SITZ BATH
Place in therapy
Use of a warm water Sitz Bath may aid in internal sphincter relaxation in patients with anorectal diseases leading to a reduction in spasm and pain. Despite wide endorsement and recommendation there is little evidence to support use of this technique. Use of a warm water Sitz bath was found to reduce postdefecation pain in patients with chronic anal fissures; however no other studies have found any benefit of the Sitz bath in reduction of pain, irritation, requirement for analgesics, or healing rate. The Sitz bath technique has never been openly studied in patients with hemorrhoids who have not undergone hemorrhoidectomy, thus recommendation and use of the Sitz bath in this population is purely anecdotal.
Although there is no evidence supporting their efficacy, the Sitz bath is still widely recommended due to reports of improved patient satisfaction, and patient perceived benefit. Due to the low morbidity of the technique patient perceived benefit can often outweigh the risk of adverse effects. Adverse effects reported in trials included: perianal rash, dizziness and perianal burn. These adverse effects are considered to be mild and self limiting. Thus, recommendation for use of the Sitz Bath technique can still be made; however, if patients do not perceive any additional benefit from the technique, discontinuation is unlikely to affect outcomes.
References
1. Carruthers-Czyzewski P. Hemorrhoids. In Patient Self-Care 2nd ed. 2010. (pp.333-340). Ottawa, ON: Canadian Pharmacists Association.
2. Gupta PJ. Supportive therapies in ano-rectal diseases – Are they really useful? Acta Chir Iugosl 2010; 57(3): 83-7.
3. Gupta PJ. Warm sitz bath does not reduce symptoms in posthaemorrhoidectomy period: a randomized, controlled study. ANZ J Surg 2008; 78(5): 398-401.
4. Hsu KF, Chia JS, Jao SW, Wu CC, Yang HY, Mai CM, Fu CY, Hsiao CW. Comparison of Clinical Effects Between Warm Water Spray and Sitz Bath in Post-hemorrhoidectomy Period. J Gastrointest Surg 2009; 13(7): 1274-8.
5. Lang DSP, Tho PC, Ang ENK. Effectiveness of the Sitz bath in managing adult patients with anorectal disorders. Jpn J Nurs Sci 2011; 8: 115-128.
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Use of a warm water Sitz Bath may aid in internal sphincter relaxation in patients with anorectal diseases leading to a reduction in spasm and pain. Despite wide endorsement and recommendation there is little evidence to support use of this technique. Use of a warm water Sitz bath was found to reduce postdefecation pain in patients with chronic anal fissures; however no other studies have found any benefit of the Sitz bath in reduction of pain, irritation, requirement for analgesics, or healing rate. The Sitz bath technique has never been openly studied in patients with hemorrhoids who have not undergone hemorrhoidectomy, thus recommendation and use of the Sitz bath in this population is purely anecdotal.
Although there is no evidence supporting their efficacy, the Sitz bath is still widely recommended due to reports of improved patient satisfaction, and patient perceived benefit. Due to the low morbidity of the technique patient perceived benefit can often outweigh the risk of adverse effects. Adverse effects reported in trials included: perianal rash, dizziness and perianal burn. These adverse effects are considered to be mild and self limiting. Thus, recommendation for use of the Sitz Bath technique can still be made; however, if patients do not perceive any additional benefit from the technique, discontinuation is unlikely to affect outcomes.
References
1. Carruthers-Czyzewski P. Hemorrhoids. In Patient Self-Care 2nd ed. 2010. (pp.333-340). Ottawa, ON: Canadian Pharmacists Association.
2. Gupta PJ. Supportive therapies in ano-rectal diseases – Are they really useful? Acta Chir Iugosl 2010; 57(3): 83-7.
3. Gupta PJ. Warm sitz bath does not reduce symptoms in posthaemorrhoidectomy period: a randomized, controlled study. ANZ J Surg 2008; 78(5): 398-401.
4. Hsu KF, Chia JS, Jao SW, Wu CC, Yang HY, Mai CM, Fu CY, Hsiao CW. Comparison of Clinical Effects Between Warm Water Spray and Sitz Bath in Post-hemorrhoidectomy Period. J Gastrointest Surg 2009; 13(7): 1274-8.
5. Lang DSP, Tho PC, Ang ENK. Effectiveness of the Sitz bath in managing adult patients with anorectal disorders. Jpn J Nurs Sci 2011; 8: 115-128.
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Place in Therapy |