Hemorrhoidal Artery Embolization (HAE)

Non-surgical treatment for chronic hemorrhoids

Surgery to treat chronic hemorrhoids—called hemorrhoidectomy—is a major surgery with a long and painful recovery. Fortunately, there is now a minimally invasive option to treat hemorrhoids and alleviate symptoms permanently.

What are chronic hemorrhoids?

About half of all Americans will experience hemorrhoids in their lifetimes. In most cases, they will go away independently or after making diet changes, administering topical treatments, or taking medications or supplements. Sometimes, hemorrhoids can’t go away on their own due to the blood not being able to drain out (prolapse). This can cause itching, bleeding and painful bowel movements.

Hemorrhoids are actually swollen veins inside the lower rectum or under the skin around the anus, similar in nature to varicose veins. They most commonly occur in those between 45 and 65 years of age. They may be caused by an increase in pressure in the lower rectum through one or more of the following factors:

Sitting for long periods
Straining or excessive exercise
Spinal cord injury
Constipation or diarrhea
Being overweight
Pregnancy or childbirth
Family history

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What are the treatment options for chronic hemorrhoids?

At first, conservative treatment for hemorrhoids is typically recommended. This may include diet changes, topic treatments (hemorrhoid creams), sitz baths and pain relievers (such as Tylenol). If the symptoms do not go away, and if you are experiencing pain, bleeding, changes in bowel habits or changes to the color or consistency of your stools, talk with your doctor about other treatment options.

Hemorrhoidectomy

When conservative treatment has failed, hemorrhoidectomy is a surgical option to remove them. However, this surgery has risks and complications that can include infection, bleeding, difficulty emptying the bladder, rectal prolapse and more. Recovery takes weeks and it can be up to six weeks before you feel normal again.

Rubber band ligation

A less invasive treatment called rubber band ligation has been used to treat chronic hemorrhoids. This approach is also linked with pain and complications, especially for those taking anti-platelet or anti-coagulant medication, who have a higher risk of hemorrhage and infectious complications.

Hemorrhoidal artery embolization (HAE)

Hemorrhoidal artery embolization (HAE) is a new and minimally invasive procedure providing relief for patients with symptomatic internal hemorrhoids. It is performed by an interventional radiologist who uses a special catheter and instruments to cut off the blood supply to the hemorrhoid, causing it to shrink and symptoms to go away.

What are the benefits of HAE?

HAE targets the blood supply of internal hemorrhoids. Blocking these arteries shrink internal hemorrhoids and stops bleeding. Studies show promise for long-term relief, with some patients experiencing significant symptom reduction lasting at least a year. HAE offers a minimally invasive option for patients with bothersome internal hemorrhoids who may not be interested in traditional surgical approaches. HAE patients typically experience less post-procedure pain and have faster recovery times than surgery or trans-anal procedures.

How is HAE performed?

HAE is essentially painless and is performed with moderate ‘twilight’ sedation as an outpatient procedure, meaning the patient will go home after the procedure. The procedure generally takes about two hours. Our IR physicians will insert a small catheter (a thin hollow tube) into the artery of the patient’s upper thigh or wrist and, with the use of X-rays, guide the catheter to the arteries supplying the hemorrhoids. Tiny particles and coils are then injected through the catheter into these arteries, reducing the blood supply. This reduction in blood supply decreases the size of the hemorrhoids and reduces associated symptoms, especially bleeding.

For more information, talk to your doctor or call our clinic to schedule a consultation.

Intellirad Clinic