Low anterior resection syndrome

Low Anterior Resection Syndrome (LARS) is a collection of symptoms that can occur after surgical resection of the rectum and sigmoid colon. The syndrome is characterized by a significant change in bowel habits, which can include fecal incontinence, urgency, and increased frequency of bowel movements.

Etiology

LARS is most commonly associated with the surgical treatment of rectal cancer, where the lower part of the rectum is removed. This procedure is known as a low anterior resection (LAR). The syndrome can also occur after other types of colorectal surgery, such as a total mesorectal excision (TME).

Symptoms

The symptoms of LARS can vary widely among individuals, but commonly include:

• Fecal incontinence: The inability to control bowel movements, leading to unintentional leakage of stool.
• Urgency: A sudden, strong urge to have a bowel movement.
• Increased frequency of bowel movements: Often, individuals with LARS will have more than five bowel movements per day.
• Nocturnal bowel movements: The need to have bowel movements during the night.
• Fragmented defecation: The sensation of incomplete evacuation after a bowel movement.

Diagnosis

The diagnosis of LARS is primarily based on the patient's symptoms and medical history, particularly a history of low anterior resection surgery. There is also a specific scoring system, known as the LARS score, which can be used to quantify the severity of the syndrome.

Treatment

Treatment for LARS is typically multidisciplinary and can include dietary modifications, medication, pelvic floor exercises, and in some cases, further surgery. The goal of treatment is to improve the patient's quality of life by managing symptoms.

Prognosis

The prognosis for individuals with LARS varies and is largely dependent on the severity of the syndrome and the individual's response to treatment. Some individuals may experience a significant improvement in symptoms over time, while others may continue to experience chronic symptoms.

See also

• Rectal cancer
• Colorectal surgery
• Fecal incontinence

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