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You can use either warm or cool water as you comfortable with.

The way that the Sitz bath works is by altering the blood flow to the area you are immersing in water.If an area of skin is getting too hot, the body increases the amount of blood flowing through that area to carry heat away. In the same way if an area is too cold, the body will stop excess heat loss by shunting blood away from that area.

For more information you can check this out:

http://www.hemorrhoidshemroids.com/hemroids-hemorrhoids-sitz-bath.html

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