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Suppositories and hemorrhoids

Hemorrhoids are swollen blood vessels in and around the anus and rectum. They can become enlarged and irritated, causing pain and discomfort.

Suppositories are a solid preparation of medicine meant to be inserted into the rectum, where they dissolve and are absorbed through the lining of the rectum. They’re most commonly a combination of an oil or cream and a medicine.

Over-the-counter (OTC) suppositories work best for mild hemorrhoid pain. Several types of suppositories exist, each has different medications for different results.

Some hemorrhoid suppositories can relieve swelling and burning. Others may relieve constipation that can worsen hemorrhoids. Prescription-strength versions of many OTC suppositories are also available.

Homemade hemorrhoid suppositories are an option, too. Herbal remedies, like witch hazel and coconut oil, can provide some relief for hemorrhoids. However, these suppositories won’t contain active medication to treat the swelling and pain.

Internal hemorrhoids occur inside the rectum, while external hemorrhoids occur under the skin around the anus.

External hemorrhoids frequently cause itching, irritation, and pain. Internal hemorrhoids can cause pain, too. However, they may not be as irritating or painful as external ones because the tissue lining the internal rectum has fewer nerve endings.

Creams, ointments, and pastes are commonly applied to external hemorrhoids for temporary relief. These OTC and prescription treatments can ease burning, itching, or mild pain.

Suppositories are better for internal hemorrhoids. The medicine is absorbed by the rectal tissue and can help all discomfort and pain caused by hemorrhoids. They can sometimes soothe the symptoms caused by external hemorrhoids as well.

Suppositories are typically used two to four times per day for a week. It’s better if you insert after a bowel movement so the effect can last longer.

External creams and ointments can be applied whenever you need relief. However, the relief isn’t as long-lasting as that of a suppository. That’s because a suppository breaks down more slowly, releasing medication over a longer period of time.

Both topicals and suppositories should only be used for a limited time to prevent possible complications.

Minor bleeding is common with hemorrhoids. If you’re seeing small amounts of bright red blood on tissue paper or on stool, that’s normal. It’s still safe to use a suppository. If, however, your stool is black, or you notice large amounts of blood in your stool, call your doctor.

It’s possible to insert a suppository on your own. You may also ask a family member for help until you get used to doing it.

To start, you will need the suppository and the applicator that comes with it, if one is available. You’ll also want to have soap and a sink nearby. Some people prefer to use a lubricating jelly to make inserting the medicine easier.

First, check that the suppository is firm. If the medicine is too warm, you may want to chill it in the fridge for a few minutes before inserting it. The cooling effect will also provide relief.

Empty your bowels if you can. The longer the medicine remains in place without being pushed out, the better.

Step 1

When you’re ready, remove lower garments, and tear off any wrappings on the suppository. Apply a bit of lubricating jelly to the end of the suppository. Don’t use a petroleum jelly-based option like Vaseline. It may prevent the suppository from melting.

Step 2

Stand beside a chair with one foot propped up. Or lie down on one side with your bottom leg straight and your top leg tucked toward your stomach. Relax your buttocks and take a deep breath.

Step 3

Insert the suppository into your rectum, the narrowed end going in first. Gently, but firmly, push the suppository into your body, making sure it’s at least one inch past the anal sphincter.

Step 4

Sit down or remaining lying down for at least 15 minutes. This allows the body’s heat to melt the suppository and the absorption process to begin.

Step 5

After 15 minutes has lapsed, dress, then throw away any wrappings. Wash your hands.

Tips for use

Try to avoid using the bathroom for at least an hour. This gives the medicine more time to work before it may be washed or wiped away by urine or a bowel movement.

If you’re using a suppository with a gauze insert, you will want to leave the gauze in place for at least an hour. After an hour, you can tug on the string to remove it from the rectum.

Several types of suppositories exist with different active ingredients. Here’s a table of OTC suppositories for comparison:

Type of medicineActive ingredientHow it helpsBrand names
vasoconstrictorsphenylephrine• shrinks blood vessel
• temporarily reduces swelling
Preparation H Hemorrhoidal Suppositories
analgesics and anestheticspramoxine• numbs nerves
• provides temporary relief from pain and discomfort
• may be combined with other medicine
Anusol Plus (20 mg praxomine)
protectivezinc oxide• forms a barrier to protect tissue from irritating contact Calmol

Shop for OTC suppository options online.

Most OTC suppositories are designed to be used for a brief period of time. If the treatments don’t ease or eliminate symptoms after one week, stop using the medicine and contact your doctor.

Your doctor may prescribe another treatment, including a prescription-strength suppository:

Type of medicineActive ingredientHow it helpsBrand names
steroidhydrocortisone• reduces itching and swellingAnucort-H

In addition to OTC and prescription medicated suppositories, you can make and use alternative suppositories. These are designed to provide comfort and relief, but they don’t have active ingredients to reduce swelling, irritation, and pain.

Coconut oil suppositories can be used with hemorrhoids. These are formed by freezing coconut oil in small cylinders. When you’re ready to insert the suppository, you can remove one and quickly insert it into the rectum.

The cooled oil provides instant relief. Coconut oil may also provide prolonged relief due to potential anti-inflammatory properties.

You can also make your own laxative suppositories. Combine mineral oil and a solid oil, such as coconut oil or cocoa butter. Freeze into cylinders, and remove one when you’re ready to insert.

Mineral oil is absorbed by the body and can help ease stool through your intestines.

Don’t use OTC hemorrhoid medication for more than one week without a doctor’s permission. The medicines in the suppositories and other medicines can irritate the delicate tissues in and around the rectum. They can also cause inflammation, skin rash, and skin thinning.

Don’t use prescription hemorrhoid medication more frequently than your doctor prescribed. If the medicine isn’t providing enough relief, talk with your doctor about other options.

Suppositories are one treatment option for hemorrhoids. They can best provide relief from discomfort and pain caused by internal hemorrhoids. They’re a good option when ointments, creams, or medicated wipes don’t provide enough relief.

OTC suppositories should only be used for a short period of time. They can cause side effects like irritation and rash if used too frequently.

Talk with your doctor if OTC options don’t provide relief and you need to consider another option.