Nobody warned me about LARS.
After my colorectal surgery, I thought the hard part was over. Tumor out, recovery ahead, life moving forward. What I didn’t expect was the complete rewiring of how my body handled the most basic human function — going to the bathroom.
Low anterior resection syndrome, or LARS, is what happens when your rectum has been partially or fully removed and your bowel has to figure out a new normal. And let me tell you — “new normal” is generous language for what the first few months feel like.
What LARS Actually Feels Like
I had to learn this the hard way:
You’ll go to the bathroom ten, fifteen, sometimes twenty times a day. You’ll feel urgency so sudden it borders on panic. You’ll have episodes of clustering — where you go five times in an hour and then nothing for six hours. You’ll deal with incomplete evacuation, gas you can’t trust, and nights where sleep is broken by trips to the bathroom.
It’s exhausting. It’s embarrassing. And for a while, it feels permanent.
I remember sitting in a follow-up appointment, trying to explain what was happening, and my surgeon nodded like it was perfectly routine. “That’s normal after this surgery,” he said. Normal. That word did a lot of heavy lifting that day.
Why Doctors Underexplain It
Here’s the thing about bowel problems after colon surgery — surgeons are focused on getting the cancer out. And they should be. But the aftereffects of life after colorectal surgery get maybe thirty seconds of pre-op conversation, if that. You hear “your bowel habits may change” and you think, okay, maybe I’ll go twice a day instead of once.
You don’t think: I will rearrange my entire life around proximity to a bathroom for months.
LARS affects the majority of people who’ve had a low anterior resection. Some studies put it at 80-90% experiencing at least some symptoms. This isn’t a rare side effect. It’s the norm. And patients deserve to know that going in.
It Gets Better
I need you to hear this part clearly: it gets better.
Not overnight. Not in a week. For me, the worst of it lasted several months, and real improvement came gradually over the first year. Your body adapts. Your remaining bowel learns to hold more. The clustering slows. The urgency softens. It doesn’t go back to how it was before — but it becomes manageable. Livable. Eventually, most days, forgettable.
What Actually Helped
Pelvic floor therapy was a game-changer. I wish I’d started it sooner. A pelvic floor therapist can teach you exercises and techniques that genuinely improve control and reduce urgency. If your doctor hasn’t mentioned it, ask. Push for a referral.
On the medication side, ondansetron helped slow things down during the worst stretches. Some people have success with ramosetron as well, though availability varies by country. These aren’t cures — they’re tools to get you through the roughest patches while your body heals.
Diet matters too. I kept a food journal and figured out my personal triggers. Everybody’s different, but tracking what you eat and how your body responds gives you back a sense of control when everything feels chaotic.
You’re Not Alone in This
If you’re reading this in the middle of it — up at 2 AM, frustrated, wondering if this is your life now — I promise you it’s not. LARS is brutal in the beginning, but it’s survivable. You adapt. Your body adapts. And you come out the other side.
I talk more about LARS and everything else I learned navigating stage 4 colorectal cancer in The CRC Roadmap at beat-crc.com. If you’re going through it, you don’t have to figure it out alone.
— Aaron M.
Keep reading:
The CRC Roadmap 
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