Hemorrhoid Embolization – Non Surgical Treatment of Hemorrhoids
What are hemorrhoids?
Hemorrhoids are a common anorectal disease that affect millions of people wordwide. They are enlargement of the normal hemorrhoidal cushions, a collection of connective tissue and blood vessels in the anal area.
Hemorrhoids may cause the appearance of blood on tissue paper or be seen in the toilet after bowel movements. Sometimes the bleeding from hemorrhoids may be severe, and require blood transfusions. They may also cause other symptoms such as itching around the anal area, pain, or protrusion (“sticking out”) into the anal canal.
How are hemorrhoids treated?
Topical creams, warm baths, and good hygiene may improve the symptoms in some people, but are usually quite limited in the benefit they provide.
‘Endoscopic’ treatments are performed by a gastroenterologist or surgeon, and involve treating the hemorrhoids through a small camera or by direct visualization of the anal area. Endoscopic treatments may involve ‘banding’ (placing a type of rubber band around the hemorrhoids), or other ‘ablative’ (destroying the hemorrhoidal tissue) procedures. Endoscopic treatments are usually the first procedural option employed to treat hemorrhoids, due to good results, minimal invasiveness, and low complication rates.
Surgical treatments are usually employed when endoscopic treatments are insufficient, or if the hemorrhoidal disease is too advanced for endsocopic treatment. Surgical treatments involve mechanically removing the hemorrhoidal tissue or reducing their protrusion into the anal canal. Surgery is generally quite effective at improving symptoms related to hemorrhoids, though often with prolonged recovery time and higher risk of complications.
Increased blood flow into the hemorrdoidal cushions is thought to be responsible for their enlargement, and thus the symptoms that hemorrhoids cause.
Reducing blood flow to the hemorrhoidal cushions has shown promising results in reducing hemorrhoid symptoms, especially chronic bleeding.
Hemorrhoid Embolization Procedure
The hemorrhoid embolization procedure is performed by inserting a tiny catheter into the blood vessels that supply the hemorroidal cushions, and injecting tiny particles to close of those vessels (‘embolization’).
The procedure itself requires only local anesthetic, and the catheter is inserted into the body through a tiny pin-hole in the upper leg. Most patients experience zero to minimal pain, which can be treated with over-the-counter pain medication. Patients are expected to go home the same day of the procedure, with immediate return to normal activities, and only a small ‘band-aid’ to show for their procedure!
Who is a candidate for hemorrhoid embolization?
Patients who have undergone endoscopic or surgical, treatment of their hemorrhoids, whose symptoms have recurred, are good candidates for the procedure. Additionally, patients who are not candidates for (or who desire to avoid) endoscopic or surgical procedures because of general anesthetic risk or other factors, may be candidates for hemorrhoid embolization.
Why Dr. Farkas?
Dr. Farkas is an experienced interventional radiologist at Shaare Zedek Medical Center in Jerusalem, and is the first physician to introduce the hemorrhoid embolization procedure to Israel. Dr. Farkas learned the procedure from his colleague and friend, Prof Vincent Vidal, of France.