What is LARS?
Low anterior resection syndrome (LARS) is a common condition that may develop after surgery involving partial or complete removal of the rectum, most often performed to treat rectal cancer.
This procedure, called a low anterior resection, involves reconnecting the remaining section of the large bowel (colon) to the anus. Because the rectum plays an important role in storing stool and regulating bowel movements, its removal can result in changes to normal bowel function.
Symptoms:
- Faecal urgency- sudden or urgent need to use your bowels
- Frequent bowel movements
- Loose or watery stools
- Bowel leakage or incontinence
- Incomplete emptying of the bowel
- Soiling or staining of underwear
- Unpredictable bowel habits
Treatment options:
Everyone’s experience is different, treatment is personalised to suit your symptoms and daily life. The focus is on helping you feel better and live well, rather than achieving a specific idea of “normal.” Your care team will guide you through options including:
Post surgery:
- Follow medical advice
- 8 glasses fluid per day (still water is best) sipped slowly through the day
- Practice pelvic floor exercises
- Use a scheduled bathroom routine where possible
- Wear protective pads if needed
- Carry a “comfort kit” – wipes, spare underwear, pads, barrier cream
- Bowel Cancer Australia have some great resources on their website
On going dietary:
- Hydration: drink plenty of water to keep stools soft and your body hydrated
- Fibre intake: eating the right amount of fibre can help regulate stools.
- Avoid trigger foods: fatty foods, caffeine, dairy runny eggs and spicy foods may worsen symptoms
- Dietician: an appointment with a dietician can be helpful so you are not missing out on vital nutrients that may be flushed with frequent loose stools
Pelvic Floor:
- Book an appointment with a Pelvic Floor Physiotherapist: pelvic floor physiotherapists have special training to provide an individualised treatment plan for you
- Toilet routine: bowels like habit, try going to the toilet at the same time each day to train your bowels
- Pelvic floor exercises: strengthening the muscles around the anus can improve bowel control
- Biofeedback therapy is recommended to learn to control bowel muscles using real-time feedback device together with a therapist
Additional treatment if conservative management is not enough:
- Trans anal irrigation – This technique flushes out the bowel using water, reducing the need for frequent toilet trips. A Pelvic Floor Physiotherapist can assist you in agreement with your colorectal surgeon.
- Sacral Nerve Stimulation – A small device is implanted under the skin to send electrical signals to the nerves controlling the bowel and sphincter. It can help improve continence and reduce urgency or limit the number of bowel movements. This is done through your colorectal surgeon.
- Stoma – In severe cases, a stoma may be created. This is an opening in the abdomen that allows stool to pass into a bag, bypassing the backend altogether. This option is usually considered as a last resort when other treatments do not provide sufficient relief. This is discussed with your colorectal surgeon failing all other options.
Disclaimer
The information provided is intended as general guidance and is designed to help inform patients as accurately as possible. It does not cover every aspect of a particular condition, procedure, or individual circumstance.
The choice of the most appropriate procedure is determined by your doctor or colorectal surgeon during consultation, based on a shared and informed decision-making process between you and your clinician.