Haemorrhoids

Who it may help

HAE may suit you if you:

• have persistent bleeding haemorrhoids
• still have symptoms despite medication, changes to diet or banding
• want to avoid surgical removal of the haemorrhoids (haemorrhoidectomy)
• would prefer a minimally invasive, day-stay treatment
• are at higher risk from surgery or a general anaesthetic

Conditions treated

• Internal haemorrhoids (grade I, II or III) causing repeated rectal bleeding
• Haemorrhoids that have not responded to conservative treatment
• Persistent bleeding haemorrhoids
• Haemorrhoids in people who want to avoid surgery

Understanding haemorrhoids

Haemorrhoids (piles) are swollen cushions of blood vessels in the lower rectum or around the anus. They are very common and can cause bleeding during bowel motions, discomfort, itching, or a feeling of fullness around the anus.

They develop when the blood vessels supplying these cushions become enlarged and congested. Increased pressure in the vessels leads to swelling and irritation, which may cause bleeding and discomfort.

Haemorrhoidal artery embolisation (HAE), also known as the “emborrhoid” procedure, is a minimally invasive, image-guided treatment that reduces blood flow to the haemorrhoids.

An interventional radiologist inserts a small catheter (a thin, hollow tube) into an artery, usually in the wrist or at the top of the thigh. Using X-ray guidance, the catheter is passed to the arteries supplying the haemorrhoids (the superior rectal arteries), and tiny particles or coils are placed to reduce their blood flow.

With less blood supply, the haemorrhoids shrink, which can reduce bleeding and improve symptoms.

How the procedure is performed

1. The procedure is performed by an interventional radiologist.
2. It is usually done under local anaesthetic with light sedation.
3. A small catheter is inserted into an artery, commonly in the wrist or at the top of the thigh.
4. Using X-ray guidance, the catheter is passed to the arteries supplying the haemorrhoids.
5. Tiny particles or coils are placed to reduce blood flow to the haemorrhoids.
6. The procedure usually takes about 1–2 hours, and you go home the same day.

Benefits

• No surgical incision
• Local anaesthetic, avoiding a general anaesthetic
• A day procedure, with no overnight hospital stay
• Less bleeding and fewer haemorrhoid symptoms
• A short recovery
• The normal anatomy of the anal canal is kept

After the procedure

• Most people go home the same day.
• Normal daily activities can usually resume within 24–48 hours.
• Mild discomfort may last a few days and can usually be managed with simple pain relief.
• Bleeding and other symptoms usually improve over several weeks as the haemorrhoids shrink.
• A high-fibre diet and drinking enough fluids help keep bowel motions soft.
• Your interventional radiologist arranges follow-up.