Understanding the Discordance between Low Anterior Resection Syndrome Scores and Bowel-Related Quality of Life: a Secondary Analysis of a Multicenter Trial.

Authors

Roseanna Presutti, Marie Demian, Sarah Sabboobeh, Sahir Bhatnagar, Julie Savard, Sebastien Drolet, A Sender Liberman, Carl J Brown, Jason Park, Carmen G Loiselle, Steven D Wexner, Liliana Bordeianou, Gabriela Ghitulescu, Julio Faria, Nancy Morin, Carol-Ann Vasilevsky, Marylise Boutros, Richard Garfinkle

Published in

Diseases of the colon and rectum. Sep 23, 2026. Epub Sep 23, 2026.

Abstract

Low anterior resection syndrome affects most individuals following rectal cancer surgery; however, symptom severity does not always correlate with bowel-related quality of life impairment.
To characterize the discordance between low anterior resection syndrome and bowel-related quality of life scores and to identify clinical factors and low anterior resection syndrome symptoms most strongly correlated with bowel-related quality of life impairment.
Secondary analysis of a completed multicenter, pan-Canadian randomized controlled trial.
Five Canadian hospitals.
Adults who had undergone a restorative proctectomy for rectal cancer with ileostomy closure.
Patient-reported outcomes were measured at 6months after ileostomy closure, including the low anterior resection syndrome score, bowel-related quality of life, general quality of life, and depression/anxiety.
In total, 135 patients were included. Among patients with major low anterior resection syndrome (n = 82), 61.0% had bowel-related quality of life impairment and 39.0% had no bowel-related quality of life impairment. Patients with both major low anterior resection syndrome and bowel-related quality of life impairment were more likely to still be working compared to those without bowel-related quality of life impairment (66.0 vs 43.8%, p = 0.044). Among those with minor/no low anterior resection syndrome (n = 53), 20.8% had major bowel-related quality of life impairment. In the major low anterior resection syndrome subgroup, patients with bowel-related quality of life impairment had significantly higher mean scores of stool incontinence (2.76 vs 1.88, p = 0.001), frequency (2.48 vs 1.63, p = 0.010), and urgency (15.6 vs 14.75, p = 0.035) than those without bowel-related quality of life impairment. In the minor/no low anterior resection syndrome subgroup, patients with major bowel-related quality of life impairment had significantly higher mean scores of frequency (1.73 vs 0.95, p = 0.047) than those without bowel-related quality of life impairment. The presence of major bowel-related quality of life impairment correlated well with decreased general quality of life and increased depression/anxiety, irrespective of low anterior resection syndrome severity.
Secondary analysis with modest sample size.
Approximately 20 to 40% of patients had discordant low anterior resection syndrome severity and bowel-related quality of life scores, the latter of which correlated better with other patient-reported outcomes. See Video Abstract.

PMID:
42775537
Bibliographic data and abstract were imported from PubMed on 23 Sep 2026.

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