Men's & Women's Health · Hemorrhoids

Stop hemorrhoid bleeding without surgery

Hemorrhoid artery embolization (HAE) treats bleeding hemorrhoids by reducing their blood supply, working from inside the blood vessels instead of operating on the anus. There are no cuts or stitches near the anus, and most patients have little pain and go home the same day.

Call to book: 737-241-2184 How HAE works
Understanding the condition

What are hemorrhoids, and how does HAE help?

Everyone has hemorrhoids: cushions of blood vessels inside the lower rectum that help with continence. They become a problem when they swell, which can cause bleeding, itching, discomfort or prolapse (tissue that bulges out).

Internal hemorrhoids are fed mainly by the superior rectal arteries, which come down from the abdomen. In people with bleeding hemorrhoids, these arteries are often enlarged and deliver too much blood.

HAE closes off the small end branches of these arteries from inside, using tiny coils and/or particles. With less blood flowing in, the hemorrhoids bleed less and shrink. The anal sphincter muscles and the lining of the anus are not touched, which is why HAE does not cause the pain after surgery that many people fear.5

Diagram of the superior rectal artery branches feeding swollen hemorrhoids, and the same branches closed with coils after embolization Bleeding hemorrhoids Too much blood flows in rectum swollen hemorrhoids After HAE Inflow reduced, bleeding stops rectum coils close the end branches
Simplified illustration. Embolization blocks the small arteries that feed the hemorrhoids, reducing bleeding and swelling.
Is HAE right for me?

Who is a good candidate?

HAE works best for hemorrhoids whose main problem is bleeding. It is often a good fit if you:5

  • Have internal hemorrhoids that keep bleeding despite diet changes, creams or office treatments such as rubber band ligation.
  • Want to avoid surgery, or have been told a hemorrhoidectomy is the next step.
  • Are at higher risk with surgery, for example because of heart disease, liver disease or the need for blood thinners.
  • Have had other treatments that didn't last, including previous surgery.

HAE is less effective when the main problem is large hemorrhoids that prolapse, or pain from an external hemorrhoid or a clot. It may not be suitable after pelvic radiation or rectal cancer. Before HAE, a recent colonoscopy is needed to confirm that the bleeding comes from hemorrhoids and not from another cause.5

Evaluation

How we decide whether HAE is right for you

We review your symptoms, your past treatments and your general health to make sure HAE is a safe and sensible choice.

1

Consultation & symptom score

We review your history and medications, and score how often and how much you bleed. The same score is used to measure improvement after treatment.

2

Colonoscopy

A recent colonoscopy confirms that the bleeding comes from hemorrhoids, grades them, and rules out other causes such as polyps or cancer.

3

Blood tests

We check for anemia caused by long-term bleeding, and make sure your kidney function and clotting are safe for the procedure.

Treatment

How HAE compares with other options

Most hemorrhoids improve with simple measures. When bleeding continues, there are several options, and the right one depends on your symptoms and health.

OptionHow it worksThings to know
Fiber, fluids & creams Softer stools and less straining; creams soothe symptoms The first step for everyone; often enough for mild hemorrhoids
Office treatments Rubber band ligation, injection (sclerotherapy) or heat (infrared coagulation) Quick and effective for many people, but symptoms often come back and treatment may need repeating5
Hemorrhoidectomy The hemorrhoids are surgically cut away Very effective, but recovery is known to be painful and can take several weeks
Hemorrhoid artery embolization The arteries feeding the hemorrhoids are closed from inside through a pinhole No cuts near the anus, little pain, same-day discharge; best for bleeding rather than prolapse2,5
The procedure

What happens during HAE

HAE is an outpatient procedure that typically takes about an hour. You are awake but relaxed, and nothing is done near the anus.

  1. Preparation

    You receive light sedation and local anesthetic at the access site. No general anesthesia is needed.

  2. A pinhole in the wrist or groin

    A thin tube (catheter) is placed into an artery in your wrist or upper thigh through a tiny puncture. No incision is made.

  3. Mapping the arteries

    Using X-ray guidance and contrast dye, a microcatheter is steered into the superior rectal arteries to show exactly which branches feed the hemorrhoids.

  4. Embolization

    Tiny coils and/or particles are placed in the end branches to reduce blood flow to the hemorrhoids, while keeping the rest of the rectum's blood supply intact.4,5

  5. Recovery

    The catheter is removed and a small dressing applied. You rest for 30 to 60 minutes and go home the same day.

What the research shows

Results

HAE was first described in 2014. A 2025 review of 22 studies covering more than 800 procedures summarizes the results to date.1

63–94%

Clinical success, meaning a clear reduction in bleeding, across the studies in the review. Patient satisfaction was above 80% in every series.1

0 vs 6.6

Average pain (out of 10) at the first bowel movement after HAE versus after hemorrhoidectomy, in a randomized trial. Symptom control at 12 months was similar.2

8–20%

Share of patients who needed a repeat treatment, often because other arteries were still feeding the hemorrhoids. Repeat embolization is usually possible.1

Most patients notice less bleeding within days to a few weeks. HAE is mainly a treatment for bleeding: it improves prolapse and pain less reliably. Individual results vary, and no treatment can guarantee success.5

Safety

Risks and side effects

Across published studies, complications have been mostly minor and short-lived, and no cases of incontinence have been reported, because the sphincter muscles are not touched.1,5 We discuss all risks with you in detail beforehand:

  • Mild pelvic or rectal ache, nausea or low-grade fever for a few days, managed with simple medication1
  • Small ulcers in the rectal lining, which are usually painless and heal on their own3
  • Bruising or tenderness at the wrist or groin puncture site
  • Rarely, reduced blood supply to a larger part of the rectum. Serious cases are very rare but have been reported.5
  • Reaction to contrast dye or sedation
  • Bleeding that continues or returns, which may need repeat HAE or another treatment
Questions

Frequently asked questions

Is the procedure painful?

It is performed under local anesthesia with light sedation, and nothing is done near the anus. Most patients feel only the small needle at the access site. Some have a mild ache in the rectum or pelvis for a few days.

How soon can I go back to work?

Most people return to normal activities within a day or two. Your physician will give you specific instructions about exercise and lifting.

How soon will the bleeding stop?

Many patients notice less bleeding within days. The full effect is usually assessed one to three months after treatment.

Will HAE affect bowel control?

No loss of bowel control (incontinence) has been reported after HAE, because the sphincter muscles are not treated.1

Can HAE be combined with other treatments?

Yes. If prolapse remains after the bleeding is controlled, office treatments such as banding can still be used, and HAE does not rule out surgery later.

Is it covered by insurance?

Coverage varies by policy. We will navigate out-of-pocket costs with you. Call us at 737-241-2184 with questions.

Find out whether HAE is right for you

If hemorrhoid bleeding keeps coming back, or you want to avoid surgery, an evaluation can show whether hemorrhoid artery embolization is a good option.

Call 737-241-2184 to schedule

References

  1. Al Jnainati M, Ikkurthy N, Ayoub M, et al. Outcomes of embolization therapy of superior rectal arteries for the management of grade 1 to 3 internal hemorrhoids: a systematic review of clinical studies. Int J Colorectal Dis. 2025;40(1):190. doi:10.1007/s00384-025-04944-4
  2. Falsarella PM, et al. Embolization of the superior rectal arteries versus closed hemorrhoidectomy (Ferguson technique) in the treatment of hemorrhoidal disease: a randomized clinical trial. J Vasc Interv Radiol. 2023. doi:10.1016/j.jvir.2023.01.022
  3. Küçükay MB, Küçükay F. Superior rectal artery embolization with tris-acryl gelatin microspheres: a randomized comparison of particle size. J Vasc Interv Radiol. 2021;32(6):819–825. doi:10.1016/j.jvir.2021.02.011
  4. Moussa N, Bonnet B, Pereira H, et al. Mid-term results of superior rectal artery and coils for hemorrhoidal embolization with particles bleeding. Cardiovasc Intervent Radiol. 2020;43:1062–1069. doi:10.1007/s00270-020-02441-5
  5. Alkhani L, Patel MV, Ahmed O. Embolization for hemorrhoids: why, when, and how. Endovascular Today. 2026;25(2):70–74.

This page provides general information and does not replace a personal medical consultation. Study results describe groups of patients and cannot predict the outcome for an individual. Urology Austin and IR Centers · 8701 N. Mopac, Suite 100, Austin, Texas 78759 · 737-241-2184