Our Summary

This research paper reviews the issue of bowel dysfunction, also known as low anterior resection syndrome (LARS), in patients who have undergone treatment for rectal cancer. After the rectum is removed, patients may experience a range of symptoms such as increased frequency of bowel movements, urgency, multiple bowel movements and inability to control the release of gas or stool. There has been an increase in the number of patients experiencing these symptoms in recent decades. The paper suggests that understanding the causes and mechanisms of this issue can help in managing patients and improving their quality of life after treatment.

FAQs

  1. What is low anterior resection syndrome (LARS)?
  2. What symptoms might patients experience after a bowel resection for rectal cancer?
  3. How can understanding the causes and mechanisms of bowel dysfunction help improve the quality of life for patients post-treatment?

Doctor’s Tip

One helpful tip a doctor might tell a patient about bowel resection is to follow a high-fiber diet to help regulate bowel movements and prevent constipation. It is also important to stay hydrated and to gradually introduce fiber-rich foods to avoid exacerbating symptoms. Additionally, regular exercise can help improve bowel function and overall digestive health. Patients should also communicate any concerns or changes in symptoms to their healthcare provider to ensure proper management and support.

Suitable For

Patients who are typically recommended for bowel resection include those with:

  1. Rectal cancer: Bowel resection is a common treatment for rectal cancer, as it involves removing the affected part of the colon or rectum to prevent the spread of cancer cells.

  2. Inflammatory bowel disease (IBD): Patients with conditions such as Crohn’s disease or ulcerative colitis may require bowel resection if their symptoms are severe and do not respond to other treatments.

  3. Diverticulitis: In cases of severe diverticulitis, where inflammation or infection of the diverticula (small pouches in the colon) occurs, bowel resection may be necessary to remove the affected part of the colon.

  4. Bowel obstruction: Patients with a blockage in the colon or rectum may require bowel resection to remove the obstruction and restore normal bowel function.

  5. Trauma or injury: In cases of severe trauma or injury to the abdomen or digestive system, bowel resection may be necessary to repair or remove damaged tissue.

Overall, patients who are recommended for bowel resection are those who have a serious condition affecting the colon or rectum that cannot be effectively treated with other methods. It is important for these patients to discuss the risks and benefits of the procedure with their healthcare provider and to follow post-operative care instructions to ensure a successful recovery.

Timeline

Before bowel resection:

  1. Patient is diagnosed with rectal cancer and undergoes various tests to determine the extent of the disease.
  2. Patient undergoes preoperative preparation, which may include bowel cleansing and dietary restrictions.
  3. Surgery is performed to remove the affected part of the bowel, often including the rectum.
  4. Patient may require a temporary or permanent colostomy or ileostomy to divert stool from the affected area.
  5. Patient undergoes postoperative recovery, which may include pain management, monitoring for complications, and gradually reintroducing food and liquids.

After bowel resection:

  1. Patient may experience changes in bowel habits, including increased frequency of bowel movements, urgency, and difficulty controlling gas or stool.
  2. Patient may experience abdominal pain, bloating, and discomfort.
  3. Patient may need to adjust their diet and lifestyle to manage symptoms, such as eating smaller, more frequent meals and avoiding trigger foods.
  4. Patient may undergo rehabilitation and physical therapy to improve bowel function and pelvic floor strength.
  5. Patient may require medication, such as laxatives or anti-diarrheal agents, to help manage symptoms.
  6. Patient may undergo regular follow-up appointments with their healthcare provider to monitor symptoms and adjust treatment as needed.
  7. Patient may require psychological support to cope with the physical and emotional challenges of living with bowel dysfunction.

What to Ask Your Doctor

  1. What is a bowel resection and why is it necessary for my condition?
  2. What are the potential risks and complications associated with bowel resection surgery?
  3. How long is the recovery period after bowel resection surgery?
  4. What kind of dietary changes or restrictions will I need to follow after the surgery?
  5. What kind of physical activity or exercise will be safe for me after the surgery?
  6. What symptoms should I watch out for that may indicate a complication after the surgery?
  7. Will I need any follow-up procedures or treatments after the bowel resection surgery?
  8. How likely am I to experience bowel dysfunction or LARS after the surgery?
  9. What can be done to manage or alleviate symptoms of bowel dysfunction or LARS if they occur?
  10. Are there any support groups or resources available for patients who have undergone bowel resection surgery?

Reference

Authors: Buzatti KCLR, Petroianu A. Journal: Rev Col Bras Cir. 2017 Jul-Aug;44(4):397-402. doi: 10.1590/0100-69912017004003. PMID: 29019544