Living with low anterior resection syndrome after rectal cancer surgery: challenges, self-management, and supportive care priorities

Low anterior resection syndrome (LARS) is a prevalent and often persistent consequence of sphincter-preserving rectal cancer surgery that substantially disrupts daily functioning and long-term adaptation. Beyond bowel dysfunction, patients frequently experience psychosocial distress and lifestyle limitations that require comprehensive supportive care. This study aimed to explore how patients live with LARS, the challenges they encounter, and the self-management strategies they develop, in order to identify priorities for supportive care across the survivorship trajectory.

A qualitative descriptive design was employed. Sixteen adults diagnosed with minor or major LARS following rectal cancer surgery were purposely recruited from a surgical outpatient clinic. Data were collected through face-to-face, semi-structured interviews and analysed using inductive thematic analysis.

Five interrelated themes emerged: changes in bowel habits, non-defecation-related difficulties, impacts on daily life, coping strategies, and patient recommendations for care. Participants described persistent bowel dysfunction, nutritional intolerance, psychological distress, sexual problems, and social restrictions that shaped everyday life. In response, they developed individualised coping strategies, largely through trial and error, including dietary regulation, behavioural adaptations, emotional coping, and reliance on family support. Participants consistently emphasised the importance of anticipatory information, continuity of follow-up, and accessible professional guidance throughout the survivorship trajectory.

Living with LARS involves a multidimensional adaptation process extending well beyond the immediate postoperative period. Findings highlight key priorities for supportive care, including structured preoperative education, symptom-oriented guidance, and sustained , person-centred follow-up. Integrating these elements into survivorship care pathways may enhance patients' capacity for self-management and long-term quality of life after rectal cancer surgery.