How to take a sitz bath for hemorrhoids

A sitz bath is a warm soak of the anal area in a few inches of water. People use it for hemorrhoid pain and itching. You can do it with a plastic basin on the toilet or in a bathtub. This page covers the water temperature, how long to sit, how often, how to dry off, what to add, and how to keep the basin clean.

The NIDDK page on hemorrhoid treatment suggests a warm sitz bath several times a day for pain, along with fiber, fluids, and less straining ¹. MedlinePlus describes the same soak as either a regular bath or a special plastic tub with a few inches of warm water ². Where a sitz bath sits in the wider plan, next to creams and fiber, is in hemorrhoid treatment.

Warm water can relax the muscle at the anal opening for a while. That is the finding from two small pressure studies ^5,6. A later review found little clinical proof that the soaks heal hemorrhoids ⁷. Use them for comfort while stool gets softer. If you need a plan for the next two days, start with how to get rid of hemorrhoids fast.

A basin on the toilet or a bathtub

MedlinePlus says either setup is fine: a regular bath, or a plastic tub that lets you sit in a few inches of warm water ². The basin rests on the toilet seat. You soak the sore area and stay dressed from the waist up. A bathtub does the same job if you do not have a basin. Fill it shallow if you only want the anal area in the water. A deeper bath is still a warm soak. The hard part after surgery, or late in pregnancy, is climbing in and out.

People who have used a foldable basin after surgery often say the toilet is easier than a bathtub. The basin in the card below sits on the seat, folds flat, and drains into the bowl. Some people with wider hips find it narrow. Roomier basins are on the best sitz baths.

How to take a sitz bath

Use warm water, not hot. A 1986 pressure study immersed the anus in water at 40 degrees C (104 degrees F) for 5 minutes ⁵. Resting anal pressure fell. Water at 5 degrees C and at 23 degrees C (room temperature) did not change the pressure ⁵. A 1993 study used 10-minute baths at 40, 45, and 50 degrees C ⁶. Pain relief was stronger and lasted longer at the higher temperatures, and the internal sphincter relaxed more ⁶. A 2005 review listed skin burns among reported complications of sitz baths ⁷. Stay near 40 degrees C. If the water stings your wrist, it is too hot. Do not copy the 45 or 50 degree baths at home.

How long: the MedlinePlus medical encyclopedia says to sit in warm water for 10 to 15 minutes ³. The pressure studies used 5 minutes and 10 minutes and still recorded a drop in pressure ^5,6. Ten to 15 minutes is a reasonable home soak.

How often: NIDDK and MedlinePlus say several times a day ^1,2. A pregnancy program used three soaks a day ⁸. Two or three times a day is the pattern those sources support. Morning, after a bowel movement, and evening is a simple way to hit three.

1. Wash the basin with soap and hot water if it has been used before. Set it on the toilet so it sits flat.
2. Fill it with a few inches of warm water, about 40 degrees C (104 degrees F). Test it with your wrist.
3. Sit for 10 to 15 minutes. A timer keeps the soak from turning into a long sit.
4. Stand up slowly. Warm water can make some people lightheaded.
5. Pat the skin dry with a soft towel. Do not rub.
6. Empty the basin into the toilet, wash it, and let it dry.

The NHS piles page says to pat the skin dry, and to avoid rubbing ⁴. MedlinePlus says too much rubbing or cleaning can make external hemorrhoid symptoms worse ². After you pat dry, a short course of cream is optional. How those products differ, and the 7-day limit on hydrocortisone, is in over-the-counter hemorrhoid treatment.

What to add to the water

The pressure studies used plain warm water ^5,6. You do not need salt, baking soda, vinegar, or a scented soak for the muscle to relax the way those studies measured.

One comparative study in pregnancy did add salt. It followed 495 pregnant women ⁸. The sitz group, 284 women, used a salty warm soak three times a day, with 20 grams of table salt. The cream group, 211 women, used a topical cream twice a day. Both groups also used a glycerin suppository before bowel movements and a daily fiber supplement. The authors reported complete healing in all 284 women in the salt-soak group and in 179 of 211 (84.8 percent) in the cream group ⁸. This was not a randomized trial, and the salt was only one part of a package that included fiber. It does not prove that salted water heals hemorrhoids on its own.

A 2005 review of the sitz bath literature found the clinical evidence thin ⁷. The authors located one randomized study that compared a sitz bath with placebo, and they concluded there was not enough science to say the soaks treat anorectal disorders ⁷. Plain warm water is the honest home version: it matches the pressure studies, and it skips additives that have not been shown to do more. The magnesium question is covered in Epsom salt for hemorrhoids.

Why warm water can ease the pain

The internal anal sphincter is the smooth muscle that keeps the anal canal closed at rest. When it squeezes hard, pain from a fissure or a swollen hemorrhoid gets worse. Both pressure studies point at that muscle.

In the 1986 study, 26 volunteers without anorectal complaints and 31 patients with hemorrhoids, anal fissure, or proctalgia fugax had resting pressure measured, then sat with the anus in water ⁵. At 40 degrees C, pressure fell in every subject. After a 5-minute soak at that temperature, the drop lasted about 15 minutes in healthy volunteers and about 30 minutes in the patients ⁵. Cold water and room-temperature water did not do this.

In the 1993 study, 18 healthy volunteers and 28 patients (18 with fissures and 10 with hemorrhoids) sat in a warm bath for 10 minutes at 40, 45, or 50 degrees C ⁶. Rectal temperature did not change. Pressure in the anal canal, and the electrical activity of the internal sphincter, dropped during the bath and climbed back over 25 to 70 minutes afterward ⁶. The hotter the bath, the bigger the drop and the longer it lasted. The author called this a “thermosphincteric reflex,” meaning a nerve reflex to warmth, because the muscle itself did not heat up ⁶.

That is a comfort effect with a timer on it, not a cure. External hemorrhoids can still itch after the pressure returns. Fiber and shorter toilet sits do the slower work.

Sitz baths in pregnancy

Hemorrhoids are common late in pregnancy. The NHS page on piles in pregnancy says to keep stools soft with fiber-rich foods and plenty of water, to avoid straining, to clean with moist paper, and to pat dry ¹¹. It also says to ask a doctor, midwife, or pharmacist before using a cream, because those products treat the soreness and not the cause ¹¹. A warm soak does not require a medicine. It can sit alongside the fiber.

The salt-soak program described above is the largest pregnancy comparison we have of sitz baths and cream ⁸. Read it as one hospital’s package (salt water three times a day, plus fiber and glycerin suppositories), not as proof that every pregnant woman needs salt in the basin. Plain warm water, two or three times a day, for 10 to 15 minutes, is a reasonable home version. Ask your obstetric provider if you have been told to limit baths, if the water makes you dizzy, or if you see bleeding that is new. Day-to-day care is in hemorrhoids during pregnancy and postpartum hemorrhoids.

Sitz baths after surgery

Surgeons often send people home with soak instructions. The evidence on the first day is more specific than “warm water is always best.”

A 2025 randomized trial compared ice packing with warm sitz baths after Ferguson hemorrhoidectomy (the closed operation that cuts the hemorrhoid out) ⁹. It included 166 people: 82 used ice and 84 used warm sitz baths. In the first 16 hours, pain scores were lower with ice. At 24 hours, 76.8 percent of the ice group had no swelling or only mild swelling, compared with 56.0 percent of the sitz group. A wound score at 7 days was 2.56 with ice and 3.27 with sitz baths, and a lower score meant a calmer wound. Morphine use in the first 24 hours averaged 4.58 mg with ice and 6.39 mg with sitz baths ⁹. The authors noted limits: one hospital, and a short follow-up.

If your discharge papers say ice for the first day, that trial supports it. If they say warm soaks, follow those. A basin is usually easier than a bathtub while sitting down hurts. When to use cold and when to use warm is compared in ice or heat for hemorrhoids. The week-by-week picture after the operation is in hemorrhoidectomy recovery.

How to clean the basin

The 2005 review found five articles that reported complications: spread of herpes, a streptococcus outbreak between mothers and newborns, and skin burns ⁷. Most of the sitz bath papers the authors found came from gynecology and nursing journals, and the infection reports fit hospital settings more than a home bathroom ⁷. They are still a reason to treat the basin like a dish you reuse.

• Wash it with soap and hot water after every soak.
• Rinse it and let it dry before you put it away. Do not leave water standing in it.
• Do not share it while you or someone else has a skin infection, open skin, or a cold sore nearby.
• Skip water hot enough to redden the skin.

A scented soak from a jar is optional and unproven for hemorrhoids. If you use one, wash the basin afterward so residue does not sit on the plastic.

If the soaks are not enough

NIDDK says to follow up if home treatment, including soaks and store products, has not helped after 1 week ¹. MedlinePlus says the same about symptoms that are still there after a week of care at home ². The NHS says to see a GP if piles are getting worse, if home treatment has not helped, or if they keep coming back ⁴.

Bleeding has other causes. The US Preventive Services Task Force recommendation on colorectal cancer screening says screening should start at age 45 for adults at average risk ¹².

NIDDK says to seek care right away for severe anal pain and rectal bleeding, particularly with abdominal discomfort, diarrhea, or fever ¹. If a week of soaks and softer stools has not changed the pain or the bleeding, the next step is a clinician visit, and sometimes an office procedure. Those options are compared in hemorrhoid procedures.

GuideWhen to see a doctor for hemorrhoids

When to see a doctor for hemorrhoids: red flags, which clinician to book, what the exam includes, how to prepare, and telehealth limits.