Tied to the Toilet: Lived Experiences of Altered Bowel Function (Anterior Resection Syndrome) After Temporary Stoma Reversal

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Abstract

PURPOSE:

The purpose of this study was to explore the lived experiences of patients with anterior resection syndrome, defined as altered bowel function as a consequence of rectal cancer treatment. Interviews were completed 4 to 6 weeks post–temporary stoma reversal.

SUBJECTS AND SETTING:

Eight rectal cancer patients, who had completed their primary treatment, and were now up to 6 weeks poststoma closure and reported altered bowel function, were recruited. The sample was drawn from St. Mark's Hospital, which is an NHS Trust situated in Greater London, England.

METHODS:

Data were collected via semistructured in-depth interviews. A Husserlian phenomenological approach was used in order to explore the lived experiences of respondents. Interviews were transcribed and analyzed using framework analysis.

RESULTS:

Participants reported significant alteration in bowel function following stoma reversal that impacted or dictated daily routines. A lack of certainty over when and how bowel movements occurred caused distress and feelings of vulnerability. Consequently respondents stated they often felt as if they were tied to the toilet. Coping strategies included conservative measures such as the use of prescribed drugs, dietary modification, and incontinence pads. These strategies did not always prove effective and most individuals perceived they were not self-managing their symptoms satisfactorily.

CONCLUSIONS:

Rectal cancer patients should be made aware of the potential for altered bowel function post stoma closure and encouraged to report bothersome bowel elimination symptoms. Treatment should promote a proactive strategy to reduce distress and the risk of symptom chronicity.

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