Low Anterior Resection Syndrome: Symptoms and Treatment Options
CancerColon Cancer

LARS: The Colorectal Cancer Surgery Side Effect No One Talks About

LARS: The Colorectal Cancer Surgery Side Effect No One Talks About
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Published on March 4, 2026
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If you’ve recently had surgery for colon or rectal cancer, you may find that you need to use the bathroom much more frequently or urgently than before. While this can feel upsetting or abnormal, the good news is that this side effect, known as low anterior resection syndrome (LARS), is actually a common, treatable condition that up to 90 percent of patients experience after colorectal surgery.

 Both LARS and quality of life can improve significantly with the right treatments and emotional support.

What Is LARS?

LARS is a group of symptoms that may develop in people who have undergone surgery to remove a part or all of their rectum.

The rectum is essentially a storage tank for your stool until you’re ready to have a bowel movement.

 When the diseased part of the rectum is removed during surgery, bowel movements become more frequent or unpredictable.

Doctors often overlook LARS as a potential consequence of colorectal surgery, leaving many people unaware that what they’re experiencing is normal.

 “I would say 9 out of 10 patients I see in my LARS clinic were not told [about] LARS by their clinician,” says Marylise Boutros, MD, a staff colorectal surgeon at the Cleveland Clinic Florida.

Signs and Symptoms to Watch for

Some symptoms you may experience with LARS include:

  • Increased frequency or urgency of bowel movements
  • A feeling of needing to defecate even when your bowel is empty
  • Involuntary leaking of gas and stool
  • Change in stool consistency
  • Difficult or painful bowel movements
  • Abdominal pain

It’s natural to feel embarrassed about sharing these types of symptoms with your doctor. “I find people don't necessarily bring it up on their own because there's a certain stigma associated with bowel movements,” says Jeongyoon Moon, MD, assistant professor of colon and rectal surgery at the University of Texas MD Anderson Cancer Center in Houston.

However, Dr. Moon says it’s important to tell your doctor what you’re experiencing so you can receive help. Although LARS has no cure, symptoms may decrease on their own during the first six months to two years after surgery, and there are also numerous treatments available that can improve your condition significantly.

Treatments and Symptom Management

Because LARS symptoms can vary widely from person to person, your doctor will likely try different treatment strategies with you to see what works best.

Lifestyle Changes

Dietary modification is the primary treatment for LARS. Some common dietary triggers include spicy food, caffeine, and alcohol, but not everyone’s triggers are the same.

Keeping a food and symptom diary can help identify your triggers. Your doctor may recommend working with a dietitian, who can help you create a personalized diet plan to reduce symptoms.

Tracking physical activity can also be useful, since this often plays a role in LARS symptoms.

 “When you walk and exercise, you increase abdominal pressure and so it can increase the symptoms,” says Dr. Boutros.

Boutros also recommends tracking the time of day when symptoms occur, which can help determine what strategies will be most effective. For example, she says, if patients recognize that symptoms are worse in the evening, they can make changes like eating dinner earlier or taking medications with dinner rather than breakfast.

Medications and Supplements

Medications and supplements used to treat LARS include:

  • Fiber supplements, such as psyllium husk, to help prevent multiple bowel movements within a short time period

  • Antidiarrheals, such as loperamide (Imodium) and ramosetron, which can reduce incontinence and urgency

  • Laxatives to treat constipation, which can lead to “overflow” diarrhea

  • Ondansetron (Zofran), a medication that’s commonly used to prevent nausea and is known to slow down bowel motility

  • Perianal skincare to reduce anal skin irritation

Pelvic Floor Physical Therapy

Many people have weakened pelvic floor muscles after surgery, which can cause incontinence or difficulty having a bowel movement. Pelvic floor physical therapy can be a great option for treating these symptoms because it can improve bowel function without causing side effects.

Physiotherapists often use techniques like pelvic floor muscle training and biofeedback that focus on helping you regain control over your bowels.

Enemas and Transanal Irrigation

Enemas, in which water or saline is injected into the rectum and lower colon, can be effective for treating LARS, though the effects are stronger in the short-term.

Transanal irrigation is a procedure in which you self-administer a balloon filled with warm water into the rectum, which causes the bowels to empty. This allows you to control when you have bowel movements. The process takes about 20 to 30 minutes and must be performed daily. “It needs a motivated patient,” says Boutros, “but it really does change people's quality of life.”

Sacral Nerve Stimulation

Sacral nerve stimulation uses a device that stimulates the nerves controlling the bowels to make bowel movements more regular.

 “It's something that is surgical, but not as invasive,” says Moon. Studies show that it may be effective for reducing incontinence caused by LARS and improving quality of life.

Colostomy

A colostomy is a surgical procedure in which a hole called a stoma is created in the abdominal wall and connected to the colon, bypassing your rectum altogether.

 Stool collects in a bag outside of the stomach.
Permanent colostomy is used only in cases where other treatments fail to improve symptoms.

 “It's not common, but it is certainly an option that people will seek out,” says Moon.

Finding Support

LARS can seriously impact quality of life, and many people struggle with the emotional toll of managing the condition.

 For example, it can be hard to return to usual routines, including work and socializing, because of the need for constant access to a bathroom.

 “[LARS] has such a deep impact on [people’s] lives, their ability to work, ability to travel,” says Boutros.

It may feel isolating trying to manage LARS on your own. “There's only so much you can talk to your friends and family about your poop habits,” says Boutros.

Getting peer support from a community of people with LARS can significantly improve quality of life.

 Many people find it empowering to share experiences and exchange advice about dietary changes, medications, and products that can help manage LARS. “Once people see that others are [living with] this and have had success,” says Moon, “they become more motivated to be engaged in their healthcare and regain ownership of their own health.”

Your doctor can help you find a peer support group to attend. “Bringing it up to your provider and seeing what kind of resources they can connect you to is a very important step,” says Moon.

There are also online communities, such as Facebook groups, where LARS patients can connect. “The only caution would be that these are not monitored by healthcare professionals,” says Moon, “so be a little careful about any sort of medical advice that may be shared.”

The Takeaway

  • Lower anterior resection syndrome (LARS) is a bowel dysfunction syndrome that commonly affects people who have had colorectal cancer surgery.
  • Symptoms include increased bowel frequency and urgency, incontinence, and difficult or painful bowel movements.
  • LARS can improve significantly with treatment strategies like lifestyle changes, medication, and pelvic floor therapy.
  • Peer support can help you cope with the emotional impact of living with LARS.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
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Yuying Luo, MD

Medical Reviewer

Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City. She aims to deliver evidence-based, patient-centered, and holistic care for her patients.

Her clinical and research focus includes patients with disorders of gut-brain interaction such as irritable bowel syndrome and functional dyspepsia; patients with lower gastrointestinal motility (constipation) disorders and defecatory and anorectal disorders (such as dyssynergic defecation); and women’s gastrointestinal health.

She graduated from Harvard with a bachelor's degree in molecular and cellular biology and received her MD from the NYU Grossman School of Medicine. She completed her residency in internal medicine at the Icahn School of Medicine at Mount Sinai, where she was also chief resident. She completed her gastroenterology fellowship at Mount Sinai Hospital and was also chief fellow.

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Zoe Cunniffe

Zoe Cunniffe

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Zoe Cunniffeis a health journalist who specializes in chronic illness, women's health, and the doctor-patient relationship. She has written for publications such as The BMJ, Aeon, Slate, and Salon.

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