Bowel Cancer UK. Facts and figures about bowel cancer. 2019. (accessed 8 November 2021)

Burch J. Low anterior resection syndrome: impact on quality of life and nurse-led management. Gastrointestinal Nursing. 2021; 19:S15-S20

Cancer Research UK. Bowel cancer statistics: bowel cancer incidence. 2021. (accessed 8 November 2021)

Christensen P, Baeten CIM, Espín-Basany E Management guidelines for low anterior resection syndrome—the MANUEL project. Colorectal Dis.. 2021; 23:(2)461-475

Emmanuel A, Collins B, Henderson M, Lewis L, Stackhouse K. Development of a decision guide for transanal irrigation in bowel disorders. Gastrointestinal Nursing. 2019; 17:(7)24-30

Iwama T, Imajo M, Yaegashi K, Mishima Y. Self washout method for defecational complaints following low anterior rectal resection. Jpn J Surg.. 1989; 19:(2)251-253

Keane C, Fearnhead NS, Bordeianou LG International consensus definition of low anterior resection syndrome. ANZ J Surg. 2020; 90:(3)300-307

Koch SMP, Rietveld MP, Govaert B, van Gemert WG, Baeten CGMI. Retrograde colonic irrigation for faecal incontinence after low anterior resection. Int J Colorectal Dis.. 2009; 24:(9)1019-1022

Liang Z, Ding W, Chen W, Wang Z, Du P, Cui L. Therapeutic evaluation of biofeedback therapy in the treatment of anterior resection syndrome after sphincter-saving surgery for rectal cancer. Clin Colorectal Cancer. 2016; 15:(3)e101-e107

National Guideline Alliance. Colorectal cancer (update): [E2] Optimal management of low anterior resection syndrome. Evidence review for National Institute for Health and Care Excellence guideline NG151. 2020. (accessed 8 November 2021)

NHS England/NHS Improvement. NHS long term plan. 2019. (accessed 8 November 2021)

Sumner D, Collins B. The Watford low anterior resection syndrome pathway for pre- and post-stoma reversal patients. Gastrointestinal Nursing. 2019; 17:(7)43-48

Using transanal irrigation in the management of low anterior resection syndrome: a service audit

25 November 2021
7 min read
Volume 30 · Issue 21


Low anterior resection syndrome (LARS) is a collection of symptoms that can occur as a result of a low anterior resection for bowel cancer. Transanal irrigation (TAI) can be used to manage these symptoms. This article describes a retrospective audit of 15 patients who were using TAI to manage symptoms of LARS. The aim of the audit was to ascertain whether the use of TAI improved outcomes for these patients. The data suggest that TAI has reduced both the frequency of bowel movements and episodes of faecal incontinence. Those patients using higher volumes of water seem to have experienced more benefit than those patients using lower volumes of water. These findings are consistent with current literature around TAI for LARS and suggest research into optimum volume of water would be beneficial.

Approximately 268 000 people in the UK are living with bowel cancer and more than 42 000 people are diagnosed with bowel cancer every year (Bowel Cancer UK, 2019). The NHS Long Term Plan (NHS England/NHS Improvement, 2019) states an ambition that by 2028, a further 55 000 patients a year will survive longer than 5 years after diagnosis. Due to this growth, there is an increased focus on post-treatment cancer survivorship issues. With 31.5% of bowel cancers occurring in the rectum (Cancer Research UK, 2021), many cancer survivors struggle with the consequences of cancer treatment. An example of this is low anterior resection syndrome.

Low anterior resection syndrome (LARS) is a collection of symptoms that may result from a low anterior resection for bowel cancer. Keane et al (2020), in their international consensus definition of LARS, identified eight symptoms and eight consequences that can result from low anterior resection surgery. They suggested that a diagnosis of LARS can be made when a patient suffers from at least one symptom, leading to at least one consequence (Table 1).

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