From the Guidelines
Hemorrhoid suppositories are not recommended as a first-line treatment for hemorrhoids, as the evidence supporting their use is lacking 1. Instead, the most recent and highest quality study suggests that non-operative management, including dietary and lifestyle changes, is the preferred initial approach for patients with complicated hemorrhoids 1. The use of flavonoids may also be considered to relieve symptoms, although the recommendation is weak and based on moderate quality evidence 1. When it comes to suppositories, there is no strong evidence to support their use, and other treatments such as topical muscle relaxants or oral medications may be more effective in certain cases 1. However, for mild to moderate hemorrhoids, over-the-counter options like Preparation H, Tucks, or generic hydrocortisone suppositories (0.5-1%) may still be used, inserted rectally after a bowel movement, typically once or twice daily for 7-10 days. Some key points to consider when using suppositories include:
- Washing hands thoroughly before and after use
- Removing the wrapper and refrigerating the suppository if it feels too soft
- Inserting the suppository into the rectum about 1 inch deep using a finger
- Remaining lying down for 15-20 minutes to prevent the suppository from coming out
- Maintaining good hygiene, increasing fiber intake, drinking plenty of water, and avoiding straining during bowel movements to help prevent hemorrhoid recurrence. It's essential to note that the evidence for the use of suppositories in hemorrhoid treatment is limited, and other treatments may be more effective in certain cases 1.
From the Research
Suppository for Hemorrhoids
- A suppository called "The Rectal Rocket" has been designed to treat internal and external hemorrhoids, as well as anal fissures, by delivering lidocaine and hydrocortisone directly to the site of inflammation 2.
- The treatment of hemorrhoids can be divided into non-operative measures, such as medication and rubber band ligation, and surgical options, such as excisional hemorrhoidectomy, which is indicated for high-graded internal hemorrhoids or when non-operative approaches have failed 3.
- A study on the use of lidocaine 5% ointment for the treatment of grade 1,2, and 3 hemorrhoids, as well as anal fissures and fistulas, showed significant symptom improvement in 28 out of 30 patients, with no adverse effects reported 4.
- The modern management of hemorrhoidal disease involves nonoperative and operative techniques, with surgical hemorrhoidectomy usually reserved for patients who are refractory to or unable to tolerate office procedures 5.
- The combination of tribenoside and lidocaine, delivered as a suppository or rectal cream, has been shown to be effective and safe in relieving symptoms caused by hemorrhoids, and can be recommended as a fast and effective option for the local treatment of low-grade hemorrhoids 6.
Types of Hemorrhoids
- Hemorrhoids can be classified into three types: internal, external, and internal-external (mixed) 2.
- Internal hemorrhoids can be further divided into low-graded and high-graded, with low-graded hemorrhoids being effectively treated with medication and non-operative measures, and high-graded hemorrhoids requiring surgical intervention 3.
Treatment Options
- Non-operative measures for the treatment of hemorrhoids include medication, rubber band ligation, and injection sclerotherapy 3.
- Surgical options for the treatment of hemorrhoids include excisional hemorrhoidectomy, Ligasure hemorrhoidectomy, doppler-guided hemorrhoidal artery ligation, and stapled hemorrhoidopexy 3.
- The use of suppositories, such as "The Rectal Rocket" and tribenoside+lidocaine, can be an effective and safe option for the local treatment of hemorrhoids 2, 6.