From the Guidelines
Soaking hemorrhoids in a sitz bath is a recommended treatment to alleviate discomfort and promote healing, as it improves blood circulation, reduces swelling, and relaxes sphincter muscles. To use a sitz bath, fill a clean bathtub with warm water (not hot) to a level that will cover your buttocks and hips, or use a specialized sitz bath basin that fits over your toilet. Soak for 15-20 minutes, 2-3 times daily, especially after bowel movements, as suggested by general medical knowledge and guidelines 1. You can enhance the bath by adding Epsom salt (1/2 cup per sitz bath) for additional anti-inflammatory benefits.
The warm water improves blood circulation to the area, reduces swelling, relaxes sphincter muscles, and cleanses the perineum. This works because heat dilates blood vessels, increasing blood flow and promoting healing while reducing pain and inflammation, as supported by the principles of wound healing and pain management. After soaking, gently pat the area dry rather than rubbing. For best results, continue sitz baths for several days until symptoms improve, and combine with other hemorrhoid treatments like over-the-counter creams containing hydrocortisone or witch hazel pads for additional relief, as recommended by recent guidelines 1.
It is essential to note that non-operative management, including dietary and lifestyle changes, such as increased fiber and water intake, is recommended as the first-line therapy for complicated hemorrhoids, as stated in the WSES-AAST guidelines 1. Additionally, flavonoids may be suggested to relieve symptoms, although the evidence is moderate, and topical muscle relaxants may be considered for thrombosed or strangulated hemorrhoids, as mentioned in the guidelines 1. However, the primary focus should be on promoting healing, reducing symptoms, and improving quality of life, which can be achieved through sitz baths and other non-operative management strategies.
From the Research
Sitz Bath for Hemorrhoids
- A sitz bath is a warm water bath used to soothe and clean the anal area, often recommended for hemorrhoid relief 2, 3, 4, 5
- The bath can help reduce pain, irritation, and swelling associated with hemorrhoids 2, 3, 5
Preparation and Usage
- Preparation of a sitz bath can be difficult for some patients, and alternative methods like water spray have been explored 2
- A sitz bath can be used with or without additives like Myrrh, which may have wound-healing properties 4
- The temperature of the bath can vary, with some studies comparing warm sitz baths to ice packing for post-hemorrhoidectomy pain management 5
Efficacy and Safety
- Sitz baths have been shown to be effective in promoting wound healing and reducing pain after hemorrhoidectomy 2, 4, 5
- However, the safety profile of additives like Myrrh is still being researched, with some studies indicating a higher complication rate 4
- Ice packing has been found to be superior to warm sitz baths in managing post-hemorrhoidectomy pain and promoting wound healing in some studies 5