Up to 60-90% of patients with rectal cancer after anus preservation surgery may have varying degrees of intestinal and anal dysfunction.
Mild cases manifest as increased frequency of defecation, severe fecal incontinence and emptying disorder, called "anterior rectal resection syndrome" (ARS).
The symptoms of ARS are complex and diverse, including incontinence, difficulty in defecation, and constipation. Can be divided into two types:
(1) Urgent incontinence type: It is mainly manifested as an increase in the number of defecations, more than 10 times per day in severe cases, the ability to control defecation and exhaust, or even complete incontinence, accompanied by a sense of urgency to defecate;
(2) Emptying obstacle type: The patient has extremely laborious defecation, incomplete emptying, long time in the toilet and less excretion of excrement. Sometimes it takes several days to accumulate excrement to form enough pressure to discharge.
The symptoms of ARS are the most serious within 1 month after the operation, which belongs to the normal recovery stage after the operation. Through exercise and recovery, it can be significantly improved within half a year after the operation. Pay attention to the following:
1. Dietary adjustment, eat more fiber-rich foods, increase exercise, supplement necessary water, and adopt the correct posture for defecation. Over time, most symptoms will gradually disappear.
2. Practice active contraction of the anus: It is recommended that patients consciously contract the sphincter in the early postoperative period, alternating between contraction and defecation, twice a day, 30 minutes each time. On the one hand, it can prevent the formation of anastomotic rigid tube, on the other hand it can improve the strength of the anal sphincter.
3. Postoperative constipation: there is gas, no defecation, no abdominal pain. At this time, it is necessary to increase dietary fiber, orally take paraffin oil or sesame oil, 50ml once a day, three times a day; laxatives are not recommended to avoid severe diarrhea and intestinal function disorder.
4. Severe diarrhea after operation: antispasmodics can be used, but antidiarrheals are not recommended to avoid constipation and intestinal dysfunction. Need to increase dietary fiber, perianal care to avoid eczema, if eczema occurs, please consult a dermatologist as soon as possible.
5. Postoperative hemorrhoids attack: After rectal cancer, hemorrhoids will be aggravated to varying degrees, manifested as anal pain and a small amount of bleeding. Diosmin and Maizhiling can be taken orally to improve venous return. When the anastomosis is well healed 2 weeks after the operation, use hemorrhoid medicine or hemorrhoid ointment via the anus under the guidance of the doctor, such as Taining suppository, popular hemorrhoid suppository, and Xiaotuozhi.