When Bowel Habits Are Still Off Nearly Two Years After Stoma Reversal — Understanding and Living With Changed Bowel Function (LARS) After Colorectal Surgery

Some people who have had a portion of the colon or rectum removed, used a stoma for a while, and then had a stoma reversal (rejoining the bowel) find that their bowel habits are still not what they used to be even one or two years after surgery. They may go to the toilet several times a day, pass loose stools, feel a sudden urgency, or empty in several small amounts. These changes are usually not a sign of personal fault or poor self-care, but a natural result of surgery altering the bowel's storage space, nerves, and muscles.

When a large part of the rectum has been removed, the bowel's ability to hold stool for a short time (its 'reservoir' function) is reduced, so stools may come more often, more urgently, and looser. Doctors often call this pattern Low Anterior Resection Syndrome (LARS). It tends to improve gradually over time, but for some people it can persist.

Greasy or spicy foods, alcohol, caffeine, lactose (milk and dairy), and artificial sweeteners can worsen loose stools and urgency. This is one reason bowel movements may be looser on days with unusual meals, such as during travel. Keeping a short food-and-symptom diary for a few days can help you learn which foods suit you and which to approach with caution.

Helpful everyday habits include eating smaller, more frequent meals instead of large ones, chewing slowly and thoroughly, sipping fluids throughout the day, and trying to keep a regular toilet routine. When symptoms are severe, you can discuss options such as adjusting fibre, anti-diarrhoeal medication, and pelvic floor exercises (biofeedback) with your care team.

However, if you suddenly have far more frequent stools than before, black or red bloody stools, severe abdominal pain and bloating, fever, or ongoing weight loss, it is safer to seek medical care rather than assume it is only a change in bowel habits.

This article is for general information only and does not replace individual medical care. Symptoms and treatments differ from person to person, so please consult your own care team for decisions about your situation.