Haemorrhoid artery embolisation

The problem: haemorrhoids that keep bleeding

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. That group has been stuck between repeat banding and an operation they don't want.

How embolisation fixes it

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.

Who it suits

• Grade II–III internal haemorrhoids with recurrent bleeding despite banding
• People who decline surgery or want to avoid the painful post-operative period
• Patients on anticoagulants or with health problems that make surgery risky
• Bleeding-predominant symptoms (prolapse-predominant disease is usually better served surgically, an honest selection discussion comes first)

What to expect

1. Consultation

   Review of your colonoscopy and treatment history, and confirmation that bleeding is from haemorrhoids, not something else.

2. The procedure (about an hour)

   Sedation, single pinhole, both sides treated in one sitting. No bowel preparation ordeal, no rectal instruments.

3. Home the same day

   Most people return to normal activity within a day or two. There is no wound to care for.

4. Follow-up

   Bleeding typically settles over the following weeks; review confirms the result.

Results & risks, honestly

Published series report meaningful reduction or resolution of bleeding in the majority of well-selected patients, with high satisfaction, largely because there is essentially no recovery period. 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.