Bring back (or not) the good old suppository?

Bring (or not) the good old suppository?

Suppository. A simple word that reminds us of so much unease… But what happened to this special little medicine? Is it still often used? And does it really work?

Surely you have already wondered what these little white rockets contain. Well, the recipe is not very complicated: a suppository is simply the mixture of a drug and a fatty substance – or a water-based synthetic solid – to hold during insertion. Once the suppository arrives in the rectum, the body's natural heat slowly melts it, allowing the blood vessels to absorb the medicine.

If you may not have used this kind of treatment for a long time, there are different suppositories that can treat fever, vomiting, constipation and hemorrhoids, among others, in adults. 

And if you've seen your parents keep this ammunition in the fridge, they're right to do so, because a suppository at room temperature softens and doesn't fit well.  

An effective treatment? 

Despite these multiple functions (and your vivid memories), suppositories have never been very popular in Quebec or Canada, says Diane Lamarre, pharmacist and former president of the Order of Pharmacists of Quebec. 

For what? “Because the rectal route is a route whose absorption capacity is erratic, that is to say that it is difficult to predict and compare from one person to another. The response is therefore difficult to predict,” she explains.  

Contacted by Métro, Jean Coutu pharmacies did not notice a marked increase as for the sale of suppositories to treat fever or gastro in the last ten years.

Although they can be useful when you can not ingest the drug, when you are vomiting for example, suppositories are not the best option for relieving ailments, she adds. “We still occasionally use the rectal route for, for example, constipation problems, with glycerin suppositories. But for drugs for which we want to be sure of their effectiveness and good absorption, we now prefer other routes of administration.”

“When you have gastroenteritis, for example, and you are vomiting, rehydration solutions can still be given by mouth.” And that also applies to children: “From four or five years old, a child who is able to swallow a bite of bread may be able to swallow a capsule or a tablet.” Before that, the liquid oral route is the preferred route for babies.

The suppository therefore still has its purpose, but the most effective route of administration at home to properly absorb a drug is orally. It is also possible to use the bucco-gingival, transdermal and subcutaneous routes before aligning the posterior, especially in palliative care.

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