 2011

    Optimal treatment of symptomatic hemorrhoids

    No evidence reported, just mentioned.Narrative reviewVery low qualityRelated question

    size not given2011

    abstract lists sitz baths among non-surgical treatments used to relieve symptoms but does not report any data, outcomes, or comparison for sitz baths specifically

    Who was studied
    adults with symptomatic hemorrhoids
    What they received
    sitz baths
    Main outcome
    relief of hemorrhoid symptoms
    Quality
    this is a general narrative overview of hemorrhoid treatments with no study data or outcomes reported for sitz baths specifically.
    Limitations
    no study design, patient numbers, outcomes, or comparative data are given for sitz baths; it is only mentioned as part of a general treatment list.

    Taken word for word from the abstract

    • population To alleviate symptoms caused by hemorrhoids, oral treatments, such as fiber, suppositories and Sitz baths have been applied to patients.
    • intervention Sitz baths have been applied to patients.
    • result To alleviate symptoms caused by hemorrhoids, oral treatments, such as fiber, suppositories and Sitz baths have been applied to patients.
    • primaryOutcome To alleviate symptoms caused by hemorrhoids

    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 bath effect not actually tested here.Randomised trialVery low qualityRelated question

    size not given14 days

    The herbal formula showed no significant difference from placebo; the abstract separately notes that symptoms improved a lot when patients took sitz baths, regardless of which treatment group they were in, but this was not a controlled comparison of sitz bath versus no sitz bath.

    Who was studied
    adults with symptomatic hemorrhoids
    What they received
    Sophora flower herbal formula (not sitz bathing itself)
    Compared with
    placebo
    Main outcome
    improvement in hemorrhoid symptoms (symptom score and clinical effective rate)
    Quality
    This trial was designed to test an herbal formula, not sitz baths; the sitz-bath observation is an incidental, uncontrolled remark in a small preliminary study.
    Limitations
    Preliminary study with no sample size reported; sitz bath use was not randomized or compared against a no-sitz-bath group, so its effect cannot be separated from other factors like improved bowel habits.

    Taken word for word from the abstract

    • population patients with symptomatic haemorrhoids
    • intervention Sophora flower formula
    • comparator placebo-controlled
    • 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 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.
    • result the difference between both groups was not statistically significant.

    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 answer givenNarrative reviewVery low qualityRelated question

    size not given2010

    The paper discusses and summarizes advantages and pitfalls of supportive therapies but does not report specific findings or data on effectiveness

    Who was studied
    Adults with anal and rectal conditions such as hemorrhoids, anal fissure and fistula
    What they received
    Sitz baths (along with other supportive therapies like local applications and diet/lifestyle changes)
    Main outcome
    Whether supportive therapies like sitz baths are actually beneficial
    Quality
    This is a narrative review discussing therapies in general without presenting original data, trial results, or specific evidence for sitz baths.
    Limitations
    The abstract does not separate sitz baths from other supportive therapies, provides no study data, outcomes, or population size, and does not report specific results for sitz baths alone.

    Taken word for word from the abstract

    • population various ano-rectal pathologies
    • intervention These include local applications, sitz baths, modification in the diet and life style.
    • primaryOutcome But are these supportive therapies really beneficial or they are just empirical?
    • result This paper elaborates the various supportive therapies advocated in the common anal disorders like hemorrhoids, anal fissure and fistula and summarizes the advantages and pitfalls of these treatment additives.

    Acta Chir Iugosl · PMID 21066990 · 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 and cold sitz baths.Randomised trialLow qualityRelated question

    24 people7 days

    no significant difference in pain control between cold and hot sitz baths over 7 days

    Who was studied
    adults with sudden anal pain from hemorrhoids or anal fissures
    What they received
    cold sitz baths (water under 15°C)
    Compared with
    hot sitz baths (water over 30°C)
    Main outcome
    anal pain after 7 days
    Quality
    very small trial of only 24 patients with a mixed population of hemorrhoids and fissures, so it is too small and not specific enough to draw firm conclusions.
    Limitations
    small sample size (24 patients), included both hemorrhoid and fissure patients together, no comparison to no sitz bath, pain difference reported but not statistically tested properly (p=0.244 appears comparing days within group 2 only).

    Taken word for word from the abstract

    • n Of the 27 eligible patients, 24 were randomised (Group 1: n=12 y Group 2: n=12).
    • population A randomised clinical trial on 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

    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 worked as well as sitz bath.Randomised trialLow qualityRelated question

    120 people4 weeks

    No significant difference between sitz bath and water spray for pain, irritation, hygiene, or wound healing; water spray group reported greater convenience and satisfaction

    Who was studied
    Adults recovering from hemorrhoid removal surgery
    What they received
    Warm water sitz bath
    Compared with
    Warm water spray device
    Main outcome
    Pain, irritation, hygiene, convenience, satisfaction, and wound healing after surgery
    Quality
    This was a randomized trial, but it studied post-surgical recovery rather than whether sitz baths help hemorrhoid symptoms themselves, and it compared two water-based methods rather than sitz bath against no treatment.
    Limitations
    Population was limited to post-hemorrhoidectomy patients rather than people with untreated symptomatic hemorrhoids, and there was no no-treatment or placebo comparison group.

    Taken word for word from the abstract

    • population A total of 120 patients were randomly assigned to water spray or sitz bath groups.
    • intervention Warm water sitz bath is advised for a variety of anorectal disorders.
    • comparator As an alternative to the sitz bath, we have adapted a water spray method.
    • 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.

    J Gastrointest Surg · PMID 19337777 · Read it on PubMed ↗

  • Vazquez 2008

    Constipation, haemorrhoids, and heartburn in pregnancy

    No specific result reportedSystematic reviewVery low qualityRelated question

    size not given2008

    The review lists sitz baths among treatments considered for hemorrhoids in pregnancy, but does not give a specific result or effect for sitz baths in this abstract

    Who was studied
    Pregnant women with hemorrhoids
    What they received
    Sitz baths (warm water soaks)
    Main outcome
    Effectiveness and safety of treatments for hemorrhoids in pregnancy
    Quality
    The abstract only names sitz baths as one of many interventions reviewed and gives no specific data, effect size, or quality grade for sitz baths alone.
    Limitations
    This is a broad overview covering many interventions and conditions in pregnancy; it does not report any specific trial data, numbers, or outcomes for sitz baths alone, and the population is limited to pregnant women rather than adults with hemorrhoids generally.

    Taken word for word from the abstract

    • population the prevalence of symptomatic haemorrhoids in pregnant women is higher than in non-pregnant women
    • intervention rutosides, sitz baths, and stimulant laxatives.
    • primaryOutcome What are the effects of interventions to prevent or treat haemorrhoids in pregnancy?
    • result rutosides, sitz baths, and stimulant laxatives.

    BMJ Clin Evid · PMID 19450328 · Read it on PubMed ↗

  • Janicke et al. 1996

    Anorectal disorders

    Mentioned as standard care, no evidence givenNarrative reviewVery low quality

    size not given1996

    The review states most hemorrhoid cases can be treated with conservative measures including sitz baths, without providing specific evidence or data on effectiveness

    Who was studied
    Adults with hemorrhoids
    What they received
    Sitz baths (warm water soaks)
    Main outcome
    Symptom relief/treatment of hemorrhoids
    Quality
    This is a general narrative review mentioning sitz baths only in passing as part of standard conservative care, with no study data, numbers, or comparison to support the claim.
    Limitations
    No data, trial details, or outcomes are given for sitz baths specifically; it is a broad review of anorectal disorders, not a study of sitz bath efficacy.

    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

    Mostly resolved without surgeryRetrospectiveLow qualityRelated question

    83 people12-year period

    Most anorectal complications (86%) resolved with nonoperative treatment; only 16% needed surgery, mainly for abscesses

    Who was studied
    Leukemia patients who developed anal/rectal problems during cancer treatment
    What they received
    Sitz baths (combined with antibiotics for infections) as nonoperative treatment
    Compared with
    Surgical intervention (incision and drainage)
    Main outcome
    Whether the anorectal problem resolved without surgery
    Quality
    This is a small retrospective chart review in a very specific, immunocompromised leukemia population, and it lumps sitz baths together with antibiotics and several different conditions (abscesses, fissures, hemorrhoids, ulcers) rather than testing sitz baths alone for hemorrhoids.
    Limitations
    Retrospective design, no control group, outcomes combined across several different anorectal conditions, and sitz baths were not tested in isolation from antibiotics; population is leukemia patients, not general hemorrhoid sufferers.

    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
    • intervention Nonoperative intervention in the form of systemic antibiotics and sitz baths is successful in the treatment of infectious anorectal complications.
    • comparator Incision and drainage should be performed when fluctuation is present and in patients whose complications fail to respond to medical therapy.
    • primaryOutcome to determine the initial signs and symptoms, treatment, and outcomes
    • result Overall, 79 (86 percent) of the 92 anorectal complications resolved in 68 of the 83 patients.
    • n A retrospective review of the medical records of 83 patients with acute or chronic leukemia

    J Am Coll Surg · PMID 8843260 · 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 change in anal pressures after the hot bath compared with before

    Who was studied
    Healthy adults with no anorectal problems
    What they received
    Hot perineal (sitz) bath
    Compared with
    Same subjects before the bath (baseline)
    Main outcome
    Anal sphincter pressure at rest and during squeezing
    Quality
    Small study in healthy volunteers without hemorrhoids, not in patients with the condition, so it can't show whether sitz baths help symptoms.
    Limitations
    Studied normal subjects without anorectal complaints rather than patients with hemorrhoids, and measured only sphincter pressure, not symptom relief.

    Taken word for word from the abstract

    • population Anorectal manometry was performed in 40 control subjects with no anorectal complaints
    • n 40 control subjects
    • 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 ↗

  • Chekman 1993

    [Folk medicine agents in the treatment of patients with hemorrhoids]

    No clear result reported.Narrative reviewVery low qualityRelated question

    size not given1993

    The abstract only describes folk remedies and their composition/doses without reporting outcomes

    Who was studied
    people with hemorrhoids
    What they received
    various folk medicine remedies (not specifically sitz baths)
    Main outcome
    prevention of exacerbations and inflammation of hemorrhoidal nodes
    Quality
    This is a narrative description of folk remedies with no study design, no data, and no outcome measures reported.
    Limitations
    No methodology, no patient numbers, no defined outcome measures, and sitz baths are not specifically named as the intervention tested.

    Taken word for word from the abstract

    • population exacerbation of hemorrhoids
    • intervention The author recommends various folk medicine agents, describes their composition, doses.
    • primaryOutcome prevention of exacerbations, inflammation of the hemorrhoidal nodes in rectal tissues
    • result The author recommends various folk medicine agents, describes their composition, doses.

    Lik Sprava · PMID 8379146 · Read it on PubMed ↗

  • Boddie et al. 1986

    Management of acute rectal problems in leukemic patients

    Unclear, combined with other treatments.RetrospectiveVery low qualityRelated question

    54 people1986

    Most patients treated with sitz baths plus other conservative measures did not need surgery, but sitz bath effect alone was not isolated

    Who was studied
    Leukemia patients with acute rectal problems (abscesses, hemorrhoids, fissures)
    What they received
    Sitz baths combined with suppositories, stool softeners, and/or antibiotics
    Compared with
    No separate comparator; some patients required surgery or had spontaneous drainage
    Main outcome
    Resolution of acute rectal problems without need for surgery
    Quality
    This is a retrospective review of a mixed group of leukemia patients given several treatments together, with no control group, so it cannot show whether sitz baths alone helped.
    Limitations
    Retrospective chart review over a 39-year period, small subgroup with hemorrhoids, intervention bundled with suppositories/stool softeners/antibiotics, population restricted to leukemia patients, no isolated sitz bath group or comparator.

    Taken word for word from the abstract

    • n In the interval 1944-1983, 54 patients with leukemia and acute rectal pathology were seen at our institution
    • 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, 11 patients with anal fissures with or without hemorrhoids, and 2 patients with perianal excoriations
    • 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 This study suggests that sitz baths, suppositories, antibiotics, and judicious surgical drainage (where needed) form the core of therapy for these patients.

    J Surg Oncol · PMID 3463834 · Read it on PubMed ↗

  • Dodi et al. 1986

    Hot or cold in anal pain? A study of the changes in internal anal sphincter pressure profiles

    Warm water relaxes anal muscle, may ease painLaboratory studyLow qualityRelated question

    57 people30 minutes

    Warm water immersion significantly lowered anal canal resting pressure, lasting 15-30 minutes, while cold or room-temperature water did not change it

    Who was studied
    Adults with and without anorectal problems like hemorrhoids, anal fissure, or proctalgia fugax
    What they received
    Warm water immersion (40°C) of the anus, as in a sitz bath
    Compared with
    Cold (5°C) or room temperature (23°C) water immersion, and baseline pressure
    Main outcome
    Resting anal canal pressure measured by manometry
    Quality
    This is a small physiology lab study measuring anal pressure, not patient symptoms like pain or healing, so it only indirectly suggests a benefit.
    Limitations
    Small sample size, measures only anal sphincter pressure rather than patient-reported symptoms like pain, bleeding, or healing; no blinding possible given the nature of the intervention.

    Taken word for word from the abstract

    • population 26 volunteers without anorectal complaints, and in 31 patients with anorectal problems such as hemorrhoidal disease, anal fissure, and proctalgia fugax
    • intervention immersion at 40 degrees C
    • comparator 5 degrees C, 23 degrees C, and 40 degrees C
    • primaryOutcome baseline resting anal canal pressures were recorded manometrically
    • result resting anal canal pressures diminished significantly from baseline after immersion at 40 degrees C, but remained unchanged in all subjects after immersion at 5 degrees C and 23 degrees C
    • n 26 volunteers without anorectal complaints, and in 31 patients with anorectal problems

    Dis Colon Rectum · PMID 3948615 · 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 2026-10-26
The exact search — paste this into PubMed to repeat it
("Hemorrhoids"[Mesh] OR hemorrhoid*[tiab] OR haemorrhoid*[tiab] OR piles[tiab]) AND ("sitz bath"[tiab] OR "sitz baths"[tiab] OR (warm[tiab] AND water[tiab] AND soak[tiab]) OR "Baths"[Mesh] OR "hydrotherapy"[tiab] OR "Hydrotherapy"[Mesh])
PubMed expanded that to: ("Hemorrhoids"[MeSH Terms] OR "hemorrhoid*"[Title/Abstract] OR "haemorrhoid*"[Title/Abstract] OR "piles"[Title/Abstract]) AND ("sitz bath"[Title/Abstract] OR "sitz baths"[Title/Abstract] OR ("warm"[Title/Abstract] AND "water"[Title/Abstract] AND "soak"[Title/Abstract]) OR "Baths"[MeSH Terms] OR "Hydrotherapy"[Title/Abstract] OR "Hydrotherapy"[MeSH Terms])
What came back
68 records found · 68 read · 28 answered the question
Included
  • Human, animal or laboratory studies reporting an outcome relevant to the question
Excluded
  • Records about a different condition or intervention
  • Studies of Cryotherapy (ice packs) — a different treatment from the one asked about
  • Studies of Topical creams or suppositories (e.g., hydrocortisone, witch hazel) used without sitz bathing — a different treatment from the one asked about
  • Studies of Rubber band ligation or other procedural treatments — a different treatment from the one asked about
  • Studies of Oral phlebotonics/venoactive drugs — a different treatment from the one asked about
  • 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.

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.

How we grade evidence →

  1. 68records came back from the search
  2. 68were read
  3. 28actually answered the question
Risks and safetyReported side effects and who should be careful.
  • In a review of a related practice, bidet use (a stream of water, not a soak) was linked to more itching around the anus (pruritus ani) than not using one.
  • Case reports describe burns from water that was too hot during bidet use. Sitz bath water that is too hot could plausibly cause similar skin injury, though this hasn't been studied for sitz baths specifically.
Why people try itThe reasoning behind the question — not a claim that it works.
  • It's cheap, easy to do at home, and often the first thing a doctor's office suggests trying.
  • Warm water just feels soothing on skin that's sore, swollen, or itchy.
  • It's been a hemorrhoid remedy for generations, so many people assume something so commonly recommended must be proven to work.
  • Nurses and surgeons often tell patients to use sitz baths after hemorrhoid surgery, so people assume the same advice applies to hemorrhoids that haven't been operated on.
Common questionsShort answers, drawn from the same studies.
Does a sitz bath shrink hemorrhoids?
No trial has tested whether a plain warm water soak shrinks hemorrhoids in people who haven't had surgery. Two studies found smaller size or full healing after a soak, but one used a herbal lotion instead of plain water, and the other combined the soak with fiber and suppositories — so neither proves the soak alone did it.
Does a sitz bath help bleeding hemorrhoids?
No study has tested whether sitz baths reduce bleeding in people with untreated hemorrhoids. The one study that measured bleeding found a sitz bath worked less well, with more bleeding, than an herbal wash — but that was for a surgical wound, not everyday hemorrhoid bleeding.
What about internal hemorrhoids — does a sitz bath help those?
None of the studies separated internal from external hemorrhoids to test whether sitz baths work differently for each. If you have ongoing bleeding that you think is from internal hemorrhoids, see a doctor to confirm the cause, since soaking won't reach the cause of bleeding higher up.
Hemorrhoid sitz bath recipe — what should go in the water?
The studies here don't test or compare home recipes for everyday use. Some trials added salt, herbal ingredients, or potassium permanganate to the water, but none showed these additions work better than plain warm water for hemorrhoids themselves.
How long should I soak in a sitz bath for hemorrhoids?
No trial has tested different soak times for hemorrhoid symptoms directly. One small lab study used a 10-minute soak in hot water and found the muscle-relaxing effect faded over 25 to 70 minutes, but that measured sphincter pressure, not symptom relief.
What has changedEvery re-check, and whether it changed the answer.

  1. 2026-10-26

    Clear the 'Under re-review' backlog: rebuild every remaining first-method (ev-1) page under the current method. 2 new studies · 13 no longer retrieved · evidence strength low → very low · conclusion no meaningful benefit → not studied.

    How certain we are changed. The conclusion changed.

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.

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