Suppositories are a common form of drug release: they provide a quick effect and have fewer contraindications. They are widely used in the treatment of diseases of the intestines and reproductive system; anti-inflammatory rectal suppositories can combat a wide range of genitourinary problems. What types of anti-inflammatory rectal suppositories are there?
Features and benefits of candles
Anti-inflammatory rectal suppositories: Duspatalin
Suppositories (another name is suppositories) are a form of drug release; they consist of the main active ingredient and auxiliary components, which are shaped like a candle or a cone. They retain their shape at room temperature and begin to soften and melt when heated, providing a gradual introduction of the active drug substance into the body. They differ from tablets and injection medications in several important advantages:
- Suppositories begin to act faster. 50% of the medicine enters the blood within half an hour, 100% within an hour. In this case, the active substance enters directly into the rectum and bypasses the liver, so the components will not be destroyed.
- Rectal suppositories have a local rather than a general effect, that is, the medicinal substance appears where it is really needed. This allows you to get a faster and more noticeable effect even with a small dosage.
- Unlike injections, they create minimal inconvenience for the patient. They do not require someone else's help to insert them, and they do not cause pain. All this makes this form of drug release convenient and effective in the treatment of various diseases.
In medical practice, anti-inflammatory, wound-healing, thrombolytic suppositories are most widely used; they are actively used in the treatment of hemorrhoids, fissures in the rectum and other problems.
Clinical picture
In world practice, the severity of an attack (exacerbation) of UC is assessed using the disease activity index. There are several indices of UC activity (Rakhmilevich, Mayo, Oxford index, Swedish index, Truelov and Witts severity rating system, Montreal classification). There is no consensus among experts regarding the preferability of using any particular index, since all of them are not sufficiently validated. Currently, there is a tendency to additionally use the level of C-reactive protein (CRP) to assess activity, which is reflected in the European consensus (ECCO-consensus) on the diagnosis and treatment of UC. This document discusses all indices, with experts making the following conclusion: currently, to assess the severity of UC, it is necessary to take into account all parameters of the disease - clinical, laboratory, instrumental and histological [4]. The Expert Council of the Russian Group for the Study of Inflammatory Bowel Diseases (IBD) proposes a set of criteria that includes easily determined parameters for exacerbation of UC, including the level of CRP. This complex is broader than what is usually used when assessing activity indices, and therefore is more informative. The set of assessed disease parameters, to a greater extent than any indices (section 2.2.2.), corresponds to the expert assessment of the ECCO-consensus and takes into account both clinical and laboratory manifestations of the disease. This scoring system is an expanded modification of the UC severity criteria proposed by Truelov and Witts [6]. In accordance with the severity of clinical and laboratory symptoms, mild, moderate and severe UC are distinguished (see table).
The clinical picture of UC includes several groups of symptoms [1]:
• intestinal (blood in the stool, diarrhea, tenesmus);
• systemic extraintestinal autoimmune manifestations (arthropathy, skin lesions, aphthous stomatitis, eye lesions, primary sclerosing cholangitis, etc.);
• endotoxemia syndrome (general intoxication, febrile fever, tachycardia, anemia, increased ESR, leukocytosis with a shift in the leukocyte formula to immature forms, toxic granularity of neutrophils, increased levels of acute-phase proteins - CRP, seromucoid, fibrinogen);
• metabolic disorders (weight loss, dehydration, hypoproteinemia, hypoalbuminemia, hypokalemia and other electrolyte disturbances).
Anti-inflammatory suppositories for intestinal diseases
Anti-inflammatory rectal suppositories for the treatment of hemorrhoids
The main active component of anti-inflammatory suppositories are broad-spectrum antibacterial drugs. They allow you to destroy pathogens and allow you to achieve good results in treatment. For colpitis and other inflammatory processes in the intestines, the following types of suppositories can be prescribed:
- Hexicon. This is an anti-inflammatory drug, the active component of which is chlorhexidine bigluconate, treatment takes 7-10 days. The dosage is determined by the doctor, usually it is 1 suppository per day.
- Polygynax is a drug that includes several active components: neomycin, nystatin, polymyxin B, the course of treatment can take up to 2 weeks, one suppository is prescribed in the morning and in the evening.
- Meratin-combi is also a complex drug; in addition to the above components, it contains prednisolone. The course of treatment is 10 days, the standard dosage is 1 suppository once a day.
- Mikozhinax is a drug whose active ingredients are metronidazole, chloramphenicol, and dexamethasone. Treatment takes up to 10 days, dosage – 1-2 suppositories per day.
- Betadine is an anti-inflammatory drug whose active components include iodine. The course of treatment reaches 12 days, dosage – 1-2 suppositories per day.
These are just some of the drugs used for inflammatory processes in the intestines. All of the listed remedies have a number of contraindications, so they are selected individually by a specialist. The dosage depends on the patient’s age and many other parameters, so it should also be selected only by the attending physician.
Suppositories for the treatment of diseases of the reproductive system
Anti-inflammatory rectal suppositories: Voltaren
For andexitis, endometritis and other inflammatory processes in the organs of the reproductive system, the doctor will prescribe antibacterial drugs; they may additionally have an antipyretic and analgesic effect. Most often, they serve as an addition to the main course of antibiotic treatment: the local effect of suppositories enhances the effect of the main antibiotic therapy and allows for a better effect.
The analgesic effect is achieved due to the fact that they suppress the synthesis of prostaglandins, which provoke pain. For diseases of the female reproductive organs, the following anti-inflammatory suppositories can be prescribed:
- Voltaren. A complex action drug, standard dosage – one suppository in the morning and evening. This is a non-steroidal anti-inflammatory drug, the main active ingredient is diclofenac.
- Diclofenac. Rectal suppositories with analgesic, antipyretic and anti-inflammatory effects. The standard dosage is 1 suppository per day, the exact dose is determined by the doctor.
- Flamax - suppositories with a predominantly analgesic and anti-inflammatory effect, the active substance is ketoprofen. The course of treatment is 7 days, the medicine is taken once a day.
- Movalis is a drug whose active ingredient is myeloxicam. It is prescribed once a day; the suppository should be used in the evening. The course of treatment takes 7 days.
When treating gynecological problems, the listed drugs can be prescribed both rectally and intravaginally - this allows for a better local effect, relieves the patient of pain and speeds up recovery. Fluomizin and Terzhinan suppositories are most often prescribed intravaginally; the course of treatment lasts up to 7 days.
Treatment of ulcerative colitis
The goal of treatment for ulcerative colitis (UC) is to reduce the inflammation that causes symptoms of the disease. If the course is favorable, it can lead not only to relief of symptoms, but also to long-term remission. Treatment for ulcerative colitis usually involves drug therapy, but in some cases surgery is required.
Doctors use several groups of drugs that reduce inflammation through different mechanisms of action. Sometimes drugs that work well for some patients may not work at all for others. Therefore, it may take some time to find the medicine that will help you. In addition, because some drugs have serious side effects, it is necessary to weigh the benefits and risks of any treatment.
Anti-inflammatory drugs.
Anti-inflammatory drugs are often the first step in treating inflammatory bowel disease. They include:
Sulfasalazine . Although this drug is not always effective in treating Crohn's disease, it may help treat other inflammatory diseases of the colon. It has a number of side effects, including nausea, vomiting, heartburn and headache. Do not take this drug if you are allergic to drugs that contain sulfur.
Mesalamine . This drug is generally better tolerated by patients and has fewer side effects than sulfasalazine, but can cause nausea, vomiting, heartburn, diarrhea and headache. It is taken in tablet form or administered rectally (into the rectum) in the form of enemas or suppositories, depending on which part of the large intestine is affected. Mesalamine is generally effective in 90 percent of people with mild ulcerative colitis. Patients with proctitis tend to respond better to combination therapy with mesalamine tablets and suppositories. For left-sided colitis of mild or moderate severity, the combination of taking mesalamine tablets and mesalamine enemas is more effective than using each of these methods separately.
Corticosteroids. Hormones - Corticosteroids can reduce inflammation anywhere in your body, but they have many side effects, including excessive facial hair growth, night sweats, insomnia and hyperactivity. More serious side effects include: high blood pressure, type 2 diabetes, osteoporosis, bone fractures, cataracts, and increased susceptibility to infections. Long-term use of corticosteroids in children may slow their growth. Doctors usually use corticosteroids only if you have severe bowel disease that doesn't respond to other treatments.
Corticosteroids are not suitable for long-term use. But, they can be used for short courses (three to four months) to reduce symptoms and achieve remission. Corticosteroids may also be used together with immunosuppressant medications. Corticosteroids help achieve remission of the disease, while immunosuppressants help maintain it for a long time. Sometimes a doctor may prescribe steroids for rectal use (into the rectum), suppositories, or enemas if the lower colon or rectum is affected. They are also intended for short-term use only.
Immunosuppressants.
They also reduce inflammation, but indirectly through the immune system. When the immune response is suppressed, inflammation also decreases. Immunosuppressants include:
Azathioprine (Imuran) and mercaptopurine (Purinethol). Since the first effects of their use may appear only after two or three months from the start of therapy, they are often prescribed in combination with glucocorticosteroid hormones, which begin to act much faster.
If you are taking any of these drugs, you should strictly follow your doctor's instructions and have regular blood tests to check for possible side effects. Side effects may include: allergic reactions, bone marrow suppression, infection, liver and pancreas inflammation. The risk of developing cancer in the future also increases slightly. If you are taking any of these medications, you should strictly follow your doctor's instructions and have regular blood tests to help detect possible side effects. If you have had cancer before, you should tell your doctor before starting treatment with these drugs.
Cyclosporine (Sandimmune, Neoral). This potent drug is often used in patients with severe ulcerative colitis who have not responded to other therapies or who are candidates for surgical treatment. Thanks to the use of Sandimmune, in such patients, surgery can be delayed until the patient is prepared for surgery. In other cases, sandimmune is used for a short period to wait for the effect of less toxic drugs that begin to act later than sandimmune. Cyclosporine “works” starting from one to two weeks from the start of therapy. It is very effective, but there may be serious side effects with its use, such as impaired kidney and liver function, high blood pressure, seizures, severe infections and an increased risk of cancer.
Infliximab (Remicade). This drug is for adults and children with moderate to severe disease who do not respond to or cannot tolerate other treatments. It works by neutralizing a protein produced by the immune system known as tumor necrosis factor (TNF). Infliximab finds TNF in the blood and neutralizes it before the protein causes inflammation in the gastrointestinal tract.
Some patients with heart failure, multiple sclerosis, or cancer cannot take infliximab and other derivatives of this class (adalimumab and certolizumab pegol). Talk to your doctor about the potential risks of infliximab therapy. Using these drugs may pose a risk of contracting tuberculosis and other serious infections because they suppress the overall immune system. If you have an active infection, you should not take these medications. You must have a TB skin test (Mantoux test) and a chest x-ray before you start taking infliximab.
Additionally, because infliximab contains mouse protein, it may cause serious allergic reactions in some people. This reaction may occur several days or weeks after starting treatment. Infliximab is often used as long-term therapy, although its effectiveness may decrease over time.
Nicotine patches. It has been noted that nicotine patches (the same ones used when a person quits smoking) may provide some people with short-term relief from a mild flare-up of ulcerative colitis. How this happens is still not entirely clear, and there is currently no evidence that the patches work better than other treatments. What is clear is that the overall health risks of smoking far outweigh any potential benefits from nicotine. So don't start smoking hoping to cure your ulcerative colitis! Before starting treatment with nicotine patches, you should consult your doctor.
Other medicines.
In addition to medications that reduce the inflammatory response in the intestinal wall, some medications may help relieve symptoms. Depending on the severity of your ulcerative colitis, your doctor may recommend one or more of the following:
antibiotics. For patients with ulcerative colitis who develop a fever, the doctor may prescribe a course of antibiotics to fight the infection.
antidiarrheal drugs (stool hardeners). The use of antidiarrheals should be done with caution and only after consultation with a doctor, as they increase the risk of toxic megacolon (acute dilatation and loss of tone of the colon), a life-threatening inflammation of the large intestine . To treat severe diarrhea, your doctor may prescribe loperamide (Imodium).
painkillers. For moderate pain, your doctor may recommend acetaminophen (Tylenol) and other pain relievers. Avoid taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen or naproxen. There is a possibility that they may worsen your illness.
iron supplements. If you have chronic intestinal bleeding, iron deficiency anemia may develop over time. Taking iron supplements will help maintain normal blood iron levels and eliminate iron deficiency anemia after intestinal bleeding has stopped.
Surgical treatment of nonspecific ulcerative colitis.
If diet, lifestyle changes, medications, or other treatments do not improve the disease or reduce symptoms, your doctor may recommend surgery to remove the part of the digestive tract damaged by inflammation. About 25-40% of patients with ulcerative colitis will ever require surgery.
Surgical treatment leads to the disappearance of ulcerative colitis. But such treatment usually means removing the entire colon and rectum (proctocolectomy) and creating a permanent or temporary ileostomy. An ileostomy is the creation of an opening in the abdominal wall to allow the remaining small intestine to drain out. Through the ileostomy, stool is collected in a special sealed bag. In the subsequent second stage, it is possible to perform an ileoanal anastomosis (the lower end of the small intestine is connected to the anus), this operation eliminates the need to wear a sealed bag to remove feces. Instead, the surgeon uses the cecum and part of the small intestine to create a pocket to collect stool, which connects to the anus. This allows stool to pass through a natural opening, although stools may be more frequent, soft, or watery because water is mostly absorbed in the large intestine that has been surgically removed.
Diet for UC.
It has not been conclusively proven that there is a clear connection between the foods you eat and the incidence of inflammatory bowel disease. But certain foods and drinks can make symptoms worse, especially during a flare-up. Try keeping a food diary to keep track of what you eat as well as how you feel. If you find that certain foods make your symptoms worse, you can try eliminating them from your diet. Here are some tips that may help you:
Limiting the consumption of certain foods. Like many people with inflammatory bowel disease, you may find that symptoms such as diarrhea, abdominal pain and bloating improve when you limit or eliminate your dairy intake. You may be lactose intolerant, a condition where your body cannot digest the milk sugar (lactose) found in dairy products. If this is the case, then you should limit your consumption of dairy products and take enzyme preparations with lactase (an enzyme that breaks down lactose) with meals. You may need to completely eliminate dairy products from your diet. In such cases, your dietitian will help you create a healthy, low-lactose diet. Keep in mind that when eliminating dairy products from your diet, you will need to use dietary supplements as sources of calcium.
Alimentary fiber. For most people, high-fiber foods such as fresh fruits, vegetables and whole grains are the foundation of a healthy diet. But if you have inflammatory bowel disease, consuming too much fiber can lead to diarrhea (loose stools), pain, and bloating. If eating raw fruits and vegetables gives you trouble, try steaming, baking or sautéing them. Legumes, nuts, cabbage, seeds, whole grains and popcorn are also poorly tolerated. Consult your doctor to adjust your diet.
"Prohibited" products. Eliminate all foods from your diet that may aggravate your symptoms. These may include "gas-producing" foods such as beans, cabbage (any kind), raw fruit juices and fruits - especially citrus fruits, spicy foods, corn, alcohol, chocolate and drinks containing caffeine and soda (sparkling water).
Eat small meals. You may feel better if you eat five or six small meals a day rather than two or three large meals.
Drink plenty of fluids. Try drinking more fluids per day, preferably water. Alcohol and caffeinated drinks stimulate your bowel movements and can increase diarrhea, while carbonated drinks often lead to bloating.
Multivitamins. Because ulcerative colitis can impair the ability to absorb nutrients and due to dietary restrictions, multivitamin and mineral supplements are often necessary. Check with your doctor before taking any vitamins or supplements.
Consultation with a nutritionist. If you begin to lose weight, or your diet has become very restrictive, you need to consult a nutritionist.
Stress management.
Although stress does not cause nonspecific ulcerative colitis, it can aggravate the disease and cause a flare-up. Stressful situations can range from minor annoyances to psychological shocks such as the loss of a job or the death of a loved one. When a person experiences stress, the digestion process is disrupted. The stomach empties more slowly and secretes more gastric juice. Stress can also speed up or slow down the passage of food through the intestines, as well as cause changes in the tissue of the intestinal wall itself. While it's not always possible to avoid stress, you can learn ways to help manage it. Some of them are given below:
Physical exercise. Even moderate exercise can help reduce stress, relieve depression and normalize bowel function. Talk to your doctor about exercise therapy that's right for you.
Regular relaxation and breathing exercises. One way to combat stress is to relax regularly. You can take yoga classes, meditation classes, or use books or CDs at home.
Pregnancy with nonspecific ulcerative colitis.
Women with ulcerative colitis, as a rule, successfully carry a pregnancy to term, especially if the disease is in remission throughout pregnancy. There is a slight increase in the risk of preterm birth and low birth weight. Some medications cannot be used to treat ulcerative colitis during pregnancy, especially during the first trimester. The effects of some drugs may continue even after you stop using them. As you prepare for pregnancy, talk to your doctor about the best way to prevent the condition from getting worse. The risk of developing ulcerative colitis in a child is thought to be less than 5 percent unless your partner has ulcerative colitis.
Alternative medicine.
Many people with ulcerative colitis or Crohn's disease have used some types of alternative therapy, such as: herbal treatments and the use of nutritional supplements; probiotics (preparations that contain live microorganisms that are representatives of the normal human microflora); fish fat; aloe vera; acupuncture.
Side effects and ineffectiveness of conventional therapy are the main reason for seeking an alternative approach. Most alternative treatments are not approved by the FDA. Manufacturers may claim that their drugs are safe and effective, but this has not been proven by serious research. In some cases, this means that you may be spending money on something that won't really benefit you. For example, studies on fish oil and probiotics for the treatment of ulcerative colitis have not noted any improvement in the course of the disease. Moreover, even medicinal herbs and supplements can have side effects and interact dangerously with each other. If you decide to try any herbal supplements, tell your doctor. Unlike probiotics (which are live bacteria), prebiotics are natural compounds found in plants such as artichokes that mimic the growth and reproduction of beneficial gut bacteria. Initiated studies on the effectiveness of prebiotics have yielded the first promising results. Additional research is ongoing. Some people with ulcerative colitis benefit from acupuncture or hypnosis, but these treatments have not been thoroughly studied.
Anti-inflammatory suppositories for hemorrhoids
Anti-inflammatory rectal suppositories: Diclofenac
Antihemorrhoidal suppositories are made on the basis of natural or synthetic components: in the first case, natural antiseptics are used in homeopathic doses. This can be calendula, sea buckthorn oil, various plant extracts, as well as propolis.
Contraindications to the use of suppositories
Anti-inflammatory rectal suppositories: Calendula
Like any medicine, anti-inflammatory rectal suppositories have a number of contraindications and limitations that preclude their use. They are not prescribed in the presence of anal injuries, intestinal bleeding, or peptic ulcers. If there is any doubt, it is necessary to resolve the issue individually with your doctor.
Another disadvantage of using suppositories is the side effects: they can lead to constipation, nausea, itching and burning sensation, and flatulence. As a rule, side effects occur when there is hypersensitivity to the components of the drug or the dosage is exceeded; allergic reactions to the auxiliary components of the drug are possible. This is another reason to be careful when choosing a drug and discuss each drug with your doctor.
Rectal suppositories are an effective means of combating inflammatory processes in the intestines and organs of the reproductive system. In many ways, they are more reliable than medications in tablets, and their use allows you to get a faster effect. A wide selection of drugs allows you to find the right option and get the desired effect; any course of treatment must be completed to the end.
Crohn's disease: causes and symptoms
Chronic inflammatory Crohn's disease is characterized by the fact that it affects the entire gastrointestinal tract, starting from the oral cavity and ending with the anus. In this case, as a rule, inflammation begins in the ileum, and then spreads to the rest of the intestine.
Symptoms of inflammation of the ileum are identical to those of acute appendicitis. Therefore, often, when doctors begin to operate on a patient, they discover Crohn’s disease and make the correct diagnosis.
As for the causes of this disease, doctors are inclined to believe that it is infectious in nature, since antibiotics cope well with it.
Predisposing factors:
- transmission of measles
- food allergy
- stress
- smoking
- heredity
The clinical picture includes local, general and extraintestinal symptoms of Crohn's disease.
