A rectal suppository is a small, solid, cone- or torpedo-shaped medication designed for insertion into the rectum, where it dissolves or melts at body temperature to release its active ingredients. This method of delivery is often used when a person cannot take medication orally, such as due to vomiting, or when a rapid effect is desired. The medication can work locally to treat conditions like constipation or hemorrhoids, or it can be absorbed through the rich network of blood vessels in the rectum to produce a systemic effect throughout the body for issues like pain or fever management. This route is an effective alternative for drug administration, bypassing the digestive system.
Getting Ready: Supplies and Positioning
Preparation begins with thorough handwashing using soap and warm water to maintain hygiene before handling any medication or body area. Gathering all necessary supplies beforehand prevents interruptions. These supplies should include the suppository itself, a paper towel for cleanup, and a water-based lubricant. Water-based lubricant is preferable to petroleum jelly, as the latter can interfere with the suppository’s ability to melt and release the drug.
Next, establishing a comfortable and accessible position is important for a smooth insertion. The most commonly recommended position involves lying on the left side (Sim’s position), with the bottom leg straightened and the upper leg bent toward the chest. This specific positioning helps the suppository travel into the lower part of the rectum, which assists in retention. If lying down is not feasible, an alternative is to stand with one foot elevated on a chair or a low surface.
Step-by-Step Guide to Insertion
Once positioned, the suppository must be unwrapped from its foil or plastic packaging. If the suppository feels too soft to handle or insert, it can be briefly run under cold water or placed in a refrigerator for a few minutes while still in its wrapper to help it firm up. It is recommended to apply a small amount of water-based lubricant to the tip of the suppository to facilitate a smoother insertion. Many healthcare providers suggest inserting the narrow or pointed end first.
The buttocks should be gently parted to fully expose the anal opening. Using a gloved index finger, the suppository is inserted gently but firmly into the rectum. The goal is to push the suppository past the internal anal sphincter, which is the ring of muscle that holds it in place. For adults, the suppository should be pushed in approximately one inch, or about the length of the first joint of the finger.
For children, a smaller depth of about a half-inch to one inch is appropriate, depending on their size. Insertion past the sphincter is necessary because if the suppository remains in the anal canal, the urge to expel it will be immediate and strong, leading to poor retention and loss of the medication. Once inserted, the finger should be withdrawn. The buttocks can be gently held together for a few seconds to help control the urge to push the suppository out.
Post-Procedure Care and Retention Tips
After the suppository has been inserted, the person should remain lying or sitting still for 15 to 20 minutes to allow the medication to begin dissolving. Staying still ensures the suppository melts and the medication is absorbed effectively into the rectal wall. Premature movement or activity can cause the suppository to be expelled before it has fully dissolved.
Avoid having a bowel movement for at least one hour following the insertion, unless the suppository itself is a laxative intended to produce a bowel movement quickly. If the suppository is accidentally expelled immediately, it may indicate that it was not pushed in far enough past the anal sphincter, and a fresh suppository may need to be inserted. Used materials should be discarded, and hands must be thoroughly washed again with soap and water to complete the procedure hygienically.