Nursing care for patients with low anterior resection syndrome using transanal irrigation

Low anterior resection syndrome (LARS) is a common and often under-recognised consequence of sphincter-preserving rectal cancer surgery, encompassing a range of bowel symptoms including urgency, faecal incontinence, increased stool frequency, clustering and incomplete emptying. These symptoms can profoundly affect quality of life, dignity, emotional wellbeing and social participation, and may persist for years as part of long-term cancer survivorship. Transanal irrigation (TAI) is one evidence-based management option for patients with problematic LARS. Recent systematic reviews and randomised controlled trials suggest that it can significantly reduce LARS symptom scores and improve bowel predictability, with benefits demonstrated at 3, 6 and 12 months. However, early discontinuation remains a concern, often linked to technical difficulties, unmet expectations or insufficient follow-up. For nurses, TAI represents a supported clinical intervention rather than a technical procedure alone. Effective nursing care requires structured pre-treatment assessment, individualised patient education, practical training, expectation setting and planned follow-up. Nurses are central to identifying appropriate patients, supporting adherence, troubleshooting common problems and recognising when onward referral is required. This article explores the pathophysiology and impact of LARS, reviews the evidence for TAI, and sets out the nursing assessment, education and support required to deliver safe and effective care. It also considers quality-of-life outcomes, safety considerations, and the implications for practice within a broader multidisciplinary survivorship pathway.