{"entity":{"id":"low-anterior-resection-syndrome","kind":"term","name":"Low anterior resection syndrome (LARS)","aka":["LARS","LARS score","bowel dysfunction after rectal surgery","anterior resection syndrome"],"tldr":"The group of bowel problems that can follow sphincter-preserving surgery for rectal cancer: going more often, urgency with or without leaking, feeling the bowel is not empty, passing small amounts little and often, and not being able to tell wind from stool. NICE asks teams to warn people before surgery, to measure it with the LARS score and to treat it in primary care.","summary":"NICE NG151 (1.6.2) says to give information on low anterior resection syndrome to people who will potentially have sphincter-preserving surgery, and to advise them to seek help from primary care if they think they have symptoms, listing increased frequency of stool, urgency with or without incontinence of stool, feeling of incomplete emptying of the bowels, fragmentation of stool (passing small amounts little and often) and difficulty in differentiating between gas and stool. It says (1.6.3) to assess people with symptoms using a validated patient-administered questionnaire, for example the LARS score published by the European Society of Coloproctology, and (1.6.4) to offer treatment such as dietary management, laxatives, anti-bulking agents, anti-diarrhoeal agents or anti-spasmodic agents in primary care, seeking advice from secondary care if that is not successful. Cancer Research UK says most people have problems with bowel function for several weeks after rectal cancer surgery and for many these continue for around a year, that bowel habits are unlikely to return to how they were before surgery but should become less severe with time, and that for some the problems become LARS. Macmillan says that after an anterior resection with a temporary stoma it can take several months after the stoma is reversed for bowel function to settle, and that for some people it never becomes regular. Practical help the same pages give: loperamide to slow the bowel and make stools more solid, sometimes taken regularly 30 minutes before meals; fybogel to bulk out loose stool when going small amounts often; laxatives or stool softeners for constipation; eating at regular times and in small frequent meals; a food and symptom diary; keeping the skin clean and dry with unperfumed wipes, barrier sprays and cotton underwear; and the Bladder and Bowel Community's Just Can't Wait card for quicker access to a toilet. The LARS score itself was published by Emmertsen and Laurberg in 2012 as a short questionnaire that separates no, minor and major LARS.","asOf":"2026-09-24","links":[{"label":"NICE NG151: colorectal cancer, recommendations","url":"https://www.nice.org.uk/guidance/ng151/chapter/Recommendations"},{"label":"Cancer Research UK: bowel changes after treatment for bowel cancer","url":"https://www.cancerresearchuk.org/about-cancer/bowel-cancer/living-with/bowel-changes-after-treatment"},{"label":"Macmillan: bowel changes after cancer treatment","url":"https://www.macmillan.org.uk/cancer-information-and-support/bowel-cancer/managing-bowel-changes-after-treatment"},{"label":"Bowel Cancer UK: change in bowel habit after treatment","url":"https://www.bowelcanceruk.org.uk/about-bowel-cancer/living-with-and-beyond-bowel-cancer/change-in-bowel-habit-after-treatment/"},{"label":"Emmertsen and Laurberg, low anterior resection syndrome score: a simple tool to identify bowel dysfunction after rectal cancer surgery (Annals of Surgery 2012)","url":"https://doi.org/10.1097/SLA.0b013e31824f1c21"}],"tags":["gi","colorectal"],"related":[],"cancers":["colorectal"],"sections":[],"technologies":["survivorship-care-plan"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["total-mesorectal-excision","stoma","late-effects"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Side effects"},"route":"/terms/low-anterior-resection-syndrome/","neighbours":{"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"}],"technology":[{"id":"survivorship-care-plan","kind":"technology","name":"Survivorship care and late-effects surveillance","route":"/technologies/survivorship-care-plan/"}],"term":[{"id":"late-effects","kind":"term","name":"Late effects and survivorship toxicity","route":"/terms/late-effects/"},{"id":"stoma","kind":"term","name":"Stoma (colostomy, ileostomy, urostomy)","route":"/terms/stoma/"},{"id":"total-mesorectal-excision","kind":"term","name":"Total mesorectal excision (TME)","route":"/terms/total-mesorectal-excision/"}]}}