A suppository is a solid, bullet-shaped medication designed to be inserted into the rectum, where it dissolves at body temperature to release active ingredients locally. Hemorrhoids are swollen veins located in or around the anus and lower rectum. Suppositories are a common and well-tolerated method of relief, specifically formulated to deliver medication directly to the inflamed tissue inside the anal canal. This targeted approach is often preferred for managing the discomfort and swelling associated with internal hemorrhoids.
Feasibility and Safety of Suppository Use
Suppositories are effective for treating internal hemorrhoids, which often sit too high in the rectal canal to be reached effectively by topical creams or ointments. The medication is absorbed directly by the tissues, providing focused relief from symptoms like pain, itching, and swelling. For external hemorrhoids, topical preparations applied directly to the affected area are typically the suggested first-line treatment.
The insertion process is safe and will not cause damage to hemorrhoidal tissue if performed gently. The suppository is designed to melt and coat the area, requiring minimal insertion depth, usually only about one inch past the anal sphincter. Discomfort experienced during insertion is usually temporary, but excessive force must never be used, especially if the area is tender or inflamed.
Common Active Ingredients in Hemorrhoid Suppositories
Suppositories contain pharmacological agents designed to address the primary symptoms of pain and inflammation. One common group is vasoconstrictors, such as phenylephrine, which temporarily narrow the blood vessels in the affected area. This action helps shrink swollen hemorrhoidal tissue and reduce associated pain and irritation.
Protectants, such as cocoa butter, hard fat, or zinc oxide, create a physical barrier over the irritated tissue. This protective layer shields the hemorrhoids from further irritation, particularly during a bowel movement, and helps lubricate the anal canal. Many formulations also include local anesthetics, like pramoxine, which temporarily numb nerve endings to provide immediate relief from pain, burning, and itching. Some over-the-counter and prescription suppositories contain corticosteroids, such as hydrocortisone, which are effective anti-inflammatory agents. These steroids reduce swelling and itching associated with inflamed hemorrhoids.
Step-by-Step Insertion Technique
It is advisable to have a bowel movement before inserting the suppository. Begin by washing your hands with soap and warm water to ensure proper hygiene and prevent the introduction of bacteria.
If the suppository is too soft from room temperature, briefly chill it in the refrigerator to firm it up. Remove the wrapper and apply a small amount of water-based lubricating gel to the tip for smoother entry; avoid petroleum jelly or oil-based products as they can interfere with melting.
The most comfortable position for self-insertion is lying on your side with the bottom leg straight and the top leg bent toward your chest. Alternatively, stand with one foot raised on a chair or toilet seat. Gently spread the buttocks and carefully insert the suppository, tapered end first, pushing it approximately one inch into the rectum with your index finger.
This depth is enough to pass the internal sphincter muscle, ensuring the medication stays in place. Once inserted, remain lying down or still for about 5 to 15 minutes to allow the suppository to melt and release the medication without being immediately expelled. Complete the process by washing your hands again.
Recognizing Warning Signs and Contraindications
While suppositories are safe for short-term use, certain signs indicate the need to stop treatment and contact a healthcare provider. Severe rectal bleeding, the passage of a large amount of blood, or black, tarry stools require urgent medical evaluation, as they may suggest a condition more serious than hemorrhoids.
If you experience a suspected anal fissure (a small tear), inserting a suppository can cause significant pain and may be counterproductive to healing. Suppositories should not be used if you have a known allergy to any ingredients or if you suspect a rectal infection is present.
If symptoms like pain, itching, or swelling do not improve after seven days of consistent over-the-counter treatment, seek professional medical advice. Prolonged use of suppositories containing corticosteroids can lead to thinning of the rectal tissue. Therefore, they should only be used as directed and never for more than the recommended period.