A suppository is a solid, cone-shaped medication inserted into the rectum, where it dissolves or melts at body temperature. For constipation, suppositories provide a localized and fast-acting option for stimulating a bowel movement. The best choice depends on a person’s specific needs, the cause of their constipation, and the desired speed of relief. These products are intended for treating temporary or acute constipation, not for long-term or chronic use.
Understanding Suppository Types
Suppositories for constipation are categorized based on their mechanism of action, which dictates their effect on the body. The two main types available over-the-counter are stimulant and osmotic/emollient suppositories. Understanding the difference between these categories is fundamental to selecting the right product for relief.
Stimulant suppositories, such as those containing bisacodyl, work by directly affecting the intestinal wall. The active ingredient stimulates the nerves in the lining of the large intestine, which promotes muscle contractions, known as peristalsis. This increased motility helps to propel stool through the colon, leading to a bowel movement. Bisacodyl suppositories are known for their rapid onset, typically producing an effect within 15 to 60 minutes of insertion.
Osmotic and emollient suppositories, most commonly containing glycerin, function in a gentler manner. Glycerin is a hyperosmotic agent that draws water into the lower bowel, softening the stool and increasing its volume. The glycerin base also melts to provide a lubricating effect, easing the passage of fecal matter. These suppositories work quickly, usually resulting in a bowel movement within 15 to 60 minutes, and are generally considered less harsh than stimulants.
Choosing Based on Your Needs
The choice between a stimulant and an osmotic suppository should be based on the nature of the constipation and the required speed of action. For situations demanding the fastest possible result, a stimulant like bisacodyl may be preferable due to its direct and forceful action on colonic muscle activity. This type is often used for rapid evacuation before medical procedures or when all other methods have failed to produce a movement.
For mild or occasional constipation, or when a gentler approach is desired, a glycerin suppository is often the recommended first choice. Its dual action of softening the stool and providing lubrication is helpful if the primary issue is hard, dry fecal matter. Glycerin is also commonly used for children and other sensitive populations, though medical guidance should always be sought in these cases. If constipation is due to reduced muscle movement (motility), a stimulant may be more effective.
Proper Use and Expected Timeline
Using a suppository correctly maximizes its effectiveness and comfort, beginning with careful preparation. Always wash your hands before and after handling the medication, and unwrap the suppository just before insertion. If the suppository is too soft, briefly chilling it in the refrigerator or running it under cold water can make it easier to handle.
To insert the suppository, lie on your left side with your right knee bent toward your chest, which helps to align the rectum. The suppository should be lubricated with water or a water-based gel for smooth insertion; petroleum jelly should be avoided as it can prevent the suppository from dissolving. Gently insert the suppository, pointed end first, using your finger to push it past the anal sphincter, which is approximately one inch (2.5 centimeters) in adults.
After insertion, it is important to remain lying down or still for about 15 to 20 minutes to allow the product to dissolve and prevent it from being immediately expelled. Both bisacodyl and glycerin suppositories are designed to work quickly, typically within 15 to 60 minutes. If a bowel movement does not occur within one hour, or if you feel a strong urge but cannot pass the stool, you should not insert another suppository and should consult a healthcare professional.
When Suppositories Are Not Appropriate
Suppositories are intended solely for short-term, acute relief of constipation and should not be used for more than one week without medical supervision. Overuse can lead to a condition known as laxative dependence, where the bowel loses its normal function and cannot produce a bowel movement without the aid of medication. This is a risk with stimulant types, but can occur with any laxative when misused.
There are specific circumstances when suppositories should be avoided completely, as they may mask a more serious underlying health issue. You should not use a suppository if you are experiencing severe, unexplained abdominal pain, nausea, vomiting, or a sudden change in bowel habits lasting longer than two weeks. These symptoms could indicate an intestinal obstruction or another acute abdominal condition where laxatives are contraindicated. Additionally, anyone with recent rectal surgery, rectal bleeding, or severe hemorrhoids should speak with a doctor before using any rectal medication.