Suppositories in France, and recollections

Zity members asked me about suppository use, some even adding that they had read that in France most medicine is given rectally rather than orally. Here is the lowdown, and some personal remembrances.

It is true that, when I grew up, 30 or 40 years ago, many medicines that were available in oral form were also available in suppository form. Many people seemed to have the idea that injections were the most potent form, then suppositories, then oral, perhaps reflecting some Catholic idea that the more uncomfortable, the better it is. So, yes, it is true that, when I grew suppositories were quite common for giving medicine – but I also got tablets and syrups.

Also, there existed some medicines for throat ache only in suppository form – they contained pungent extracts of eucalyptus etc. and I suspect an oral version would have been unpalatable. The rectal version stung the rectum a bit (imagine some kind of mint candy up there). Unfortunately for me, my mother believed in the efficiency of these medicines, and I got these suppositories (2 or 3 a day) pretty much whenever I had a sore throat, which is not uncommon in schoolchildren.

Nowadays, however, most suppositories as alternate to oral forms are no longer manufactured; I think the only major exception is paracetamol (acetaminophen, that is found in Tylenol), which is also available in baby, children and adult forms (I guess, for vomiting patients; also the baby form is useful for babies that refuse ingesting the oral form). There is only one remaining brand of suppositories for throat ache (Biquinol). The days of widespread rectal medication are long gone.

The reason is that suppositories are a fairly embarrassing and messy way of giving medicine. They are basically grease (probably cocoa butter, back then) in which drugs are dissolved. My parents kept them in the fridge door when in use, because, if stored at room temperature (perhaps only in the summer?) they would be soft and difficult to insert. Once they are inside the body, they melt; the drugs cross the rectum walls into the bloodstream. The problem is that the remaining grease will inevitably leak out (faster if passing gas), giving some very unpleasant squishy feeling between the buttocks and soiling underwear. For this reason, mom would place a panty liner in my underwear under my anus…

Furthermore, and especially with irritating suppositories such as that for throat ache, the suppository may have a laxative side effect – and then the patient poops the suppository before it has acted! To avoid that, mom would always send me potty before inserting a suppository, whether I felt the urge or not, except if I had just done number two.

To summarize, the whole procedure was humiliating. I was sent to go potty, asked whether I had had a bowel movement (and encouraged to go back, otherwise), I was then bent over the toilet (or asked to lay on the side over the bed), told to “bear down” and mom would insert the suppository, then place the panty liner and ask me to get dressed again. She used no lubrication apart from the suppository’s grease, and seldom wore a finger cot (I think it happened when she had injured her finger). I still can feel her fingernail up there – the inserted her fingertip to make sure the suppository would not come back. If this happened before school, I would be in class with greasy buttocks, a tell-tale smell of eucalyptus if for throat ache, waiting for the break to go to the toilet and wipe myself. Yeesh!

Another kind of suppository still commonly used is glycerin, for inducing a bowel movement, particularly when constipated. When I was in elementary school, it was not uncommon (though not extremely common either – I guess it happened once every two months?) that I got constipated. I guess it’s because I retained my feces because I disliked going to the squat toilets at school, and perhaps I was not drinking enough. In any case, this largely disappeared as I grew up. Mom’s reaction to constipation, including just being “late”, was to give me a spoonful of a kind of jelly of mineral oil (Lubentyl) and/or prunes with every meal. If, however, I complained of feeling a need to go but not being able to since I was “plugged up”, if I strained on the toilet, she would also give a glycerin suppository. I think (it was long ago) that she would then give suppositories until I had a normal bowel movement (soft stools). Her idea was that straining would just risk damaging my rectum (a few times, hard stools caused slight injuries and blood on the toilet paper). Sometimes, if she suspected difficulties in going, she would order me not to flush so that she could have a look – a few hardened lumps were likely to result in a suppository being given.

Mom would insert the glycerin suppository after wetting it with saliva, then order me to get dressed again and wait until it was melted and I got a real urge. I was prohibited from going potty too soon – unsure about the retention period, perhaps 15 minutes? I recall my relief when expelling. Sometimes mom ordered me not to flush so that she could check the results...