Ultra low anterior resection

[Binalcorn]

Hi guys.
I had an ultra low anterior resection almost 3 months ago for severe endometriosis. My entire rectum was removed and I had a coloanal anastomosis and a temp ileostomy which was reversed about 6 weeks ago.

I'm having the expected frequency (15-25 times a day), urgency, incontinenece etc - I can live with this. However I am having HUGE difficulty with virtually constant knee buckling anal spasms/pain, intense anal/rectal pressure and weird bearing down sensations. I usually get about 5 mins of relief from these sensations after a BM however outside of these brief reprieves, it is brutal.

My surgeon blithely says it will PROBABLY improve over time.. However my research online re low anterior resection syndrome (what I think I have) is not encouraging!!

Has anyone here had an ultra low resection of there entire rectum and can u tell me a bit about your experience??
Thank youuuuu!
Belinda

[ozziej]

Hi Belinda,
I had a reversal after ULAR on 23 May so we're about the same time out. I also had the rectal pain and that bearing down sensation. I'm in Australia so not sure if you have access to Rectinol. It's for hemorrhoid pain. I also used a microwave hot pack alternated with an ice pack. These plus some paracetamol seemed to ease the spasms. I also stuck to a strict low residue diet which I'm still on. Boring but worth it I think. Hopefully some of this helps. Kind regards
Jan

[Nik Colon]

I have not had a ULAR but understand some of the things you described, the spasms and bearing down. I don't have much suggestions except trying to relax and lay down, maybe some cream, and the other suggestions of hot or cold packs or heating pad. Best wishes

[Jachut]

The bearing down (tenesmus) is awful. I found anti inflammatory medication helped a bit when I had it before diagnosis - for me, it came on like labour, it was THAT strong. I had it a lot after reversal of my ileostomy and the medication was not so helpful then. For me, it was a feature of every bowel movement, and it didnt improve, but I found I had a prolapsed pouch, - any sort of physical problem in that area can cause tenesmus. Most doctors will tell you it will improve, and they're probably right, but it takes about two years to really get to your new normal. Hang in there, ULAR is not an easy surgery to recover completely from.

[Binalcorn]

Hey guys.
Thanks so much for your responses.
Good to know it's not just me.
A few more months down the track (7 months post op) and those symptoms are not as bad... Still there and I still find I am thinking about my bum almost constantly... But def some improemt and have been able to get off pain meds which is REALLY good.

I'm more focused on trying to manage cluster pooing now. Ie some days it's just poo poo poo. Then other days hardly anything.. It's restrictive but at least I am somewhat more comfortable than before.

Hope u guys are doing ok too.

Thanks again
Belinda

[ozziej]

Hi Belinda
Good to hear that you're doing well. We're at about the same time out from reversal. Your experience is very similar to mine. I still have occasional tenesmus and i know what you mean about some days just being poop poop poop. I'm sure sometimes more comes out than went in, as though there's a little factory going on in there . All in all though for me things are much improved and most days are very manageable.
Wishing all our reversalists a smooth recovery.
Jan

[Jachut]

D'oh, just realised i'd already replied to this! Glad things are better.

[Daisymae]

I had a ULAR march 2012 - ostomy reversal may 2012. I get that weird, debilitating rectal pressure/pain you are describing, but only when I ovulate. It's like clockwork every month. Initially it was so bad that I couldn't walk up stairs, had to lie on the floor with my legs in butterfly position because I felt like my rear was being shisk-a-bobbed. When I finally figured out what was going on I tried a variety of meds. The only thing that works is naprosyn (same as 500mg aleve I belive). If I take it at onset it knocks it out. Nothing else works. As for cluster poo, it's just a part of my life. I don't have urgency just high frequency which is manageable, I just pop in and out of bathrooms as needed. Sometimes is annoying but it could be worse. I def have found w each passing month/year things improve, or I just get used to it good luck.

[Jachut]

Isnt that weird - because in hindsight I had symptoms of rectal cancer for a couple of years before diagnosis - terrible tenesmus (like labour, as I mentioned) but it only happened just before my period arrived. Doctors chalked it up to endometriosis and I could handle the pain so because I was 40ish, we never really did anything about it.