Low Anterior Resection (LARS)
LARS is a group of bowel symptoms that occur after surgical removal of the rectum, usually following low anterior resection for rectal cancer. The condition develops because the rectum’s capacity to store stool is significantly reduced, and the normal coordination of bowel function can be altered by changes to nerve pathways during surgery or radiotherapy. A temporary stoma is often created to protect the anastomosis.
When the stoma is reversed, symptoms can lead to urgency, frequent bowel movements, clustering (several stools in a short time), incontinence, difficulty distinguishing wind from stool, and a sense of incomplete emptying.
LARS affects up to 80% of patients after stoma reversal and can have a major impact on quality of life.
Source references
Berger et al (2016) Low anterior resection syndrome: current management and future directions. Clin Colon Rectal Surg, 29(03);239-245
Bradshaw E (2022) ‘Colorectal nursing and low anterior resection syndrome’, British Journal of Nursing, 31(4), pp. 178–182.
National Cancer Strategy (2015) www.england.nhs.uk/cancer/ invest/
Power-Chandler et al (2018) PARiS (Physiotherapy and Anterior Resection Syndrome) Trial Management Group. Feasibility study protocol. BMJ Open, 8(6);e021855
Sumner, D. and Collins, B. (2019) ‘The Watford low anterior resection syndrome pathway for pre- and post-stoma reversal patients’, Gastrointestinal Nursing, 17(7), pp. 43–49. doi: 10.12968/gasn.2019.17.7.43.
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