LARS

[Ladytot]

Hi there anyone.
I had an ultra low anterior resection done in May 2016. Up until a couple of months ago I had no idea that there was such a thing as the "Low Anterior Resection Syndrome". Having now read up on it and following the dietary advice along with using the low FODMAP diet, I have gone from being unable to go out for a meal, or go on holiday, or indeed take part in any social event, because of my toileting requirements, to now leading a normal life. This has happened because I have learned and followed the strict dietary requirements for this condition. I would be interested to hear if anyone else has had the same experience and...if their surgeon advised them at any time of either the syndrome or what dietary changes would be advisable. On the quatilty of life score for this Syndrome I was extremely poor quality of life. Not now!
Thanks for reading. I have a lot more to say, but that will do to be going on with!

[Green Tea]

Hi there anyone.
I had an ultra low anterior resection done in May 2016. Up until a couple of months ago I had no idea that there was such a thing as the "Low Anterior Resection Syndrome". Having now read up on it and following the dietary advice along with using the low FODMAP diet, I have gone from being unable to go out for a meal, or go on holiday, or indeed take part in any social event, because of my toileting requirements, to now leading a normal life. This has happened because I have learned and followed the strict dietary requirements for this condition. I would be interested to hear if anyone else has had the same experience and...if their surgeon advised them at any time of either the syndrome or what dietary changes would be advisable. On the quality of life score for this Syndrome I was extremely poor quality of life. Not now!
Thanks for reading. I have a lot more to say, but that will do to be going on with!

My experience was almost exactly like yours, except for the fact that my surgery was LAR not ULAR. My surgeon never ever mentioned LARS and he pretended not to have heard ever about it when I eventually mentioned it to him. Also, I never got any useful LARS-related helpful advice from him. What I did was to treat LARS myself by developing an extremely strict diet after doing months of food-and-toilet logs to see just what my bowel was doing with the food and beverages.

Now, like you, I have a reasonably normal life. It's not perfect, but it allows me to do almost anything, provided I stick to my very rigid food-and-beverage rules. If I don't stick to the diet, then disaster strikes within a day or so, but I haven't had that happen to me for at least three years now, because I now know just what I need to know to keep everything under control.

[Ladytot]

Thank you for your response. What country are you in? I'm in Australia.

[Swirdfish]

I get my reversal soon. Any of you able to post what diet requirements you follow? Not sure how LARS will affect me, but being prepared so I can continue to work will be a major hurdle.

[Ladytot]

Everyone is different and what I do may not suit you but.....I would suggest the first place to look for advice is the Monash University Melbourne website for a low FODMAPs diet. I contacted them before I knew anything about the existence of LARS, and asked if this diet would help me, even though it is actually for people with IBS. They confirmed that it can be used after an ileostomy.
So I started following the low FODMAPs diet and I kept a food diary for about 6 weeks. I also had the help of a dietician. I then discovered the existence of the LAR syndrome and followed the advice on the Low Anterior Resection Syndrome website as to diet. It uses a questionnaire to ascertain the extent of your quality of life. After learning all that, it was up to me to follow the advice and to pay the price if I chose to eat anything Not recommended. So, if I want a square of chocolate, I make sure I'll be home for the next few hours!
It may be that you don't suffer as badly as I did and also it takes a while for your bowel to settle down after the reversal. I was still finding it impossible to go out in the evening after 12 months so that was when I really got serious.
My main triggers are wheat, sugar, stone fruit, alcohol, lactose, soft cheeses, nuts, seeds, legumes and any vegetable other than root veg. That sounds awful but actually I have found alternatives and it's ok ..not even as antisocial as I thought it would be. Look at the Monash website. There is wonderful information here. Sorry it's such a long answer. Good luck with everything.

Also, I take 1 teaspoon fibre (benefibre) in water each day and 1 gastrostop before a main meal

[Ladytot]

Sorry..I forgot..very important..onion and garlic are very strong triggers of diarrhoea.

[Green Tea]

I get my reversal soon. Any of you able to post what diet requirements you follow? Not sure how LARS will affect me, but being prepared so I can continue to work will be a major hurdle.

... I'm arming myself with all the knowledge I can obtain to help me fight this...

Swirdfish- What is the scheduled date of your upcoming reversal? I might be able to give you some detailed information later, but right now I'm a bit busy.

Your DX and past treatments seem to be somewhat similar to mine, so I might have some relevant comments. The main comment I would have, though, is that I think all LARS patients are different in their responses, so it is necessary to start from Day 1 to search for some kind of program that will properly define your own type of LARS and that will narrow down the available treatment options to the ones that are actually going to be useful for the long term. I think it is a mistake to blindly try to follow someone else's diet or someone else's treatment regimen. You need a customized treatment plan designed especially for you, but it doesn't hurt to have a look around at what others have done. It's just that you can't routinely accept someone else's treatment program and expect that it's going to have the same effect on you.

So, when will you have a reversal date?

[Swirdfish]

I get my reversal soon. Any of you able to post what diet requirements you follow? Not sure how LARS will affect me, but being prepared so I can continue to work will be a major hurdle.

... I'm arming myself with all the knowledge I can obtain to help me fight this...

Swirdfish- What is the scheduled date of your upcoming reversal? I might be able to give you some detailed information later, but right now I'm a bit busy.

Your DX and past treatments seem to be somewhat similar to mine, so I might have some relevant comments. The main comment I would have, though, is that I think all LARS patients are different in their responses, so it is necessary to start from Day 1 to search for some kind of program that will properly define your own type of LARS and that will narrow down the available treatment options to the ones that are actually going to be useful for the long term. I think it is a mistake to blindly try to follow someone else's diet or someone else's treatment regimen. You need a customized treatment plan designed especially for you, but it doesn't hurt to have a look around at what others have done. It's just that you can't routinely accept someone else's treatment program and expect that it's going to have the same effect on you.

So, when will you have a reversal date?

Reversal will be around 15 march as I have two folfox treatments left to go. I know everyone is different but it gives me ideas of what to try if the shit hits the fan lol. I'm a fly in and out worked so I fly every week for my job.if I have issues straight away I want to be able to try things that other people have had success with. No harm in that.

I maybe alright I may not be. But I will see a dietician etc but ideas are always welcome.

[Green Tea]

... But I will see a dietician etc but ideas are always welcome.

When seeing a dietitian, be sure to see one who is a certified oncology dietitian, not just a generic dietitian. It should be a dietitian who knows how to recommend diets for the recovery from all sorts of cancer treatments, including rectal cancer treatments.

In your situation, you are a Rectal Cancer patient who has had both radiation therapy and chemotherapy. Thus, you have three potential problems to be addressed:

• Bowel damage caused by surgery
• Bowel damage caused by chemotherapy
• Bowel damage caused by pelvic radiation therapy

In the post-reversal recovery period, the diet has to take into account the fact that your bowel (including the neo-rectum and anal canal) is trying to get back to normal, and the foods sent down the line must not interfere with the healing process. In fact, it is preferable if the foods can be chosen so as to facilitate the recovery of the GI tract as a whole. A good oncology dietitian will understand this problem and will be able to talk about the various physical and chemical properties of food that trigger bad bowel reactions and that cause digestive problems in general.

This is the kind of dietitian you want, not one who is going to spend half an hour expounding on the glorious benefits of anti-oxidants, low-sugar diets, low-fat diets, etc., etc., etc. You want someone who will be able to address the problem that you will be facing.

Tips for Managing Diarrhea after Radiation Therapy for Rectal Cancer

• Keep a detailed food record of what you eat and drink. The foods that cause symptoms are different for each person. Record what and how much is eaten, whether foods are home- made or from a restaurant, food temperature, and time of day. Include specific details about the symptoms you experience. Discuss the food and symptom diary with your Registered Dietitian (RD), who can help you determine what triggers symptoms. It may take several weeks to identify patterns, so be patient!

Reference: https://www.oncologynutrition.org/erfc/eating-well-when-unwell/tips-for-managing-diarrhea-after-radiation-therapy-for-rectal-cancer/

[Green Tea]

... Ideas are always welcome.

In your situation, you are a Rectal Cancer patient who has had both radiation therapy and chemotherapy. You can make some improvement to the pelvic floor muscles.right now by doing daily Kegel exercises or sphincter control exercises. Four sets per day between now and March 15 should help.

[Swirdfish]

... Ideas are always welcome.

In your situation, you are a Rectal Cancer patient who has had both radiation therapy and chemotherapy. You can make some improvement to the pelvic floor muscles.right now by doing daily Kegel exercises or sphincter control exercises. Four sets per day between now and March 15 should help.

Thanks Green Tea for your help. Ill have to look up what kegel exercises are, but I usually try to do bowel movements with a temp illestomy. I think this will help me learn some more control and help when this all happens. I dunno what im going to do if I have full blown LARS and cannot fly in and out for work. But with all the above information and information on this site I have plenty of options to try if things go bad.