Chronic hemorrhoids quickly affect the quality of life of those who suffer from them. They can cause pain and itching during everyday activities and even impact your comfort while sitting, standing or exercising. For those who have cycled through creams and other treatments without lasting relief, the next recommendation is usually surgery. Many are never told that there is another option. 

At Orange County Interventional Radiology (OCIR), we offer a treatment called hemorrhoid artery embolization (HAE), which we use to treat internal hemorrhoids without surgery. This method involves no trauma to the rectum and is performed through access to the arteries through the wrist or hip.

About Internal Hemorrhoids

Patients often find it difficult to talk about hemorrhoids, but they can dominate daily life. Pain and bleeding create anxiety about bowel movements, and prolapsing tissue makes exercise uncomfortable. Hemorrhoids can create even more problems, such as lower iron levels from chronic blood loss. Some patients live with this condition for years because conservative treatments don’t help, and they don’t want surgery.

How Hemorrhoid Artery Embolization Works

The HAE technique, originally called the Emborrhoid technique, was first documented by Dr. Vincent Vidal in 2014. The idea came from an older embolization technique used to stop severe gastrointestinal bleeding. It was postulated that if blocking small arteries could stop a dangerous bleed, it could also shrink the swollen vessels that cause internal hemorrhoids. 

Internal hemorrhoids are fed by branches of the superior rectal artery. During the treatment, an interventional radiologist enters a small artery in the upper thigh or wrist and threads a thin catheter up to these branches under live X-ray imaging. Once it reaches the swollen veins, the doctor releases small coils that block blood flow in the vein. Without blood flow, the hemorrhoids shrink. During this procedure, no endorectal methods are needed, and no part of the rectum or anus is cut or banded.   

Why Choose an Interventional Radiologist?

An interventional radiologist is a physician who has completed a radiology residency, plus an additional fellowship in image-guided procedures, which means they can use imaging like X-ray, ultrasound, CT and MRI to treat conditions through tiny catheters and needles instead of open surgery. They treat a wide range of conditions across the body, including uterine fibroids, enlarged prostates, liver tumors, peripheral artery disease, varicoceles, painful joints and hemorrhoids, often as outpatient alternatives to more invasive surgical options. HAE brings together vascular imaging and catheter-based intervention, which is what interventional radiologists do daily.

What the Research Says About HAE

In 2025, a systematic review was published in the International Journal of Colorectal Disease that pooled data from 22 studies and included 810 patients treated with HAE. During these studies, 93-100% of patients were successfully treated, meaning the arteries were successfully reached and blocked. Clinical success, which measured the actual reduction in bleeding and symptoms, ranged from 63% to 94%. During these studies, no cases of tissue ischemia or loss of continence were reported. 

Who Is a Candidate for HAE?

• Grade 2 and 3 Internal Hemorrhoids: Hemorrhoids that bulge with straining and either retract on their own or need to be pushed back respond best.
• Recurrent Rectal Bleeding: HAE reduces flow through the vessels that cause bleeding, which is often the symptom patients want solved first.
• Failed Conservative Care: Patients who have tried fiber, creams and banding without lasting relief are often ideal.
• Preference to Avoid General Anesthesia: HAE uses local anesthesia with or without mild sedation, as preferred by the patient.
• Concerns About Rectal Trauma or Access: Access is through the thigh or wrist, so nothing invasive touches the anal canal.

Not all patients are good candidates. This treatment is:

• Not a Fit for External Hemorrhoids Alone: External hemorrhoids have a different blood supply, though patients with mixed hemorrhoids often see overall improvement.
• Not a Fit for Grade 4 Prolapse: Permanently prolapsed hemorrhoids usually need a surgical option. Your consultation will cover this information and more.

Recovery Timeline and When You Will Notice a Difference

Bleeding tends to be the first symptom to improve, often within the first month. A study in the Journal of Vascular and Interventional Radiology reported clinical success in 93% of 134 patients at one-month follow-up, with significant improvements in bleeding and quality of life scores. Full results typically develop over four to six weeks.

How to Prevent Hemorrhoid Recurrence After HAE

HAE treats the vessels, but does not address any of the pressure patterns that may have caused the problem in the first place. Certain habits or circumstances can produce new hemorrhoids. 

One of the most important factors is stool consistency. Hard stools force straining, which pushes rectal veins outward until they bulge. A high fiber diet is recommended, working towards around 25 to 35 grams of fiber per day, along with increased hydration. Fiber comes from plant sources such as fruits, vegetables and whole grains.

Limit the amount of time you spend on the toilet. The seat puts additional pressure on the anus and rectum and causes blood to pool. In addition to hemorrhoids, long periods on the toilet can also weaken the pelvic floor. Regular exercise is also important as it helps stimulate bowel movements and improve circulation. Finally, if you have to lift heavy objects, learn to brace your core and breathe through the movement to avoid putting pressure on the rectal veins. 

Why Patients in Orange County Choose Us for HAE

OCIR is a dedicated outpatient interventional radiology center with three locations across Lake Forest, Mission Viejo and Irvine. We have a team of fellowship-trained interventional radiologists who focus on minimally invasive, image-guided care, and HAE is performed by physicians who embolize vessels every day.

Our patients also appreciate being seen outside a large hospital setting. They meet the physician who will perform their treatment at the consultation, with no handoff between the doctor you talk to and the one who does the work. 

Schedule a Consultation for Hemorrhoid Artery Embolization

If you are tired of living with your hemorrhoids and want to know whether HAE fits your situation, call 949-919-6169 or book a consultation online. A consultation at Orange County Interventional Radiology includes a symptom review and an honest answer about whether embolization is the right option for you.