LARS, or Low Anterior Resection Syndrome, is a varying array of symptoms or issues resulting from the surgical procedure known as a Low Anterior Resection. Symptoms and issues may include some or all of the following
Bowel Frequency: Frequent movements in a day- some patients report an average of 6-10 bowel movements or as many as 20 per day.
Clustering: This refers to the bowel not being able to empty completely. You may go and eliminate small partial stools, think you are done, only to find you have to move your bowels again within a short amount of time. Stools may vary in consistency and size. Some stools are small and pellet like, some are thin and pencil like and other stool lacks any formation and seems to have a pasty consistency.
Flatulence: Frequent uncontrolled passing of gas. You may notice that the gas is very smelly and often loud and uncontrollable.
Incontinence: Inability to control stool resulting in defecation- sometimes in small accidents and other times substantial.
Tenesmus: A feeling that you need to empty your bowels even when they are empty. This sensation can lead to painful spasms. Tenesmus is different than clustering as with tenesmus, the bowels are empty.
Constipation- Not being able to have bowel movements for a period of time. This can lead to bloating and discomfort and pain.
Additional challenges that affect those of us who live with LARS
Digestive Paralysis and Blockages- The digestive tract either freezes up or is blocked. Signs of this happening are extreme bloating, abdominal pain and lack of bowel movements.
Skin issues- Itching and irritation- This can come from excessive bowel movements and/or constant wiping.
Quality of Life Effects of LARS
The following list of issues are a sampling of what patients have reported for quality of life issues as a direct result of living with LARS.
- Ability to function effectively at work- The lack of bowel control often makes it difficult to manage plans for a successful day of work. Also, fear that employers and co-workers will not understand or become aware of embarrassing flatulence and/or incontinence is a concern for returning to work or changing jobs.
- Ability to exercise– Concern that any movement that causes physical strain may lead to increased bowel movements and incontinence.
- Impact on sex life– Some may find diminished sexual drive, an overall fear of sexual intimacy or fear that partners have lost interest due to LARS.
- Ability to travel any amount of distance- Some fear travel with concerns of not knowing where bathroom is located, being able to make it to the bathroom in time and/or dealing with flatulence in public places.
- Ability to go out with family and friends- Similar to travel, fear of not knowing where bathroom is located, being able to make it to the bathroom in time as well as dealing with flatulence in public places.
Anxiety and depression are very common, if not certain, for with those living with LARS. Anxiety and depression are a direct result of living with LARS symptoms and the impact of the quality of the patient’s life. Anxiety and depression are also very common for caretakers of those who are living with LARS.
You will find more details on each of these symptoms/issues under the section on management tips.
Why Do I have LARS?
Some of you may be asking yourself why you are dealing with the symptoms of LARS. The answer to that question may be different for each patient. The body has been through major changes and disruption and many nerve systems have been disrupted. It is likely that rectal surgery to remove the cancer- the low anterior resection- played a major role in the development of this condition. Some rectal cancer patients also undergo chemotherapy and radiation, both which may play a small or a significant part in LARS. Let’s face it, our bodies have been through a trauma or numerous traumas, and our digestive systems have been permanently changed and impacted.
Understanding how the digestive system works may help you see how the body functions have been changed with surgery and treatment. For more on how the digestive system relates to LARS, click here.
In all honesty, it is important to not get too caught up in trying to figure out why you have LARS and focus more on management of LARS so that you can get back to a decent quality of life.