How Should the Low Anterior Resection Syndrome Score Be Interpreted?

BACKGROUND Bowel dysfunction after low anterior resection is often assessed by determining the low anterior resection syndrome score. What is unknown, however, is whether this syndrome is already present in the general population and which nonsurgical factors are associated. OBJECTIVE The purpose of this study was to determine the prevalence of minor and major low anterior resection syndrome in the general Dutch population and which other factors are associated with this syndrome. DESIGN This was a cross-sectional study. SETTINGS The study was conducted within the general Dutch population. PATIENTS The Groningen Defecation and Fecal Continence Questionnaire was distributed among a general Dutch population-based sample (N = 1259). MAIN OUTCOME MEASURES Minor and major low anterior resection syndrome were classified according to the scores obtained. RESULTS The median, overall score was 16 (range, 0-42). Minor low anterior resection syndrome was more prevalent than the major form (24.3% vs 12.2%; p < 0.001). Bowel disorders, including fecal incontinence, constipation, and irritable bowel syndrome were associated with the syndrome, whereas sex, age, BMI, and vaginal delivery were not. Remarkably, patients with diabetes mellitus were significantly more prone to experience minor or major low anterior resection syndrome. The ORs were 2.8 (95% CI, 1.8-4.4) and 3.7 (95% CI, 2.2-6.2). LIMITATIONS We selected frequent comorbidities and other patient-related factors that possibly influence the syndrome. Additional important factors do exist and require future research. CONCLUSIONS Minor and major low anterior resection syndrome occur in a large portion of the general Dutch population and even in a healthy subgroup. This implies that the low anterior resection syndrome score can only be used to interpret the functional result of the low anterior resection provided that a baseline measurement of each individual is available. Furthermore, because people with low anterior resection syndrome often experience constipation and/or fecal incontinence, direct examination and diagnosis of these conditions might be a more efficient approach to treating patient bowel dysfunctions. See Video Abstract at http://links.lww.com/DCR/B110. ?COMO DEBE INTERPRETARSE LA PUNTUACION DEL SINDROME DE RESECCION ANTERIOR BAJA?: La disfuncion intestinal despues de la reseccion anterior baja a menudo se evalua determinando la puntuacion del sindrome de reseccion anterior baja. Sin embargo, lo que se desconoce es si este sindrome ya esta presente en la poblacion general y que factores no quirurgicos estan asociados.Determinar la prevalencia del sindrome de reseccion anterior baja menor y mayor en la poblacion holandesa general y que otros factores estan asociados con este sindrome.Estudio transversal.Poblacion holandesa general.El cuestionario de defecacion y continencia fecal de Groningen se distribuyo entre una muestra general de poblacion holandesa (N = 1259).El sindrome de reseccion anterior baja menor y mayor se clasifico de acuerdo con las puntuaciones obtenidas.La mediana de la puntuacion general fue de 16.0 (rango 0-42). El sindrome de reseccion anterior baja menor fue mas frecuente que la forma principal (24.3% versus 12.2%, (P