Skip to main contentLast updated: 04-Nov-2026
Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Gastro & Cancer Surgeon
Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad · 18 years of experience
In short
After rectal cancer treatment you need a fixed plan of visits, blood tests and scans for about five years. The plan is written down on day one, so nothing depends on memory.
Many people have bowel changes after the operation, such as urgency, clustering and leaks. The name for this is low anterior resection syndrome, or LARS. It is common, it can be treated, and it should be discussed before the operation.
Follow-up is also about living well: bladder, sexual health, mood, exercise and diet all need a plan.
The full plan of care, from tests to surgery, is on the middle rectal cancer surgery page. This post explains what comes after treatment.
Follow-up has two jobs: to find a return of cancer early, and to help you recover your daily life. Both need a schedule and a team.
People often stop coming once they feel well. That is the time to keep the plan, not to drop it. Bring your family member to the visits, as they notice changes that you may not.
For most people after a full operation, the schedule is a visit with a CEA blood test every three months for two years, then every six months to year five.
| Check | When | Why it is done |
|---|---|---|
| Clinic visit with examination and CEA blood test | Every 3 months for 2 years, then every 6 months until year 5 | Looks for symptoms, checks the wound and bowel habit, and watches the CEA trend |
| CT scan of the chest, belly and pelvis | Every 6 to 12 months for 3 years, then yearly until year 5 | Looks for spread to the liver, lungs or pelvis |
| Colonoscopy | At 1 year, then at 3 and 5 years if clear | Checks the join of the bowel and finds new polyps |
| MRI of the rectum and a scope examination | Not routine after a full operation. Used if symptoms or a high CEA appear | Looks at the pelvis in detail when there is a reason |
Very early cancers treated by a small operation need fewer scans but a closer look at the scar with the scope. Cancers that had spread to the liver or lungs and were removed need a tighter schedule. Your own plan is written for your own stage.
If the tumour vanished after chemotherapy and radiation and you kept your rectum, the follow-up is much closer. This is the price of keeping the organ.
Missing these visits is the main risk of this path. Read more in our post on rectal cancer organ preservation.
Closer watching finds more returns earlier, but studies have not shown that everyone lives longer for it. So the plan balances benefit, cost and worry.
New symptoms matter more than any schedule. Bleeding, a change in bowel habit that does not settle, pain in the pelvis or back, or weight loss should bring you in sooner. Our post on when rectal cancer blocks, bleeds or returns explains the next steps.
LARS is a group of bowel problems after the rectum is removed and the colon is joined low down. It affects many people to some degree, and a fair share have a major form.
Your doctor can measure the effect with the LARS score, a short list of questions. It sorts the problem into none, minor and major. The score is repeated at each visit, so that treatment can be matched to it.
Some things raise the chance of major LARS:
Having your rectum saved is not the same as having normal control. Please ask about this before the operation, not after it.
LARS usually improves over six to twelve months and keeps getting better for one to two years. Simple steps help first. Stronger ones are kept for people who still struggle.
| Step | What it involves | Who it helps |
|---|---|---|
| Diet advice | Smaller meals, fewer trigger foods, steady fibre, enough water | Everyone, as the first step |
| Fibre supplement | A soluble fibre such as psyllium husk to firm the stool | Loose or broken-up stool |
| Medicine to slow the bowel | A tablet such as loperamide, taken as advised by your doctor | Frequent loose stools and urgency |
| Pelvic floor exercises with biofeedback | A trained physiotherapist teaches the muscles to hold better | Urgency and leaks. Often very helpful |
| Anal plug | A soft plug worn for a few hours | Passive leakage |
| Bowel irrigation | Water is passed into the bowel through the anus to empty it on schedule | Clustering and incomplete emptying |
| Nerve stimulation | A small device that stimulates the nerves of the bowel | Severe LARS that has not responded, at a specialist centre |
| Permanent colostomy | A planned stoma | A small number whose life remains badly affected |
Pelvic floor physiotherapy and diet advice give the most help for the effort, yet they are often skipped in India. Ask for them by name.
A stoma, whether temporary or permanent, needs a trained nurse from the day it is marked before surgery to long after you go home.
Yes. Surgery and radiation in the pelvis can affect nerves and tissues for sex and urine. These changes can often be treated, but only if you tell your doctor.
Your baseline before surgery should be noted, so any change can be measured and treated.
Regular exercise is the single habit with the strongest evidence after bowel cancer treatment. It comes before any special diet or supplement.
Many people are lost to follow-up after two years. A few simple requests keep you on track, even if you live far away.
Most people are followed for five years. Visits are every three months for the first two years, then every six months. After five years, a yearly visit is common. Your own plan is written for your stage.
LARS is low anterior resection syndrome. It means frequent stools, urgency, clustering, leaks or a feeling of not emptying after the rectum is removed and the bowel is joined low down. It usually improves over one to two years and can be treated.
Bowel habit often changes for good, but it usually gets better with time and with help. Diet advice, fibre, medicines, and pelvic floor exercises with biofeedback make a large difference. Stronger options are kept for people who still struggle.
Yes. A trained physiotherapist teaches the muscles around the anal opening to hold better. With biofeedback it helps urgency and leaks, and it is one of the most useful steps. Ask for it early, not as a last choice.
Often it can improve, but changes are common after pelvic surgery and radiation. Tablets for erection, a vacuum device, lubricants, dilators, local oestrogen cream, pelvic floor care and counselling can all help. Tell your doctor, as these problems are treatable.
No. CT is done at set gaps, about every six to twelve months in the first three years, then yearly to year five. The CEA blood test and the clinic examination are done at every visit. New symptoms can bring a scan sooner.
The full range of rectal cancer care starts at the middle rectal cancer page. For questions before you travel, call +91-63555-64601.
Dr Harsh Shah — Dr. Jivraj Mehta Hospital, Vasna, Ahmedabad
Dr. Jivraj Mehta Hospital, Dr Jivraj Mehta Marg, Vasna, Ahmedabad 380007.
Consultations, review of reports and scans, operations and follow-up. OPD Monday to Saturday, 9 am to 5 pm.
Appointments: +91-63555-64601 · +91-63590-11009 · Hospital 079-2663 6363
Directions to the hospital · WhatsApp +91-63555-64601
Has your rectal cancer treatment finished, and now you are unsure what check-ups to keep, or why your bowels have changed? Bring your reports with you. Dr Harsh Shah will give you a written follow-up schedule and talk through bowel, urine and sexual changes in plain words. Call, or send a message on WhatsApp. Call +91-63555-64601 Ask on WhatsApp
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