Rectal Rockets

What's a hemorrhoid? It's a swollen vein in the rectum, and it's a pain in the butt. They can be itchy, painful, random, constant, but above all, they're incredibly annoying.

For most people, dealing with hemorrhoids is something done in private. Suffering alone, quietly grimacing after every visit to the bathroom, internalizing the anxiety that goes along with where you are, what you're wearing, what you should and shouldn't eat, and when you'll finally get home to calm down.

When there's a rather large hemorrhoid on the outside of the rectum, it's tricky to not re-open the wound when cleaning up after a bowel movement. When there's a bunch of them on the inside of the rectum, it's nearly impossible not to re-open each of the painful sores.

For these exterior pests, there are compounded ointments available with a prescription that contain nitroglycerin and nifedipine, or even just nifedipine by itself. They're ointments, so they're not the cleanest method of treatment, but they WORK!

For the internal variants, as well as a large percentage of the external variety, there's something called a "Rectal Rocket" that's a sort of miracle worker down there.

It's a contoured suppository with a flared base (and a slit to allow for the passage of gas) that is inserted at bedtime and allowed to remain in direct contact with the offending wounds while you sleep.

Sounds wonky, sure, but the people who come into our pharmacy time after time for refills on nifedipine ointments for chronic hemorrhoids didn't need much convincing to try them when we offered to discuss the Rocket option with their doctors.

The medications that do the most work in fixing the wound stay in contact with offending source of pain, there's no mess, and some people report success with as little as three applications.

The most popular formula contains 3% lidocaine and 2% hydrocortisone. Lidocaine is a topical anesthetic that "numbs" the area. There may be some initial stinging, but it quickly dissipates. Hydrocortisone is a bioidentical steroid that has powerful anti-inflammatory action when applied topically.

Some doctors add Neomycin (an antibiotic) and Nifedipine (a drug that increases blood flow to the area and enhances healing). These are particularly helpful when there is repeated tearing and local infection.

With proper care and a cautious diet, there is little need to use this kind of treatment every day for long periods of time. Most people use them for 3 days in a row, with a repeat every few weeks.