Low Anterior resection - outcomes and quality of life

Morning. 
This is a dilemma.

I was very unsure if I was going to have a reversal as after having my LAR

lived life to the full with my Ileostomy.

travelled ate out and managed my stoma well and had amazing advice here from the stoma support. 

 Living well with a stoma reversal or LARS 

It is definitely worth checking out the sub group I’ve linked for you in the Stoma Suppirt 

I decided to go for the reversal as I was told that there was support if I needed it 

Hi, I had lower anterior surgery last May. I did manage to avoid having a stoma (although some that I’ve spoken to feel no discomfort or disadvantage from having one).

l have certainly had issues over the last 11 months ranging from extreme urgency to abject constipation (sometimes together!) With judgement you do get a reasonable balance via the use of loperamide. Over the last 3 months my movements have improved dramatically and I have found that good hydration also helps enormously. I am to scared to go out without any loperamide in my pocket at the moment but don’t actually have to worry too much and can see light at the end of the tunnel.

kind regards. -  Daniel 

Hi Seekinginfo It’s a tricky one isn’t it? My tumour was 9cm in and I had a temporary Ileostomy for 15 months. I also had an anastomic leak after surgery which they’ve said is not that unusual but resulted in me having to have a drain inserted for several weeks - the Ileostomy did not prevent this - I think it’s just one of those things that can happen sometimes - if you click on my name then you can see my treatment line although it’s a lot more straight forward for most people!

When discussing the reversal my surgeon said that he’d left me plenty of rectum but I would have to get used to a ‘new’ normal. The first few months were tough with a lot of rushing to the toilet and burning loose stools resulting in a very sore bottom. Things settled down over time but even now, 6 years later, I have good days and not so good days. I take loperamide and vary from 0 visits a day to 6-8 visits a day. Having said that I do not watch what I eat or drink and I lead a normal life although I don’t work so usually have easy access to a toilet. 

community.macmillan.org.uk/.../ileostomy-and-colostomy-discussions-forum

I’ve attached a link to the Stoma Board which also has a section about reversal and LARS. LARS is Low Anterior Resection Syndrome - if you google it then there is an online calculator which calculates whether you’re low or high risk - there’s not a lot of medical knowledge about LARS but there is an online group that talks about their struggles and various tips.

Hope this helps? I don’t know how old your mum is or her physical condition? My friend has a permanent colostomy and lives a full and normal life. I dont regret my reversal as my stoma tended to be quite loose when active but I wish I could go once a day and be done like the old days

Take care

Karen x

Thank you Karen.  My mum is in her 60s.  She’s fit and in good health. 

I had rectal cancer back in 2022, diagnosed May 31st then had LAR July 14th, I was told I could wake up with a stoma and I was fully prepared for that but my amazing surgeon managed to remove tumour and join both ends back together, at the beginning my surgeon said I would have poor bowel function long term and I have constant constipation, I have to take lactulose every other night (doesn’t help I have to take iron tablets now) but yea a friend of mine who I met during treatment she went the other way and suffers with diarrhoea, I asked why my bowels ended up this was but no clinician can tell me why :(  I wish her all the best x 

As others have said this is a dilema. I am 67 years old now and consider myself to have a good lecel of fitness.

I had an LAR with an ileostomy in November 2021, followed by 6 months of FOLFOX chemo. I coped well with my stoma and lived an active and full life with it.

In September 2022 my surgeon said I was suitable for a stoma reversal if I wanted one. I decided, despite the risks, to opt for the reversal, and one year on have no regrets.

I had the reversal in early May 2023. The early weeks were a challenge and my colorectal nurse said it would be at least 12 months before I would get to my ‘bew normal’.

In the past six months I have had three trips abroad without issue. I eat and drink whatever I want and my new normal varies between 2-6 bowel movements a day. I no longer need loperamide, although I always have some with me when going out for the night/day.

Everyone is different, and mybe I am lucky, but in my case a reversal was certainly a risk worth taking.