What suppository is recommended for internal hemorrhoids?

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Last updated: May 28, 2025View editorial policy

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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 may be considered as they can help shrink swollen hemorrhoid tissue by constricting blood vessels. When considering treatment options for internal hemorrhoids, it's essential to look at the available evidence and guidelines. According to the american gastroenterological association technical review on the diagnosis and treatment of hemorrhoids 1, over-the-counter topical agents and suppositories are commonly used, but data supporting their use are lacking. Some key points to consider when treating internal hemorrhoids include:

  • Increasing dietary fiber and avoiding straining at stool can help alleviate symptoms
  • Topical analgesics may bring symptomatic relief of local pain and itching
  • Corticosteroid creams may ameliorate local perianal inflammation, but long-term use of high-potency corticosteroid creams should be avoided
  • Oral micronized, purified flavonoid fraction (MPFF) has shown symptomatic improvement in some studies, but results are inconsistent when combined with fiber It's crucial to note that the evidence for specific suppositories is limited, and the best course of treatment may involve a combination of lifestyle changes, such as increased fiber intake and adequate hydration, and medical treatments. If symptoms persist or worsen, it's essential to consult a healthcare provider for further evaluation and guidance.

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 be divided into several options, including:

  • Medical management, such as stool softeners and topical over-the-counter preparations 2
  • Dietary modifications, including increased fiber and water intake 2
  • Behavioral therapies, such as sitz baths 2
  • Office-based treatments, including rubber band ligation and injection sclerotherapy 3, 2
  • Surgical options, including excisional hemorrhoidectomy and stapled hemorrhoidopexy 3, 2

Suppository Options

While the provided studies do not specifically mention suppository options for internal hemorrhoids, they do discuss various treatment methods. However, it is essential to note that suppositories can be used to relieve symptoms of internal hemorrhoids, such as pain and discomfort.

Comparison of Treatment Options

A systematic review and meta-analysis compared the efficacy of rubber band ligation and polidocanol sclerotherapy for the treatment of symptomatic grade I-III internal hemorrhoids 4. The results showed that polidocanol sclerotherapy may be associated with higher therapeutic success in patients with symptomatic grade I-III internal hemorrhoids. However, further evaluations in the form of randomized trials are required to determine the most effective treatment option.

Key Considerations

When choosing a treatment option for internal hemorrhoids, it is crucial to consider factors such as:

  • The grade of the hemorrhoid
  • The presence of symptoms, such as pain and bleeding
  • The patient's medical history and comorbidities
  • The patient's preference for treatment options 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

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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