When Hemorrhoid Symptoms Persist, a Minimally Invasive Alternative to Surgery

Hemorrhoids are common—more than half of people over 50 have them. Often, they can be managed with dietary and behavior changes, but when hemorrhoids become painful or cause bleeding, your doctor may recommend treatment. 

The broad range of hemorrhoid treatments now includes a minimally invasive procedure called hemorrhoid artery embolization, performed by an interventional radiologist. Patients are treated in an office setting with moderate sedation and go home after their procedure, with little or no recovery time.

“This procedure is a great option for people who are not having success with other treatments and want to avoid surgery, or who have delayed getting treatment for their symptomatic hemorrhoids,” says John Filtes, MD, an interventional radiologist at Columbia University Irving Medical Center, adding that the procedure is particularly effective for people who are experiencing bleeding from their hemorrhoids.

“Surgery for hemorrhoids can be painful and involves a significant recovery time. It also comes with an unfavorable risk profie,” says Filtes. “Hemorrhoid artery embolization fills an important gap in the list of treatments available to patients with this common condition.”

Filtes and his interventional radiology colleagues use X-ray and other imaging techniques to deliver localized treatments from inside the body, avoiding the need for large incisions. Most of the time, the only visible sign of an interventional radiology procedure is a tiny nick on the skin—usually on a patient’s wrist or groin—where the physicians access the patient's veins and arteries.

During a hemorrhoid artery embolization procedure, blood flow is blocked in the small arteries that feed the hemorrhoidal tissue. Under live X-ray, an interventional radiologist guides a catheter to these blood vessels and injects tiny coils and/or beads. The coils and beads serve to dramatically decrease the blood flow to the swollen tissue. Deprived of blood, the hemorrhoid shrinks over the next days and weeks, relieving symptoms.

“Our patients have been very happy with the results,” Filtes says.

Studies have shown that more than 90 percent of patients experience significant improvement after hemorrhoid artery embolization, with many patients benefiting from long-lasting results.

Interventional radiologists have used embolization for decades to treat everything from fibroids and enlarged prostates to cancer. Its use for hemorrhoids was developed in France and has been performed at Columbia since 2022.  

“The best part of any interventional radiology treatment is the recovery,” says Filtes. “For this procedure, we will ask you to avoid heavy lifting for a few days, but you can otherwise resume your daily activities almost immediately.”

Filtes and his colleagues offer consultations for patients who want to learn more about the procedure before making a decision about treatment.

“We’re happy to offer a minimally invasive alternative that can have such a large impact on our patients’ quality of life,” he says.