Internal, external, and prolapsing hemorrhoids
Hemorrhoids are not all the same. Internal hemorrhoids develop inside the rectum and most often cause bleeding. External hemorrhoids develop under the skin around the anus and more often cause discomfort, swelling, or clotting. Prolapse refers to internal hemorrhoidal tissue that protrudes outward. HAE focuses on internal hemorrhoids; it does not remove external hemorrhoids or surgically correct prolapse.
What physicians generally look for
HAE is generally considered for selected patients with Grade I–III internal hemorrhoids whose main problem is bleeding — including people who have already tried measures such as dietary changes, medications, or office-based procedures without adequate relief. Whether it fits your situation depends on your examination, your overall health, and your goals.
Confirming the source of bleeding
Rectal bleeding has many possible causes, and assuming hemorrhoids are responsible without an evaluation can miss other conditions. Your evaluation may include anoscopy — a brief office examination of the anal canal — and other testing. Whether a colonoscopy is appropriate depends on your symptoms, your screening history, and your clinician's judgment; there is no single rule that applies to everyone, and some patients do need one.
Blood thinners and other medications
Taking a blood thinner does not automatically qualify or disqualify you — but do not stop or change any medication based on this website. Any medication changes needed for evaluation or treatment must be reviewed by the clinicians who manage your care.
What if bleeding continues after banding?
Persistent bleeding after a previous treatment is a reason to seek reassessment, not proof that embolization is the next step. Your physician considers whether internal hemorrhoids remain the source, what was treated previously, and whether another approach would better address your symptoms.
Read about HAE, its risks and alternatives before discussing an individual treatment plan.
The next step
If you are dealing with bleeding internal hemorrhoids and want to know whether HAE is worth discussing, the next step is a consultation. A physician will review your history and examination and explain which options — embolization or otherwise — fit your situation.