(aka hemroid suppositories aka pile suppositories)

There are many medications that offer to treat hemorrhoids via hemorrhoids suppositories. But what are hemorrhoids suppositories? and What can hemorrhoids suppositories do that a pill or cream can’t?

This article will aim to answer those questions, and even have a look at some of the specifics of hemorrhoids suppositories.

What are Suppositories?

Suppositories (singular ‘suppository’) are medications that are taken either anally, vaginally or via the urethra (that’s the opening through which you pass urine).

They usually have a shape rather like a rounded bullet, and they are made of a binding substance that will melt at body temperature but stay solid at room temperature, and the active medication is mixed through this or dissolved in it.

They are usually rather waxy to the touch.

Different brands will use different binding agents, and it’s worth looking on the label to see what each medication uses – you may be allergic to some for example, or find extra relief with a particular type.

The name has a Latin derivation, and roughly means ‘to put under’ (from ‘suppositus’), which is a very genteel way of describing how you apply them.

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A little History on hemorrhoids suppositories

There’s a treatise by Hippocrates, one of the founding fathers of Western medicine, on the treatment of hemorrhoids.

Much of it boils down to burning them away with hot pokers, or shearing them off with specially made blades, and all sounds pretty uncomfortable – there’s a bit where he says that the patient should be encouraged to scream, as that will make the rectum and therefore the piles stick out even further, making them easier to snip off.

But he goes on to explain that, seven days after the operation, when you’ve stopped applying the paste of lentils and tares that has been encouraging local healing, you should prepare a flap of sponge bound about with cloth.

The tip of this cloth is smeared with honey and a preparation to promote strong healing of the skin, and then the whole lot pushed up the anus with one finger, afterwards packing in some sheep’s wool to stop it coming out again (and also to give a little string to pull it out when it’s done).

Most suppositories these days aren’t meant to be reusable like this one was, but the principle is pretty much the same – they’ve been around for a long time.

Why are hemorrhoids suppositories shaped like a bullet?

Basically, it makes them much easier to insert.

You use a suppository by pushing it up past the anal sphincter (in the case of anal suppositories), so it makes sense to avoid anything with sharp edges!

They usually have a flat end to make it easier to push against them. Once they are inside the rectum, natural muscle action will grip and pull the suppository further inside.

Oddly, someone in the nineties did some research into the best way to insert a suppository.

Their results were challenged, as they didn’t necessarily have a large enough survey group to be sure of their findings, but they found that if you insert a suppository flat end first, it’s easier for the muscles of the rectum to grip it and pull it in.

There’s certainly no harm in doing it that way, other than a little additional discomfort of getting past the flat edges.

How do you insert hemorrhoids suppositories?

There should be clear instructions with the medication explaining how to insert hemorrhoids suppositories, or your doctor should have given you some advice.

A couple of guidelines, from Donald, for inserting suppository:

• 1.. If you are inserting the suppository yourself, one way is to squat down and then gently, but quickly insert it. Another way for to insert the suppository is to lay on one side, then pull the upper leg toward the chest, then gently and quickly insert the suppository.
• 2.. If another person you trust is inserting the suppository, lay on one side, pull both knees up toward the chest, relax. This should expose the anal hole sufficiently for the other person to insert the suppository.

Assuming we’re talking about an anal suppository (as all hemorrhoid suppositories will be) you simply push it gently into the anus until it’s taken up into the body by a natural muscle reflex.

If it comes back out, you need to push it in further than you did until that doesn’t happen.

As indicated above, it doesn’t really matter which way up you push it, but the rounded end is probably the most comfortable way to do it.

Inserting hemorrhoids suppositories may feel a little cold or unusual going up, but it will quickly warm up once inside and you’ll quickly forget about it as it dissolves.

You may find it useful to warm it a little with your fingers before using a hemorrhoids suppository, but don’t get it too warm or it will melt!

Similarly, if there are any rough edges or ridges on the hemorrhoids suppositories, usually left over from the way they are manufactured, it’s fine to rub these down before insertion.

It’s worth mentioning that a lot of people find hemorrhoids suppositories embarrassing to use or to talk about, simply because of where you put them.

A friend of mine, when I was a teenager, had to take a course of suppositories to provide pain relief in the wake of a bout of kidney stones, and he took a lot of grief from boys at school – although he did volunteer the information to a fairly unsympathetic audience in the first place.

It’s fine to be discreet about using hemorrhoids suppositories, but you shouldn’t feel ashamed or embarrassed about it – it’s a good way of getting effective medication directly to where it is needed, and has been around for a very long time.

Do make sure you clean your hands before and after using a hemorrhoids suppository, though, and it may help you to take a warm bath beforehand, as this helps the anal sphincter to relax, as well as probably soothing any piles pain you are experiencing at the same time.

When should I use hemorrhoids suppositories?

Hemorrhoids Suppositories are NOT for External Hemorrhoids

If you have external hemorrhoids, that’s ones that occur around the anal margin and are entirely outside the body, it’s fine to treat them with a topical cream. Topical creams must not be used on internal hemorrhoids, though. This is because of the difference in the skin that covers the two kinds of hemorrhoid.

External hemorrhoids are covered by external skin, and external skin is pretty tough stuff to get drugs across. You need to apply a cream that has quite high doses of the medication, and that medication needs to be in a form that is fat-soluble, because skin is water-proof, so normal solutions will just run off.

It also takes some time before the medicine penetrates through the skin to the blood vessels (and thus the hemorrhoids) under it – you get a time delay effect, essentially, so a large dose on the outside turns into a slow, gradual dose by the time it’s been absorbed.

Hemorrhoids Suppositories are for Internal Hemorrhoids

Internal hemorrhoids are covered by the same kind of mucus membrane that lines the surface of the intestines.

It’s a much thinner, frailer tissue, and it is designed for fluids to pass across it, as one of the key things that the lower intestine does is reabsorb water into the body.

This makes it much easier to get a drug into the bloodstream through these membranes, and an external cream, if applied here, would result is a huge dose getting into the blood supply all at once, far more than you need to achieve your goals.

But in theory, any kind of cream that you can buy to apply to your hemorrhoids is likely to be available to get as a suppository, and if your internal hemorrhoids aren’t at an advanced stage (they aren’t prolapsing and they haven’t thrombosed), then you may find a lot of helpful relief from the hemorrhoids suppositories treatment.

What do hemorrhoids suppositories do for my hemorrhoids?

There are three basic kinds of hemorrhoids suppositories that you may either buy over the counter or be prescribed by your doctor.

I’m not going to list all the many different brands of hemorrhoids suppositories for two reasons – firstly, there are far too many of them to make a helpful list, and secondly, different medications are licensed for use in different countries. The hemorrhoids suppositories that are available in the UK will be different to those around in Australia or the USA, for example.

Seeing as hemorrhoids suppositories all have more or less the same way of working, though, it is still useful to have a brief look at the types you may use:

• Vasoconstrictors, which work by causing the local blood vessels to tighten up. This reduces hemorrhoids inflammation andhemorrhoids bleeding, and, over time, will reduce the size of piles. These can have interactions with other drugs, especially those used in the treatment of high blood pressure, so it’s well worth checking with a doctor before using these hemorrhoids suppositories.
• Analgesics and anaesthetics, which reduce and remove pain. Many painkillers can be applied locally to internal hemorrhoids via hemorrhoids suppositories, and will quickly and effectively relieve the pain of your hemorrhoids.
• Laxatives, which don’t work directly on the piles but help if you’re having problems with constipation, a key cause of hemorrhoids. Some of these work directly on the bowel wall, stimulating extra muscle action, some work more like lubricants. Either way, be careful and know exactly what you are using, as the use of laxatives can have long term effects on the way your bowel works.

Some hemorrhoids suppositories may have combinations of these effects, or may achieve the same ends using herbal ingredients, but either way you should make sure you know exactly what it is you are using.

Either ask you doctor, read the labels and instructions that come with the hemorrhoids suppositories carefully, or talk to your pharmacist when buying hemorrhoids suppositories before using them. Never assume something that worked for someone else is right for you, and do not use hemorrhoids suppositories that have been prescribed for someone else!

Summary of hemorrhoids suppositories

Hemorrhoids suppositories are a pretty old, tried and tested mode of getting drugs into the body, and hemorrhoids suppositories can be used safely and effectively to provide direct relief from the pain and discomfort of piles provided you use a bit of common sense in finding the right hemorrhoids suppositories for you.

Research and write by James Hogg,(BSc Oxon, MBBS & BA Hons), Doctor of Medicine, minor editing by Donald Urquhart.

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