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Glycerol suppositories and Bisacodyl suppositories

This is a short blog to alert people about the hazards of walking onto a pharmacy and getting a substitute suppository when the brand recommended is out of stock. I had a patient who had significant bowel emptying dysfunction and who was straining quite a lot report that she had gone to the pharmacy to purchase the suppository that can be helpful to achieve better evacuation without straining. She reported that the pharmacist did not have any glycerol suppositories in stock – the commonly recommended ones that colorectal surgeons suggest. The pharmacist suggested Bisacodyl suppositories instead.

She used one of the Bisacodyl and reported distressing symptoms that then made her very uncomfortable- burning all around the perineum and constant ongoing bowel urges all day, with a feeling that she could’t control her bowels if the urge hit.

One of the things I ask my physios to do is to be aware of what some of the things we talk about actually feel like. All of them who have done pessary courses have tried a pessary so they understand what patients may feel (they may not need them but they still get to trial it). Of course, as I tell all my patients, I use a pessary for my prolapse and due to my own pelvic floor dysfunction, experience the day-to-day delights of childbirth. I have always tried any product that I may suggest to my patients will be helpful so I understand the ramifications of it.

So when this patient reported these unpleasant symptoms – I thought it essential I test it out….she wasn’t lying. It was extremely unpleasant with the generalized burning and the ongoing constant urges through the day.

Glycerol suppositories are NOT Bisacodyl suppositories.