Introduction: Anterior resection syndrome (ARS) can affect up to 70% of patients, with no standard treatment currently available. This study evaluated the effectiveness of a novel 3-stage bowel management programme in patients with ARS. Methods: Prospective data was collected from 31 consecutive patients, with symptoms of ARS, who underwent a 3-stage nurse specialist-led bowel management programme (stage 1-conservative management, stage 2-biofeedback, stage 3-neuromodulation). All patients underwent a low or ultra-low anterior resection. Outcomes were assessed using bowel diaries, Wexner/SF-36/GIQoL scores, with patients being discharged if satisfied with symptom improvement (primary endpoint). Results: All patients completed treatment with 90% meeting the primary endpoint. 5 patients completed stage 1 and were discharged. 18 patients completed stage 2 with improvements in defecations/day [mean baseline: 7.2 (1-15) vs. post-biofeedback: 2.4 (1-4) P<0.001], leakages /day [mean baseline: 6.5 (1-14) vs. post-biofeedback: 0.1 (0-1) P<0.001], deferment time (mins) [mean baseline: 3.5 (0.5-15) vs. post-biofeedback: 11.6 (2-30) P<0.001] and incontinent episodes/week [mean baseline: 4.4 (0-28) vs. post-biofeedback: 0.1 (0-1) P<0.007]. Significant improvements were seen in Wexner/QOL scores. 8 patients completed stage 3, with significant improvement in outcomes. Mean follow-up was 17 weeks (4-44). Conclusion: A 3-stage bowel management programme is effective in the short-term management of ARS.
Rimmer, C., Stackhouse, K., Cruickshank, N., & Gill, K. (2013). Anterior resection syndrome- effective short-term management via a novel bowel management programme. International Journal of Surgery, 11(8), 624–625. https://doi.org/10.1016/j.ijsu.2013.06.203