The reason my doctor switched me from the Rowasa enemas to Canasa was because I had an internal hemorrhoid flare up (thanks to a weird time period where my body was transitioning from diarrhea to solid stool, resulting in a very irritating peanut butter-consistency stool - which is killer for my hemorrhoids) and inserting the rough plastic applicator of the enema bottle was extremely painful and actually cutting my hemmies
The hemmie flare up is mostly calmed down now, but the reason I haven't gone back to Rowasa is that I was never able to hold them very long. I would wake up in the middle of the night to pass the enema. That said, I have an
open packet of Rowasa and I've been trying to do an enema 1 x a week since I'm still having bothersome rectal symptoms and no sense in them going to waste. The Canasa is just SO much easier to use.
I use the Vitamin E supps for hemorrhoids, specifically for post-BM irritation of hemorrhoids. I was using the Canasa at night but needed something for after morning BMs. My doc said I couldn't use my usual Rx supps (hydrocortisone) so I use the Vitamin E (non-medicated) supps to sooth hemmie irritation post-BM.