Effects of warm water sitz bath on symptoms in post-anal sphincterotomy in chronic anal fissure--a randomized and controlled study

World J Surg. 2007 Jul;31(7):1480-4. doi: 10.1007/s00268-007-9096-1.


Background: Sitz bath is frequently recommended by physicians for a variety of anal disorders including anal fissure. The aim of the present study was to determine whether sitz bath does have any therapeutic properties improving upon a patient's postoperative symptoms after a closed lateral sphincterotomy.

Materials and methods: Forty-six patients were randomly assigned to receive analgesics and fiber supplement alone (control patients) or a twice-daily sitz bath along with identical fiber and analgesics (sitz bath group). A 24-h pain score--post-defecation anal burning and symptom improvement--was evaluated on a visual analog scale (VAS).

Results: The groups were equally matched for age, gender distribution, and duration of disease. No significant difference in mean pain score between groups (p = 0.284) was noticed after one week. However, the patients from the control group experienced significant anal burning compared with patients from sitz bath group (p < 0.0001). The improvement score was higher in the sitz bath group when compared with the control group; however, it did not reached a statistically significant level.

Conclusions: Patients after sphincterotomy for anal fissure receiving sitz bath experienced similar levels of pain when compared with those not receiving sitz bath. However, they reported a significant relief in anal burning and a marginally better satisfaction score and no reported adverse side effects.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anal Canal / surgery*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Chronic Disease
  • Citric Acid / therapeutic use
  • Diclofenac / therapeutic use
  • Drug Combinations
  • Fissure in Ano / surgery*
  • Fissure in Ano / therapy*
  • Humans
  • Hydrotherapy*
  • Pain Measurement
  • Pain, Postoperative / prevention & control*
  • Plant Extracts / therapeutic use
  • Sodium Bicarbonate / therapeutic use
  • Wound Healing


  • Anti-Inflammatory Agents, Non-Steroidal
  • Drug Combinations
  • Plant Extracts
  • Diclofenac
  • Citric Acid
  • citric acid, ispaghula husk, sodium bicarbonate drug combination
  • Sodium Bicarbonate