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)