Evaluation of Superior Rectal Arterial Embolization in Hemorrhoidal Disease

Inclusion Criteria: All patients referred for Hemorrhoidal disease with bleeding are eligible. Significant bleeding is defined as a HBS of ≥ 5. Age > 18 years old; Sexes eligible for study: all Hemorrhoidal disease grade I-III according the Goligher classification with rectal bleeding as predominant symptom History of prior instrumental treatment of HD does not prohibit inclusion Able to understand and read Dutch, French or English Exclusion Criteria: Permanent hemorrhoidal prolapse/grade IV hemorrhoidal disease Rectal prolapse History of proctological surgery for HD Acute complicated course of HD i.e. acute thrombosis (fluxio hemorrhoidalis or perianal hematoma) Anal stenosis, congenital of acquired Chronic anal fissure Active rectal inflammation, including peri-anal abscess (e.g. Inflammatory Bowel Disease, infectious,…) History of colorectal or anal cancer History of rectal or sigmoidal resection Portal hypertension and liver cirrhosis Child Pugh C Radiation rectitis Neurological disease involving anal sphincter musculature Severe psychiatric disorder Pregnancy Allergy to iodinated contrast agents Colorectal neoplasia as the cause of bleeding (excluded with a (virtual) colonoscopy in the last year)