Examination under anaesthetic (EUA)

An examination under anaesthetic (EUA) is a short procedure where your anal canal, lower rectum, and the surrounding skin are examined while you are asleep under a general anaesthetic. With your muscles completely relaxed, areas that would be too painful or difficult to examine properly in the clinic can be felt, inspected, and assessed thoroughly. A proctoscope (a small, lighted tube) is used, and in some cases a flexible sigmoidoscope (a slender instrument that allows a view of the lower bowel). Where appropriate, the findings can be treated in the same session — for example, draining an abscess, placing a fistula stitch, or taking a tissue sample — so you do not need a separate operation.

• Your condition is too painful or complex to examine properly in the clinic — an EUA removes the discomfort completely so the area can be assessed thoroughly
• You have an anal fistula (a tunnel connecting the inside of the anal canal to the skin) and its exact path needs to be mapped out — this is often combined with seton insertion, where a fine thread is placed through the fistula to begin treatment
• A lump or area of tissue inside the anal canal or rectum needs to be examined and possibly biopsied — a tissue sample can be taken during the EUA so you do not need a separate procedure
• You have a perianal abscess (a pocket of infection) that needs to be drained — the EUA allows both proper assessment and treatment at the same time
• You have rectal prolapse (where part of the bowel slides out through the anus) or a pelvic floor disorder that is easier to assess under anaesthetic
• You have Crohn's disease affecting the anal area — the EUA allows the full extent of the disease to be mapped so the best treatment plan can be made

• You are completely comfortable throughout — the examination is thorough precisely because you are not in pain and your muscles are fully relaxed
• Diagnosis and treatment often happen in the same session, so you wake up knowing what was found and, in many cases, already having had something done about it
• Complete muscle relaxation allows the full extent of the problem to be assessed — something that is simply not possible in a clinic when the area is sore
• The EUA can be combined with endoanal ultrasound — an imaging scan done from inside the anal canal — to give a precise picture of a fistula's path
• One anaesthetic, one procedure, one recovery — rather than coming back for multiple separate visits
• If a biopsy is needed, the sample is taken accurately and sent to the laboratory for analysis

• Anaesthetic risks — general anaesthesia is safe for most people. Your anaesthetist will go through the small risks with you beforehand and is there specifically to keep you safe throughout
• Minor bleeding from a biopsy — if a tissue sample is taken, a small amount of bleeding can occur, but this is uncommon and usually settles on its own
• Occasionally scarring from a previous infection or operation can make it harder to assess certain areas fully — if this happens, the next steps will be discussed with you
• If an additional procedure is performed during the EUA (such as a fistulotomy — dividing a fistula — or rubber band ligation of haemorrhoids), there are small risks specific to that treatment. These are explained at consent before you sign the form

If you take blood thinners, diabetes medication, GLP-1 weight-loss injectables, or iron supplements, please flag this when you book — these need specific adjustments before the procedure. Full details are in the guide above.

• Depending on what is planned, you may need to do a bowel preparation — if so, our rooms will give you specific instructions. For a basic examination alone, preparation is usually not needed
• Please arrange for a responsible adult to drive you home and stay with you for the rest of the day after your anaesthetic — you will not be able to drive yourself
• Before your procedure, the planned examination is explained, your questions are answered, and you will sign a consent form. If there is any chance an additional treatment may be required — for example, placing a fistula stitch — this will be explained to you beforehand

• You will be admitted to the day-stay unit at Warringal Private Hospital or Epworth Eastern, where the nursing team will get you settled and answer any last-minute questions
• Your anaesthetist will give you a general anaesthetic so you are fully asleep and comfortable throughout
• A thorough examination of the anal canal, rectum, and surrounding area is then carried out. You will be positioned to allow the best access while keeping you comfortable and dignified throughout
• A proctoscope (a small lighted tube) is used, and in some cases a flexible sigmoidoscope to look at the lining of the lower bowel — everything found is carefully documented
• Any planned treatments are carried out at the same time — this might include a biopsy, draining an abscess, placing a seton (a thread through a fistula), or rubber band ligation for haemorrhoids
• You will recover in the day-stay unit and, in most cases, go home the same day once you are comfortable and the nursing team is happy with how you are doing

• Day 0 (the day of your procedure): Rest at home for the remainder of the day. Some mild soreness around the anal area is normal and expected — take the pain relief you have been prescribed, and do not push yourself. The anaesthetic can leave you feeling a little groggy or tired, which is completely normal
• Day 1 onwards: Most people are back to their usual activities within a day or two if only an examination was performed. If an additional treatment was carried out during the EUA, recovery will depend on what was done — the practice team will give you specific guidance for your situation
• After the procedure, the findings are discussed with you and the next steps are outlined — whether that is reassurance, medication, or a planned operation
• A post-procedure review is routinely arranged 2–6 weeks after your procedure to go through the findings, discuss any biopsy results, and plan the next steps in your care — this review is provided at no charge
• For day-by-day guidance on comfort measures, hygiene, and what to expect if a same-session treatment (drainage, seton, biopsy) was performed, see the Post-anal-procedure aftercare guide on the Resources page.

Post-operative concerns: Please call our rooms on (03) 9816 3951 and leave a message — this will be sent directly as a text to Mr Nguyen. Alternatively, you may text the office mobile on 0499 090 126. We aim to respond promptly during business hours.

Emergencies: For any life-threatening emergency, call 000 immediately or go to your nearest emergency department. Do not wait for a call back from our rooms. For the Austin Hospital Emergency Department: (03) 9496 5000.