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

25 November 2021
7 min read
Volume 30 · Issue 21

Abstract

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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