Inclusion Criteria:  Over age 18 LARS syndrome (LARS score of 21 or higher) one month post sphincter sparing rectal resection Able to read, understand and communicate in Hebrew  Exclusion Criteria:  Pregnancy Actively undergoing Chemotherapy or Radiation Other causes of anal incontinence or bowel dysfunction (ex: Irritable Bowel Syndrome) Concurrent performance of other exercise methods Unable or unwilling to perform the Paula exercises