A Minimally Invasive, Image-Guided Treatment for Hemorrhoids
Seeing blood after a bowel movement can be unsettling, especially when it keeps happening. If fiber, changes to your bowel habits, medication, or previous office treatments have not provided lasting relief, you may have options beyond hemorrhoid surgery.
Hemorrhoid Artery Embolization (HAE) is a minimally invasive treatment for selected patients with symptomatic internal hemorrhoids. During a hemorrhoid embolization procedure, a vascular specialist reduces blood flow through the arteries supplying the hemorrhoidal cushions. The goal is to decrease bleeding and allow the enlarged vascular tissue to shrink without cutting or removing tissue from the rectum or anus.
At The Vascular Care Group – Lowell, patients can meet with a specialist to learn whether hemorrhoid embolization fits their diagnosis, anatomy, prior treatment, and goals. Our partnership with Tufts Medicine and Commonwealth Radiology Associates helps bring coordinated vascular and interventional care to Lowell and communities throughout the Merrimack Valley.
Talk With a Lowell HAE Specialist
Hemorrhoid symptoms are common, but rectal bleeding should never be assumed to come from hemorrhoids without an appropriate evaluation. A consultation can help confirm the source of your symptoms and determine whether hemorrhoid artery embolization or another hemorrhoid treatment is most appropriate.
Our Lowell team will review your medical history, prior examinations or colonoscopy results, current medications, bleeding pattern, and treatment preferences before recommending care.
Understanding Hemorrhoid Artery Embolization
What Is HAE?
Hemorrhoid Artery Embolization is a catheter-based procedure that targets the arteries supplying internal hemorrhoids. An interventional specialist guides a very small catheter through the blood vessels to branches of the superior rectal artery. The specialist delivers a specialized embolic material through the catheter to reduce excess blood flow.
By reducing blood flow to the hemorrhoidal tissue, HAE can help control bleeding and allow internal hemorrhoids to gradually shrink without cutting or removing tissue in the anal canal. Because it targets internal hemorrhoids, HAE may not be appropriate for large external hemorrhoids or significant prolapse.
What Happens During the HAE Procedure?
The hemorrhoid embolization procedure is tailored to your individual anatomy. While the exact approach can vary from patient to patient, HAE typically involves the following steps:
- The access area is numbed, and you may receive medication to help you relax during the procedure.
- A small puncture is made in an artery, commonly at the wrist or groin.
- Using real-time X-ray imaging, a thin catheter is carefully guided to the arteries supplying the hemorrhoids.
- The catheter delivers tiny embolic particles to reduce excess blood flow to the hemorrhoids while preserving surrounding healthy tissue.
- The catheter is removed, and a dressing or compression device is placed over the access site.
Patients are monitored after treatment and commonly return home the same day. Procedure time, access route, embolic material, medications, and aftercare instructions depend on the individual treatment plan.
Symptoms Hemorrhoid Embolization May Help Improve
HAE is most often considered when confirmed internal hemorrhoids are causing persistent or recurrent symptoms such as:
- Bright red bleeding during or after bowel movements
- Blood on toilet paper, in the bowl, or on the stool
- Bleeding that continues despite fiber and bowel-habit changes
- Bleeding that returns after prior hemorrhoid treatment
- Irritation, pressure, or discomfort from internal hemorrhoids
- Internal hemorrhoids that occasionally prolapse
- Iron-deficiency anemia linked to ongoing hemorrhoidal bleeding
Colorectal cancer, inflammatory bowel disease, polyps, diverticular disease, or other conditions may also cause rectal bleeding. Before choosing any hemorrhoid treatment, you may need an examination, anoscopy, colonoscopy, laboratory testing, or additional evaluation. HAE is not intended to treat an emergency or unexplained bleeding.
What Does the Research Say About HAE?
A 2025 systematic review evaluated 22 studies encompassing 810 hemorrhoid embolization procedures for grade I through III internal hemorrhoids. Technical success ranged from 93% to 100%, while clinical success ranged from 63% to 94%. Overall, the findings suggest that HAE can provide meaningful symptom improvement for appropriately selected patients, although additional long-term research is still needed.
In a small randomized clinical trial comparing rectal artery embolization with surgical hemorrhoidectomy in patients with grade II and III hemorrhoids, bleeding completely resolved in 83.3% of patients treated with embolization. Patients in the embolization group also experienced significantly less pain and required far less pain medication after treatment. At the first bowel movement, the average pain score was 0 after embolization compared with 6.08 after surgery. No severe adverse events were reported in either group.
Could HAE Be Right for You?
You may be considered for a Hemorrhoid Artery Embolization procedure when internal hemorrhoids have been confirmed, and one or more of the following apply:
✓ Rectal bleeding continues despite conservative care
✓ Prior banding or another office treatment did not provide lasting relief
✓ You want to avoid surgical removal of hemorrhoidal tissue
✓ Bleeding is the dominant symptom and prolapse is limited
✓ You have medical factors that make surgery less desirable
HAE is not the best choice for every person with hemorrhoids. Large external hemorrhoids, thrombosed external hemorrhoids, severe or nonreducible prolapse, anal fissures, infection, and other anorectal conditions may require a different approach. Your care team may coordinate with a gastroenterologist or colorectal specialist to confirm the diagnosis and compare appropriate options.
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Why Patients Consider HAE for Hemorrhoid Treatment
The right hemorrhoid treatment depends on the source of symptoms, hemorrhoid grade, degree of prolapse, prior care, overall health, and personal priorities. For appropriately selected patients, HAE offers several potential advantages.
No Rectal Incisions or Tissue Removal
Convenient Outpatient Procedure
Faster Return to Everyday Activities
Focused Treatment for Hemorrhoidal Bleeding
Less Pain Than Traditional Hemorrhoid Surgery
Comparing HAE With Other Hemorrhoid Treatments
| HAE | Rubber Band Ligation |
Sclerotherapy | Infrared Coagulation |
Hemorrhoidectomy | |
|---|---|---|---|---|---|
| How It Works | Reduces blood flow to internal hemorrhoids | Bands hemorrhoids to cut off blood flow | Injects medication to shrink hemorrhoids | Uses infrared energy to shrink tissue | Surgically removes hemorrhoids |
| Access Route | Wrist or groin | Anus | Anus | Anus | Anus |
| Treatment Setting | Outpatient procedure | Office procedure | Office procedure | Office procedure | Outpatient surgery |
| Recovery Time | 1–3 days | 1–3 days | 1–3 days | 1–3 days | 2–4 weeks |
| Symptom Improvement | Gradual; over weeks or months | Often noticeable soon after recovery | Gradual; over weeks or months | Often noticeable soon after recovery | Gradual; over weeks or months |
*This chart provides a general comparison. The best option depends on whether hemorrhoids are internal, external, or combined; the degree of prolapse; the main symptoms; prior treatment; and overall health. Recovery, risks, durability, and insurance coverage vary. Your physicians can help you compare treatments after confirming the source of rectal bleeding.
Why Choose The Vascular Care Group of Lowell for HAE?
Hemorrhoid symptoms can be difficult to talk about, and some patients may not realize that minimally invasive treatment options are available. The Vascular Care Group of Lowell provides specialized hemorrhoid embolization care close to home for patients throughout the Merrimack Valley and Southern New Hampshire.
Experience With Minimally Invasive Embolization
HAE requires precise navigation through very small arteries. Our vascular and interventional specialists use advanced imaging to identify the vessels supplying the hemorrhoids and treat them through a small catheter rather than traditional surgery.
Care That Connects With Your Medical Team
Through our partnership with Tufts Medicine and Commonwealth Radiology Associates, we can coordinate evaluation and treatment with gastroenterology, colorectal surgery, primary care, and other members of your medical team when needed.
Outpatient Care Designed Around Your Comfort
HAE is performed in an outpatient setting using advanced imaging and minimally invasive techniques. Patients can receive specialized treatment without a traditional hospital stay.
Convenient Merrimack Valley Location
Located at 1115 Westford Street in Lowell, our center provides convenient access to HAE for patients from Lowell, Haverhill, Methuen, Lawrence, Nashua, and surrounding communities, without routinely traveling into Boston for care.
Frequently Asked Questions About Hemorrhoid Artery Embolization
Is HAE the same as hemorrhoid surgery?
No. HAE works through the arteries and does not remove hemorrhoidal tissue or create rectal incisions. It is still a medical procedure with potential risks.
What types of hemorrhoids can the HAE procedure treat?
HAE is generally considered for grade I through III internal hemorrhoids when bleeding is the main problem. It does not remove external hemorrhoids and may not suit substantial prolapse.
What is recovery like after a hemorrhoid embolization procedure?
Temporary pressure, mild discomfort, nausea, fatigue, or a low-grade fever may occur. Many patients return to light activity quickly; follow your physician’s instructions.
Will HAE make the hemorrhoids disappear?
The goal is symptom control, especially reduced bleeding. Internal hemorrhoids may shrink, but external hemorrhoids or significant prolapse may need separate treatment.
How long do HAE results last?
Early studies show relief for many patients, but long-term evidence is still developing. Recurrence can lead to repeat embolization or another hemorrhoid treatment.
What are the possible risks of HAE?
Risks include access-site bruising or bleeding, infection, contrast reaction, temporary pelvic or rectal discomfort, and unintended blockage of a nearby artery. Serious tissue injury has been uncommon in published studies but remains possible.
How soon will hemorrhoid bleeding improve after HAE?
Improvement may begin within the first few weeks after HAE and continue as blood flow to the hemorrhoids decreases. Results vary depending on hemorrhoid severity and other individual factors.