The rectal absoprtion of cannabis suppositories is very high, and maybe as high as 75%. Placement of the suppository will have an impact on the absorption.
I would like to think that the suppositories would help but unfortunately, the circulation from the rectum goes to the liver so it may not be concentrated enough in the pelvis and actually the problem is coming from the low back. It would likely be far more productive if you used the topical cannabis balm on your low back, wait 5 minutes and apply another layer and you should obtain hours of relief. You may want to try the suppository in your lower rectum just to see if it provides any relief. You may also need magnesium to relax any muscle spasm and you may need vitamin D3. If you have too much calcium without enough vitamin D, your body will have more muscle spasms as the body puts the calcium into the muscles instead of in the bone. It may be very significant for you to balance these minerals and vitamins.
To clarify Dr. Olson's response. The venous drainage of the rectum has three major veins. The superior, middle and inferior rectal veins. The superior vein drains to the liver and the middle and inferior ones bypass the liver and enter the systemic circulation directly and therefor avoid metabolism.
A company called Foria makes a specific suppository that is used for woman's menstrual cramps inserted vaginally. There has been anecdotal evidence that when inserted rectally for people who have back pain that it can help. Its direct action may also help the type of rectal spasms that you are having. You might have to adjust the dosing amounts to see what may work for you. Again, as with all cannabis products, start low and go slow when increasing your dosages.
Perry Solomon, MD
I can not comment on Dr. Frankel's study as I am not a clinician. I can say that anecdotally we have heard from many, many people at HelloMD suppositories it helps with pain. It does not create a head high but my feeling when I have used a rectal cannabis suppository is overall pain relief and relaxation. Everyone responds differently but many people say it helps with PMS cramping and lower back pain specifically. Here is an article we wrote on cannabis suppositories: https://www.hellomd.com/health-wellness/the-butt-of-the-story-why-rectal-cannabis-is-a-great-choice-for-many-patients
Please check out this resource: https://unitedpatientsgroup.com/blog/2015/01/22/cannabis-suppositories-why-the-posterior-is-superior/
It appears as though Inhalation and oral are around 10-25% in bioavailability, while rectally the cannabinoids are up to 70% in bioavailability.
In the case of THC, the liver transforms around half of what is ingested into the significantly more psychoactive metabolite 11-Hydroxy-Δ9-tetrahydrocannabinol. While not harmful in and of itself and potentially of therapeutic benefit, this molecule causes much more intense cognitive effects than THC. Rectal administration not only avoids these effects, but also allows a much greater proportion of THC to eventually reach the blood stream. This increase in overall efficiency is also shown in the different levels of bio-availability that different administration routes afford. Rectal administration also allows for medicine to exert effects over localized ailments (e.g., hemorrhoidal tissue, inflammation of the rectum, or tumors in the rectal cavity). This form of use also has a much faster uptake than oral administration (around 10 minutes, on average) and leads to more consistent blood concentrations of the active constituents. The speed and reliability of their uptake combined with their circumvention of many of the issues surrounding both ingestion and inhalation make rectal applications an excellent addition to both new and pre-existing therapeutic regimens.
We're so sorry to hear about your condition. With that said, we're glad to see this question being asked as there are probably others out there who are wondering the same thing. There is a company called Foria that has a line of suppositories which come in capsules with 60mg of THC and 10mg of CBD. We currently only carry women suppositories but will expand the catralogue soon. In the interim feel free to browse our catalogue here: https://greendoorwest.com/collections