From the Guidelines
Rectal suppositories such as hydrocortisone, glycerin, witch hazel, and Preparation H are available for treating internal hemorrhoids, but their use should be combined with increased fiber intake, adequate hydration, and avoiding straining during bowel movements for best results. Several options are available, including:
- Hydrocortisone suppositories (typically 25mg, used up to 3 times daily for 1-2 weeks), which reduce inflammation and itching 1
- Glycerin suppositories, which work as mild laxatives to soften stool and reduce straining
- Witch hazel suppositories, which provide cooling relief and help shrink swollen tissue
- Preparation H suppositories, which contain phenylephrine and constrict blood vessels to reduce swelling For more severe cases, prescription options like anesthetic suppositories containing benzocaine or lidocaine can provide pain relief 1. It is essential to note that while these suppositories can provide relief, they should not be used as a replacement for lifestyle modifications, such as increasing fiber intake and avoiding straining during bowel movements. According to the American Gastroenterological Association, medical therapy is most appropriate for first-degree hemorrhoids, and the cornerstone of medical therapy is adequate intake of fiber and water 1. Additionally, topical corticosteroids and analgesics are useful for managing perianal skin irritation, but prolonged use of potent corticosteroid preparations may be harmful and should be avoided 1.
From the Research
Available Treatments for Internal Hemorrhoids
- Medical management, including stool softeners and topical over-the-counter preparations 2
- Dietary modifications, such as increased fiber and water intake 2
- Behavioral therapies, including sitz baths 2
- Office-based treatments, including rubber band ligation for grades I to III internal hemorrhoids 2, 3, 4
- Polidocanol sclerotherapy, a relatively new approach for treating symptomatic grade I-III internal hemorrhoids 3, 4
- Endoscopic polidocanol foam sclerobanding (EFSB), a novel outpatient procedure for treating internal hemorrhoids 3
Rectal Suppositories for Internal Hemorrhoids
- Although the provided studies do not specifically mention rectal suppositories for internal hemorrhoids, topical nitroglycerine is mentioned as a medical management option 2
- It can be inferred that rectal suppositories containing ingredients like nitroglycerine or other topical anesthetics may be available for internal hemorrhoids, but further research is needed to confirm this