Faecal incontinence and LARS after bowel surgery

What is faecal incontinence?

Faecal incontinence means that wind or stool cannot be held back reliably. The spectrum ranges from occasional loss of wind to involuntary passage of solid stool. Among other forms, a distinction is made between urge incontinence, where the urge comes so suddenly that the toilet cannot be reached in time, and passive incontinence, where stool is lost unnoticed.

Possible causes

• injuries to the sphincter muscle, for example during childbirth
• surgery on the rectum or anal region
• weakness of the pelvic floor and sphincter muscles
• nerve damage, for example due to neurological conditions or diabetes
• changes in stool consistency, for example with chronic diarrhoea

What is LARS?

LARS stands for “Low Anterior Resection Syndrome”. It describes symptoms that can occur after a low anterior resection of the rectum, i.e. an operation in which part of the rectum is removed, often as part of the treatment of rectal cancer. The symptoms often appear after closure of a temporary stoma.

Typical symptoms are frequent and urgent bowel movements, emptying in several portions, involuntary loss of wind or stool and a feeling of incomplete emptying. Severity varies widely and can change over time.

What treatment options are there?

Treatment depends on the cause and severity and is decided individually. Possible components are:

• dietary adjustments and regulating stool consistency
• medication, for example to slow down bowel activity
• pelvic floor and sphincter training, often supported by biofeedback
• electrical stimulation, depending on the findings
• transanal irrigation
• in selected cases, procedures such as sacral neuromodulation or surgery

This article is for general information only and does not replace medical advice, diagnosis or treatment. If you have symptoms, please consult your doctor.