If conservative measures haven’t resolved your hemorrhoid symptoms, you likely have several treatment options to consider — ranging from in-office procedures to traditional surgery. Here’s how hemorrhoid artery embolization (HAE) compares to the other treatments commonly used for internal hemorrhoids.
Conservative (At-Home) Treatment
For mild hemorrhoid symptoms, doctors typically recommend starting with conservative measures: increasing dietary fiber, drinking more water, avoiding straining during bowel movements, limiting time on the toilet, and using over-the-counter creams or sitz baths. These steps can resolve mild cases, but they don’t address hemorrhoids that are already enlarged or bleeding regularly — and symptoms often return once you stop.
Rubber Band Ligation
Rubber band ligation is one of the most common in-office treatments for internal hemorrhoids. A small rubber band is placed around the base of the hemorrhoid, cutting off its blood supply so it shrinks and falls off over about a week. It’s effective for smaller hemorrhoids, but it can cause discomfort, and multiple sessions are often needed for larger or multiple hemorrhoids. There’s also a small risk of bleeding as the hemorrhoid falls off.
Sclerotherapy
Sclerotherapy involves injecting a chemical solution directly into the hemorrhoid, causing it to shrink over time. It’s a relatively simple in-office procedure, but it tends to be less durable for larger hemorrhoids and may require repeat treatments.
Infrared Coagulation (IRC)
IRC uses infrared light to reduce blood flow to the hemorrhoid, causing it to shrink. It’s generally painless and can be effective for smaller internal hemorrhoids, though like banding and sclerotherapy, larger or more advanced hemorrhoids may not respond as well.
Hemorrhoidectomy (Surgery)
Traditional surgical removal of hemorrhoids, called a hemorrhoidectomy, is generally reserved for severe or recurrent cases that haven’t responded to less invasive treatments. It’s effective, but it comes with real tradeoffs: a longer and often painful recovery, the need for anesthesia, and a higher risk of complications like infection or temporary difficulty with bowel control compared to less invasive options.
Hemorrhoid Artery Embolization (HAE)
HAE takes a fundamentally different approach. Instead of removing, banding, or injecting the hemorrhoid tissue directly, an interventional radiologist threads a tiny catheter through an artery in the wrist or groin and blocks the specific blood vessels feeding the internal hemorrhoids, using tiny coils or particles. With less blood flow, the hemorrhoids shrink and bleeding stops over the following weeks.
Because HAE doesn’t involve any instrumentation through the anus, it avoids the discomfort associated with banding, sclerotherapy, and surgery, and it preserves the anal sphincter completely. The procedure is done on an outpatient basis under moderate sedation and typically takes 30–45 minutes, with most patients home the same day and back to normal activity within days rather than weeks.
How Do the Options Compare?
- Best for mild symptoms: Conservative measures, IRC, or sclerotherapy
- Best for moderate, recurring internal hemorrhoids: Rubber band ligation or HAE
- Best for hemorrhoids that haven’t responded to less invasive treatment, without wanting surgery: HAE
- Reserved for severe or non-responsive cases: Hemorrhoidectomy
Every patient’s situation is different, and the right treatment depends on your hemorrhoid grade, symptoms, and overall health — which is why a proper evaluation matters before deciding on a treatment path.
Is HAE Right for You?
HAE tends to be a good fit for patients with symptomatic grade 1–3 internal hemorrhoids who haven’t found lasting relief from conservative measures, and who want to avoid the pain and downtime associated with surgery. Learn more about HAE at MIVA Medical. Want to learn more about what causes hemorrhoids in the first place? Check out our post on internal vs. external hemorrhoids.
If you’re in the Kansas City area and dealing with bleeding internal hemorrhoids, MIVA Medical’s board-certified interventional radiologists can help you understand your options. Take our HAE quiz or book a consultation to find out if HAE is right for you.