What suppository is recommended for internal hemorrhoids?

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From the Guidelines

For internal hemorrhoids, there is no clear evidence supporting the use of specific suppositories, but preparation H suppositories containing phenylephrine or hydrocortisone suppositories may be beneficial in reducing symptoms. When considering treatment options for internal hemorrhoids, it's essential to prioritize reducing inflammation, constricting blood vessels, and providing lubrication to ease discomfort.

  • Preparation H suppositories containing phenylephrine can help shrink swollen hemorrhoidal tissue by constricting blood vessels, as mentioned in various over-the-counter treatments 1.
  • Hydrocortisone suppositories can help reduce inflammation and itching, although long-term use of high-potency corticosteroid creams should be avoided due to potential deleterious effects 1. For use, insert one suppository rectally after a bowel movement, typically once or twice daily for up to 7 days.
  • Before insertion, remove the wrapper and moisten the suppository with water for easier application.
  • Lie on your side, insert the suppository into the rectum about 1 inch deep, and remain lying down for a few minutes to prevent it from coming out. It's crucial to note that data supporting the use of over-the-counter topical agents and suppositories are lacking, and their effectiveness may vary depending on individual cases 1. If symptoms persist beyond a week, or if you experience severe pain or bleeding, consult a healthcare provider as you may need prescription-strength medication or other treatments.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Treatment Options for Internal Hemorrhoids

The treatment of internal hemorrhoids can vary depending on the severity and grade of the hemorrhoids.

  • Medical management, such as stool softeners and topical over-the-counter preparations, is often the first line of treatment 2.
  • Dietary modifications, including increased fiber and water intake, and behavioral therapies, such as sitz baths, can also be effective in managing internal hemorrhoids 2.
  • Office-based procedures, such as rubber band ligation, can be used to treat grades I to III internal hemorrhoids, with a lower failure rate than infrared photocoagulation 2.

Suppository Use for Internal Hemorrhoids

There is no specific mention of suppository use for internal hemorrhoids in the provided studies.

  • However, topical over-the-counter preparations are mentioned as a part of medical management for internal hemorrhoids 2.
  • It is essential to consult a healthcare professional for proper diagnosis and treatment of internal hemorrhoids, as they can recommend the most suitable treatment options, including any necessary medications or procedures 3, 4, 2, 5.

Alternative Treatment Options

Other treatment options for internal hemorrhoids include:

  • Polidocanol sclerotherapy, which has been shown to have a higher therapeutic success rate compared to rubber band ligation in some studies 5.
  • Excisional hemorrhoidectomy, which is often reserved for recurrent or higher-grade disease, and can be performed using various techniques, including diathermic or ultrasonic cutting devices 3, 2.
  • Stapled hemorrhoidopexy, which can be used to elevate grade III or IV hemorrhoids to their normal anatomic position, but may have potential postoperative complications 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Hemorrhoids: Diagnosis and Treatment Options.

American family physician, 2018

Research

Treatment of hemorrhoids: A coloproctologist's view.

World journal of gastroenterology, 2015

Research

Clinical inquiries. Which treatments work best for hemorrhoids?

The Journal of family practice, 2009

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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