My surgeon wants to examine me under general anaesthetic and possibly do botox injections. Why can’t these procedures be done under local anaesthetic?
I know I should have asked him this question but I get seriously overwhelmed in these appointments and my mind goes blank.
Thanks.

Do you know how they will examine you? (proctoscopy? sigmoidoscopy?) have you been examined before without anaesthetics?

east_123 wrote:Do you know how they will examine you? (proctoscopy? sigmoidoscopy?) have you been examined before without anaesthetics?

Hi, no he didn't say much about how he's going to do it, just that he wants a "really good look".
I've had quick, general exams where they just look and prod the area a bit. Today at my appointment the surgeon couldn't see anything from a visual inspection so he wants to do a more thorough exam.

I suspect he can see how painful it is for you to be examined-  it would be more comfortable to examine you while you are asleep. It would probably involve a sigmoidoscopy to see  internally if he can see any piles, fissures or other abnormalities such as a prolapse.
I think having local anaesthtic injected round the bottom area could be really painful. I was surprised I had to have a GA for removal of a sentinal pile- the surgeon said the local anaesthetcic would make everything swell and make it more difficult to do the removal as well as being painful.

Hi Pamplemousse,
From what I've heard, general anesthetic is normally used for a more thorough exam because you're completely out and it makes the job easier for you and the surgeon. For myself, I wouldn't do the internal exam or LIS without the general. I have panic disorder and would completely freak out, probably even with mild sedation. So, being completely asleep is best for everyone, unless you have prior problems with general anesthetic or have a preexisting medical condition that warrants them not using it. They can do spinal anesthesia, from what I've heard, instead.
Also, I know that sometimes they will opt for Botox or LIS during the exam under anesthesia if the fissure looks bad enough and the surgeon doesn't think it will heal on its own. Of course, you'd have to discuss this with your surgeon beforehand and I'd assume sign the necessary papers. I know for myself that if the surgeon thought it wouldn't heal without LIS, that I'd just want to get it over with while completely asleep for the exam. I've wasted too much time on this already and wouldn't want to get the general anesthesia twice (I've only had general anesthesia once in my life, when I was eight and needed hernia surgery). I had horrible nausea afterward, but I got through it in a few hours and I would assume they'd have something to help that nowadays since my previous surgery was years ago.

I have had 2 GA's this year and I mentioned to the anaesthetist that I was sick the time before and also got very dehydrated. The 2 GA's I have had this year were fantastic - no nausea, problems with dehydration. the only thing was a very dry mouth I think from the meds to stop the nausea.