Rectal suppository: commonsense and mode of insertion

Area of Science:

• Pharmacology
• Gastroenterology
• Patient Education

Background:

• Rectal suppositories are a common medication delivery system.
• The typical suppository shape features a pointed apex and a blunt base.
• Information regarding optimal suppository insertion technique is lacking.

Purpose of the Study:

• To investigate the common practice of rectal suppository insertion.
• To compare the efficacy of apex-first versus base-first suppository insertion.
• To provide evidence-based recommendations for suppository administration.

Main Methods:

• A questionnaire was administered to 360 lay subjects and 260 medical personnel regarding insertion preference.
• A comparative study evaluated suppository retention and expulsion rates in 100 subjects (adults and children) based on insertion direction.
• Data analysis focused on common insertion practices, reasons for preference, and clinical outcomes.

Main Results:

• Overwhelmingly, both lay subjects and medical personnel preferred apex-first insertion, citing common sense and prior information.
• Suppository retention was significantly easier with base-first insertion (98% success rate).
• Base-first insertion required less digital manipulation (1% vs. 83%) and resulted in lower expulsion rates (0% vs. 3%).

Conclusions:

• Current common practice for rectal suppository insertion is suboptimal.
• Evidence supports base-first insertion for improved efficacy and patient comfort.
• Patient and medical education should be updated to reflect evidence-based suppository administration techniques.