Hemorrhoids (Piles)
Symptomatic hemorrhoids, also known as piles, are abnormally enlarged and inflamed veins in the rectum and anus caused by increased venous pressure. Hemorrhoids are a very common condition affecting nearly half of the population by the age of 50. There are two types of hemorrhoids, internal and external. Internal hemorrhoids occur in the lower rectum while external hemorrhoids are found in the skin around the anus. Hemorrhoid embolization is often an effective treatment option for symptomatic internal hemorrhoids.
Symptoms of Internal Hemorrhoids
Internal hemorrhoids are often painless. In fact, many people with internal hemorrhoids do not know they have them. When symptomatic, the most common symptom is rectal bleeding. Other symptoms include painful inflammation and an itchy sensation. Patients with internal hemorrhoids may notice blood when they wipe or in the toilet after a bowel movement. Larger, inflamed internal hemorrhoids often prolapse or bulge from the rectum.
- Bleeding
- Internal hemorrhoids extending through the anal canal
- Painful swelling
- Itchy sensation around the anus
How Are Internal Hemorrhoids Diagnosed?
Internal hemorrhoids are diagnosed with a physical exam and medical history. Your provider may also perform a digital rectal exam and perform other tests to rule out other causes of rectal bleeding. Other tests may include:
- Anoscope – used to visualize the lower rectum
- Colonoscopy – used to view the entire colon
How Are Internal Hemorrhoids Treated?
Internal hemorrhoids may be treated in several ways. Dietary and lifestyle changes are the first line of conservative treatment. Increasing fiber in your diet, ensuring adequate hydration, and moderate aerobic exercise can increase bowel function, reducing pressure on hemorrhoids. Rubber band ligation is a non-surgical treatment that uses elastic bands to cut off blood supply. Hemorrhoidectomy is a surgical treatment that removes problematic veins. Here at IVC® we specialize in a minimally invasive procedure called hemorrhoid embolization.
Who Is a Candidate for Hemorrhoid Embolization?
Hemorrhoid embolization is an effective treatment option for patients who:
- Have symptomatic grade 1,2, or 3 internal hemorrhoids
- Have failed conservative measures like diet and lifestyle changes
- Did not benefit from non-surgical or surgical treatment
Hemorrhoidal Artery Embolization (HAE)
Hemorrhoidal artery embolization is a minimally invasive procedure that has been shown to provide long lasting relief from the bleeding, itching, pain and irritation of internal hemorrhoids. HAE is performed in our outpatient lab by our board-certified, fellowship-trained interventional radiologists. The procedure typically takes 45 to 60 minutes.
Patients are given IV conscious sedation for optimal relaxation and pain management during the procedure. The physician will then access an artery in the groin or wrist in order to advance a tiny catheter into the arteries which supply blood to the hemorrhoids. Small particles and/or platinum coils are then used to close (embolize) the targeted arterial branches which cuts off the blood supply to the hemorrhoids causing them to shrink. Once all the problematic vessels are embolized, the physician removes the access catheter and a small bandage is placed on the access site. Patients are then monitored for 1-2 hours while they recover from the sedation drugs before they can go home. Pain following the procedure is minimal and most patients typically return to routine activities the next day.
Advantages of Hemorrhoid Embolization
- Relief from rectal bleeding and discomfort
- Does not require general anesthesia
- Can be performed as an outpatient with quick recovery
- Does not create painful rectal wounds
- Preserves anal continence
