Low Anterior Resection Syndrome (LARS)

Learn what Low Anterior Resection Syndrome (LARS) is, why it happens after rectal cancer surgery, and the tools and strategies that can help you manage symptoms.

What causes LARS?

Low anterior resection surgery involves removing portions of the colon containing cancer cells and connecting the remaining parts of the colon, leaving only healthy cells and tissue. Rectal cancer patients may undergo resection or removal of part or of the entire rectum (the last 6-8 inches of the large intestine), which can lead to a collection of symptoms known as Low Anterior Resection Syndrome (LARS).

Colorectal Cancer Surgery

About LARS

Low anterior resection syndrome can occur after resection surgery to the lower part of the colon. After the resection or removal of the part of the rectum containing cancer cells, your surgeon will perform an anastomosis, or “hook up,” of the colon.

Anastomosis means that the two remaining ends of the large intestine and the rectum are sewn or stapled back together, resulting in a shorter colon, which leads to the symptoms that make up LARS.

Symptoms of LARS

LARS refers to several related symptoms that patients may experience post-surgery. The symptoms are different for everyone, but could include:
  • Frequency or urgency of stools, largely due to the fact you have less space to store stool after removing part of the rectum
  • Clustering of stools (many bowel movements during a few hours)
  • Fecal incontinence (lack of control over bowel movements)
  • Constipation for more than a few days, followed by multiple bowel movements a few days later
  • Increased gas
  • Abdominal pain
  • Risk of urinary and/or sexual dysfunction due to nerve damage

Many survivors report symptoms of lower anterior resection syndrome can interfere with daily living and reduce their quality of life. While some patients report that these side effects improve over time, some experts believe that if symptoms exist at one-year post-surgery (or stoma closure), they are likely to continue to exist 10 years later.

Check out our Pelvic Floor Webinar for tips to manage LARS:

 

Managing LARS

There are ways to manage LARS, but finding the right regimen can be challenging, as management is extremely individualized: What works for one person may not work for another. Here’s a list of some ways people manage:

Kegel Exercises

Kegels may help strengthen the muscles of the pelvic floor. To do this, tighten your muscles like you are trying to hold back a bowel movement. Hold this position for 5 to 10 seconds. Release and rest. Repeat. Before you begin a kegel routine, please consult with a pelvic floor specialist.

Irrigation

Many patients with LARS claim that irrigation to clean out the colon greatly decreases the daily distress and LARS symptoms. Irrigation must be done carefully and under the advisement of a doctor. There are irrigation products by Coloplast that can be used, and some patients also buy supplies via Amazon.

Medicines and Probiotics

There are medications and over-the-counter drugs that can help with incontinence (Imodium for clustering, Metamucil® as a fiber supplement, for example). Also: some patients find that taking a probiotic pill, or having daily servings of yogurt, kombucha, Keifer, or other probiotic-rich foods and drinks help. Be sure to talk with your physician before beginning a new medication regimen.

Stool training and biofeedback

These are non-surgical therapies that can retrain your muscles to manage bowel dysfunction like fecal incontinence and constipation. Essentially, you learn through reinforcement how to train the muscles in your bowel to normalize function. Seek pelvic floor physical therapy to address your symptoms of LARS.

Survival pack

You need to be prepared if you have LARS. Consider carrying a survival pack that includes soft/flushable wipes, clean underwear, plastic bags, hand sanitizer, Imodium, and butt paste.

Counseling

For some, talking about the challenges that result from LARS can really help ease stress and shift the focus to other things in life. Reducing stress may also reduce LARS symptoms.

LARS: A Survivor’s Perspective

In this Taboo-ty Podcast, colorectal cancer survivor, Jon, talks about all things LARS. He reviews the “must-haves” a person with LARS should carry with them at all times, the ups and downs of symptoms like frequency, and more.

 

Diet For LARS

Making changes to your diet may help prevent urgency and incontinence. Here are some to consider:

  • Eat small, frequent meals (skipping meals can cause increased gas)
  • Drink plenty of fluids slowly
  • Eat foods that help slow and firm up stool including:, white rice, pasta, bread, pretzels, tapioca, marshmallows, peanut butter, bananas, potatoes, and yogurt
  • Avoid foods that cause gas, including:, carbonated beverages, beer, dairy products, nuts, and certain vegetables (such as cabbage, spinach, cucumbers, broccoli, cauliflower, onions, beans, and corn) 

Surgery Brochure

From side effects of surgery, types of colon and rectal surgeries, questions to ask your medical team, to a packing list, the Fight CRC surgery brochure covers important information for you to consider. Request your FREE copy today.
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