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After sphincter-preserving surgery (SPS), patients with rectal cancer present multiple bowel symptoms, which significantly affect their daily lives. However, to date, few studies have been conducted in China to identify bowel symptoms and self-management behaviors and to explore the relationship between these behaviors and bowel symptoms.To describe bowel symptoms among Chinese patients with rectal cancer after SPS, the self-management behaviors used, and the relationship between the symptoms and behaviors.A convenience sample of 175 rectal cancer patients who underwent SPS was recruited from 2 tertiary hospitals in Beijing, China, between July and December 2014. The participants completed a general information structural questionnaire, the Chinese version of the Memorial Sloan-Kettering Cancer Center Bowel Function Instrument, and the Bowel Symptoms Self-Management Behaviors Questionnaire.The frequencies of 18 bowel symptoms ranged between 16.0% and 96.0%. Diet self-management was the most common behavior and therapy self-management was the least frequent behavior. Although therapy self-management had best effects relatively, other effective behaviors included self-management of the perianal skin and self-management of social activities. The frequency of use of self-management behaviors was significantly positively associated with bowel symptoms (r=−0.232 to −0.580, P < .01).Several bowel symptoms after SPS are highly prevalent. Patients with severe bowel symptoms are more likely to use self-management behaviors regularly; however, there is no scientific evidence that these behaviors produce satisfactory results.Healthcare providers should identify bowel symptoms after SPS and develop supportive interventions for the self-management of symptoms.