At a glance
An examination under anaesthesia (EUA) is a thorough examination of the anal canal and rectum performed while you are under general anaesthesia. It is recommended when a complete assessment cannot be done while you are awake — usually because the area is too painful or the sphincter is too tense to allow a proper examination.
Many people feel anxious about an EUA. This guide covers what to expect before, during, and after.
Why an EUA is recommended
Limitations of clinic examination
When you visit a clinic, the surgeon can do an external examination and sometimes a limited internal examination. But for conditions like chronic fissures, complex fistulas, or unexplained symptoms, this may not be enough:
- Pain prevents a complete examination — the area is too tender to examine properly
- Sphincter spasm — the muscle is too tight to allow instruments or a thorough assessment
- Complex anatomy — fistula tracts, deep fissures, or multiple conditions may need careful mapping
- Combined approach — the surgeon may want to examine and treat in the same session
What it achieves
Under anaesthesia:
- The sphincter muscles fully relax, giving the surgeon complete access
- The surgeon can assess the full extent of conditions like fistulas
- Any treatment planned can be carried out at the same time
- The examination is painless for you
Before the EUA
The consultation
Your surgeon should explain:
- Why the EUA is recommended
- What they expect to find
- Whether treatment may be performed during the EUA
- What consent they need from you
Preparation
- You will be given instructions about fasting before the anaesthesia — typically no food or drink for six hours before
- Arrange transport home — you cannot drive after a general anaesthetic
- Plan for someone to be with you for the rest of the day
- Take the day off work
Consent
Your surgeon will ask you to consent to the examination and any treatment that may be performed. It is important to:
- Understand what treatments are being considered
- Ask questions about anything you are unsure about
- Know that you can set boundaries about what you consent to
During the EUA
You will be under general anaesthesia, so you will not be aware of or feel anything during the procedure.
The surgeon will:
- Examine the external perianal area thoroughly
- Perform an internal examination of the anal canal and lower rectum
- Assess any fissures, fistulas, haemorrhoids, or other conditions
- Potentially perform treatment — botox injection, sphincterotomy, fistula surgery, or other procedures
The entire process typically takes fifteen to forty-five minutes, depending on the findings and any treatment performed.
After the EUA
Immediate recovery
- You will wake up in the recovery area feeling groggy
- Mild soreness in the examined area is common
- You will be monitored for an hour or two before being discharged
- Most people go home the same day
At home
- Rest for the remainder of the day
- Take prescribed pain relief if needed
- Light diet and plenty of fluids
- Avoid driving or operating machinery for twenty-four hours after general anaesthesia
If treatment was performed
If the surgeon carried out a procedure during the EUA, recovery will depend on the specific treatment. Your surgical team will provide specific aftercare instructions. Common guidance includes sitz baths, stool management, and a follow-up appointment.
Follow-up
You will typically have a follow-up appointment to discuss the findings and any treatment that was performed. This is the time to ask questions about what was found, what was done, and what happens next.
Common concerns
“Will I be awake at all?”
No. A general anaesthetic means you are completely asleep. You will not be aware of the examination.
“How many people will be in the room?”
An operating theatre typically has the surgeon, an anaesthetist, a scrub nurse, and possibly a trainee or assistant. Everyone present is a medical professional.
“Is it embarrassing?”
The medical team examines this area routinely. It is a normal part of their work, and they are focused on providing good care, not on any aspect that feels embarrassing to you.
“What if they find something unexpected?”
If the surgeon finds something unexpected, they will discuss it with you at the follow-up appointment. If they had consent to treat, they may address it during the procedure. If it is outside the scope of what was consented, they will explain the findings and discuss next steps with you when you are awake and alert.