What Are Hemorrhoids?

Hemorrhoids are swollen veins in the anus and lower rectum, similar to varicose veins. Hemorrhoids can develop inside the rectum (internal hemorrhoids) which are rarely visible or under the skin around the anus (external hemorrhoids). Nearly three out of four adults will have hemorrhoids at some time in their life.

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Symptoms & Treatment Options

Symptoms depend on the location of the hemorrhoids

Internal Hemorrhoid Symptoms

Rarely cause discomfort | Painless bleeding during bowel movements

External Hemorrhoid Symptoms

Itching or irritation in the anal region | Pain or discomfort | Anal swelling | Bleeding

Treatment Options

Although external hemorrhoids may be treated by home remedies and medications and rarely require surgery, internal hemorrhoids may become a source of chronic bleeding and anemia. If having significant bleeding symptoms, patients should be evaluated by a colorectal surgeon or proctologist to exclude other causes of rectal bleeding including anal cancer. As a less invasive treatment option than surgery, patients may be candidates for embolization in the outpatient setting. After an initial clinic consultation and diagnostic imaging including a CT scan, hemorrhoid embolization may be considered.

Hemorrhoid Embolization

Hemorrhoid embolization is a minimally invasive treatment for bleeding or prolapsing hemorrhoids by blocking the blood flow to small arteries contributing to the bleeding from the hemorrhoids. Candidates for hemorrhoid embolization are those patients with bleeding or prolapsing hemorrhoids during bowel movements or those patients with irreducible hemorrhoids who are not surgical candidates.

Citations

“Embolization of Symptomatic Internal Hemorrhoids: A Safe and Effective Alternative to Surgery.” Journal of Vascular and Interventional Radiology, vol. 27, no. 5, 2016, pp. 668–674., doi:10.1016/j.jvir.2015.12.006.
“Hemorrhoidal embolization: an update.” International Journal of Colorectal Disease, vol. 33, no. 2, 2018, pp. 221–225., doi:10.1007/s00384-017-2862-7.

Hemorrhoid Embolization Procedure

At our VIP office and under moderate sedation, the interventional radiologist advances a small catheter through a needle stick in the artery under x-ray guidance to the small arteries of the rectum and anus contributing to the bleeding hemorrhoids. From this position, small coils are deployed in the tiny arteries to block the blood flow to the bleeding hemorrhoids. Patients are discharged a couple hours after the procedure. 80-90% of patients experience improvement in their bleeding symptoms soon after the procedure.

VIP is the first outpatient facility in Indiana to provide this minimally invasive therapy option in an outpatient clinic model.

According to a study published in the Journal of Vascular and Interventional Radiology in 2016, hemorrhoidal embolization is effective in treating symptomatic internal hemorrhoids. The study found that the procedure resulted in significant improvement in symptoms, such as pain and bleeding, in the majority of patients.

Another study published in the International Journal of Colorectal Disease in 2018 found that hemorrhoidal embolization is a safe and effective treatment option for symptomatic internal hemorrhoids, with a success rate of 85-90%.

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Source: Boston Scientific

Citations

“Embolization of Symptomatic Internal Hemorrhoids: A Safe and Effective Alternative to Surgery.” Journal of Vascular and Interventional Radiology, vol. 27, no. 5, 2016, pp. 668–674., doi:10.1016/j.jvir.2015.12.006.
“Hemorrhoidal embolization: an update.” International Journal of Colorectal Disease, vol. 33, no. 2, 2018, pp. 221–225., doi:10.1007/s00384-017-2862-7.