Clinical Management of Bowel Dysfunction After Low Anterior Resection for Rectal Cancer

Abstract

The American Cancer Society estimated that 39,610 new cases of rectal cancer were diagnosed in the United States in 2015. Surgery is the primary treatment for rectal cancer, with the majority of patients undergoing sphincter-preserving surgery with low anterior resection. Although low anterior resection can prevent patients from having a permanent colostomy, bowel dysfunction may occur in 60% to 90% of patients. Bowel dysfunction symptoms may include fecal and gas incontinence, urgency, frequent bowel movements, clustering of stools, and difficulty emptying. The symptoms collectively are referred to as low anterior resection syndrome (LARS) and adversely affect quality of life. There are no specific therapies for management of LARS. This comprehensive literature review evaluates evidence-based, clinical nonsurgical interventions for symptom management of LARS and will assist advanced practitioners in recognizing symptoms and implementing clinical interventions in the outpatient setting for management of LARS.