• The bases of all products are likely to contribute an additional emollient and soothing effect, and the lubricating effect of suppositories may ease straining at stool.
• The recommended treatment regimen for most preparations is twice daily, morning and evening, and after each bowel movement.
• Creams and ointments are generally considered to be preferable to suppositories for self-treatment of haemorrhoids.
• Suppositories may slip into the rectum and melt there, bypassing the anal areas where the medication is needed and increasing the possibility of systemic absorption of local anaesthetics and hydrocortisone. This possibility is increased if the patient is lying down.

How effective are OTC preparations?
There appears to be no published evidence on the efficacy of licensed medicinal products for OTC treatment of haemorrhoids. A protocol for a Cochrane systematic review was published in 2011³, but no report has yet appeared.

References

1. Bentley JP, Hunt TK, Weiss JB, Taylor CM, Hanson AN, Davies GH, Halliday BJ. Peptides from live yeast cell derivative stimulate wound healing. Arch Surg. 1990;125:641-6.
2. Crowe MJ, McNeill RB, Schlemm DJ, Greenhalgh DG, Keller SJ. Topical application of yeast extract accelerates the wound healing of diabetic mice. J Burn Care Rehabil. 1999;20:155-62.
3. Kopljar M, Balduzzi S, Patrlj L, Mihanovic J, Markulin H, Bakota B, Zhang JSF, Sobar M, Sambunjak D. Topical treatment for hemorrhoids (Protocol). Cochrane Database of Systematic Reviews 2011, Issue 11. Art. No: CD009443. DOI: 10.1002/14651858.CD009443.