"In patients with acute anal pain due to hemorrhoids or anal fissures, neither cold water (<15°C) nor hot water (>30°C) sitz bath (SB) did control pain statistically. Similarly, after sphincterotomy for anal fissure, SB produced no significant difference in pain but significant relief in anal burning and better satisfaction score with no adverse effects were observed compared with control group. Healing and pain relief was not significant in SB but it improved patient satisfaction in acute anal fissures. Though there was no strong evidence to support the use of SB for pain relief and to accelerate fissure or wound healing among adult patients with anorectal disorders (ARDs), patients were satisfied with using SB and no severe complications were reported. In contrast, warm-water SB (40°C, 45°C, and 50°C for 10 min each time) in ARD, pain relief was more evident and lasted longer at higher bath temperatures. Pain relief after SB might attribute to internal anal-sphincter relaxation, which might be due to thermosphincteric reflex, resulting in diminution of the rectal neck pressure. The higher the bath temperature, the greater the drop in rectal neck pressure and internal sphincter electromyographic activity, and longer the time needed to return to pretest levels."