HAE reduces arterial inflow to bleeding internal haemorrhoids without rectal instrumentation or a surgical wound.
Internal haemorrhoids are cushions of blood vessels that have become enlarged and fragile. For many people, banding fixes the problem. For others, bleeding keeps returning. Or surgery is unappealing because of the recovery, or unsafe because of blood thinners or other health problems. For selected patients with recurrent bleeding, HAE provides another treatment option between repeated office procedures and surgery.
Haemorrhoids are fed mainly by branches of the superior rectal arteries. In HAE, a catheter is guided from a pinhole in the wrist or groin into those branches, and the feeding vessels are blocked with tiny coils or particles. With their inflow reduced, the haemorrhoid cushions decompress and the bleeding settles, while the back passage itself is untouched: no cutting, no wounds, no anal stretching.
Review of your colonoscopy and treatment history, and confirmation that bleeding is from haemorrhoids, not something else.
Sedation, with a small arterial puncture and both sides treated in one sitting. No rectal instrumentation is required during the embolisation.
Most people return to normal activity within a day or two. There is no wound to care for.
Bleeding typically settles over the following weeks; review confirms the result.
Published series report improvement in bleeding in most well-selected patients, with a short recovery because there is no surgical wound. It does not remove prolapsing tissue, so patients with significant prolapse are usually still best served by their colorectal surgeon, and all surgical options remain fully available after HAE.
Risks are low: mild pelvic discomfort for a day or two and bruising at the puncture site are the common ones; rectal injury is avoided because nothing is done via the rectum. Recurrent bleeding can occur and can be re-treated.
Banding treats haemorrhoids from inside the rectum and works well for many. Surgery removes tissue but involves a notoriously painful recovery. HAE works from inside the blood vessels. Nothing is done via the back passage, so there is no wound and minimal downtime. It sits between banding and surgery: more durable than repeat banding for bleeding, far gentler than excision.
Not reliably. HAE is a bleeding treatment. If prolapse is your main problem, a colorectal surgical opinion is the right path, and Dr Tarr will say so at consultation.
Usually yes. That's one of HAE's main advantages. Your individual plan is confirmed at consultation.
Recent colonoscopy (or equivalent assessment) is required before treating presumed haemorrhoidal bleeding. Rectal bleeding must never be attributed to haemorrhoids without excluding other causes.
A short explainer on haemorrhoid artery embolisation from Dr Chris Rogan, an Australian interventional radiologist.
Watch on YouTube ↗Selected sources supporting the information on this page. General information only, not a substitute for personalised medical advice. Reviewed by Dr Gregory Tarr; last reviewed September 2026.