Hemorrhoid Treatment: Questions About Suppository Use

Hemorrhoid medication consultation

Hello, Vice Dean Chen! A few days ago, I noticed blood when wiping after using the bathroom, so I quickly made an appointment to see a doctor who diagnosed me with internal hemorrhoids.
I was prescribed suppositories for hemorrhoids.
I would like to ask if I should continue using the remaining suppositories if I am currently not experiencing any bleeding after bowel movements.
Also, I find that after inserting the suppository, I often feel the urge to have a bowel movement, but I have been able to hold it in.
Will the suppository melt and come out? Last night, I inserted one before bed, and in the middle of the night, I felt some gas.
This morning, when I checked around my anus and looked at my underwear, it was oily and watery with a strong odor.
I believe this is the smell from the suppository breaking down inside me.
Will this leakage irritate my skin? Thank you for your hard work!

Jia Ying, 30~39 year old female. Ask Date: 2023/09/17

Dr. Chen Shidian reply Gastroenterology and Hepatology

After three additional days without bleeding, it should be safe to discontinue and observe.

Reply Date: 2023/09/17

More Info

When it comes to understanding hemorrhoid treatment, particularly the use of suppositories, it's essential to grasp both the purpose of the medication and how to use it effectively. Hemorrhoids, especially internal ones, can cause discomfort, bleeding, and other symptoms that necessitate treatment. Suppositories are commonly prescribed to provide localized relief and promote healing.

Use of Suppositories for Hemorrhoids
1. Continuing Treatment: If you've been prescribed a suppository for your internal hemorrhoids and you notice that you are no longer experiencing bleeding after bowel movements, it is still advisable to continue using the suppository as directed by your healthcare provider. The medication is designed to reduce inflammation, alleviate pain, and promote healing of the affected area. Stopping treatment prematurely may lead to a recurrence of symptoms.

2. Feeling the Urge to Defecate: It is common to feel an urge to have a bowel movement after inserting a suppository. This sensation can occur because the suppository may stimulate the rectal area. However, it is important to resist the urge to defecate immediately after insertion. Allow the suppository time to dissolve and take effect, which typically occurs within 15 to 30 minutes.
3. Suppository Dissolution and Leakage: After the suppository dissolves, some of the medication may indeed leak out, especially if you have a bowel movement shortly after insertion. This is normal. The active ingredients are designed to be absorbed by the rectal mucosa, but some may escape. If you notice a significant amount of leakage, it may indicate that the suppository was not retained long enough for optimal absorption.

4. Odor and Skin Irritation: The odor you described could be due to the ingredients in the suppository, especially if it contains certain oils or other compounds. If the suppository is leaking and causing irritation to the skin around the anus, it is crucial to keep the area clean and dry. You can gently wash the area with mild soap and water, and pat it dry. If irritation persists, consult your healthcare provider for advice on how to manage it or whether a different formulation might be more suitable.

General Advice
- Follow Instructions: Always follow the instructions provided by your healthcare provider regarding the dosage and frequency of suppository use. If you have any doubts or experience unusual symptoms, do not hesitate to reach out to your doctor.

- Diet and Hydration: Alongside the use of suppositories, consider dietary changes that can help manage hemorrhoids. Increasing fiber intake and staying hydrated can promote regular bowel movements, reducing the strain that can exacerbate hemorrhoids.

- Monitor Symptoms: Keep track of your symptoms. If you notice any new symptoms, such as increased pain, persistent bleeding, or any signs of infection (like fever or increased swelling), contact your healthcare provider immediately.

In summary, while it may be tempting to stop using the suppository if you no longer see blood, continuing the treatment as prescribed is important for healing. The sensations you are experiencing are common, and with proper care, you can minimize any discomfort. Always consult your healthcare provider for personalized advice and treatment options tailored to your specific situation.

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