Low anterior resection syndrome: impact on quality of life and nurse-led management

Abstract

Rectal cancer is common and is often treated with surgical removal of the rectum, potentially including chemoradiation. Despite improvements in surgical technique, this treatment often results in long-term negative consequences. The most common of these symptoms involve bowel dysfunction, such as faecal incontinence, constipation and urgency, and are collectively termed low anterior resection syndrome (LARS). These often negatively impact on quality of life in a number of areas, including work, relationships and mental wellbeing. These symptoms can be eased with conservative management techniques, such as dietary modification, pelvic floor exercises and medication. If these are insufficient, patients can try specialist nurse-led interventions, including biofeedback, hypnotherapy, nerve stimulation and/or transanal irrigation. If these management options do not provide adequate quality of life, a permanent colostomy can be formed. It is important for nurses to recognise that problems can occur after treatment for rectal cancer and assist patients to overcome these problems and improve their quality of life.