Long-term changes in bowel habit

There is information on regaining bowel control after surgery here.


If your bowels aren’t settling down

It may take you longer to adapt to changes if you are having chemotherapy or radiotherapy after surgery. It is normal for your bowel function to be erratic and difficult to control for several weeks or even months. However, if your bowels really aren’t settling into a new routine or you are struggling to put on weight, do talk to your GP or colorectal nurse. They may recommend referring you to a dietician or be able to prescribe medication to control the symptoms.


Also remember you’re not alone – perhaps you could post on our forum, explain the problems you’re having and see if there are others who can give you hints and tips about what they did. It can be completely anonymous – and you may find people out there coping with exactly the same problems.


Anterior resection syndrome

Some people who have had surgery for rectal cancer can experience problems with controlling bowel motions for many weeks or months afterwards.If this is the case for you, you may be suffering from anterior resection syndrome, which is a collection of symptoms patients have after undergoing removal of part of their rectum (the last 6-8 inches of the large bowel). The symptoms may include pain, incontinence, frequency or urgency of stools, clustering of stools (numerous bowel movements over a few hours) and/or increased wind.


Those most at risk are people who have had radiotherapy or chemotherapy before surgery or where the tumour was very low in the rectum. Some people find that their symptoms resolve over time, while others may continue to have problems, in which case you should talk to your GP or colorectal nurse about being referred to a gastro-enterologist or continence service.


Managing anterior resection syndrome is often a question of trial and error.  Your healthcare professional will suggest things for your to try; it’s important to introduce changes step by step to see what works best and go back for more help if necessary.


Ways to manage these symptoms

  • loperamide is an over-the-counter medication that helps to slow down your bowel function
  • chew foods thoroughly and try small, frequent meals (5 – 6 per day)
  • add new foods one at a time to determine the effect it has
  • drink plenty of fluids; avoid caffeine, alcohol and sorbitol (an artificial sweetener)
  • in the first 6 – 12 weeks it can help to eat a low-fibre diet, gradually introducing fibre as your bowel settles down
  • carry a survival pack of wet wipes, protective ointments and loperamide.


Further information and support