ABDOMINAL ADHESIONS -PAIN AND OBSTRUCTION
Adhesions represent an essential part of the healing process in the abdomen. We heal injuries by growing new tissues and generating scar tissue both in the skin where we can see and in the abdomen where we cannot.
When structures in our abdomen are injured either by intentional surgery, trauma, or infections our bodies react by creating scar tissue. Inside the abdomen these scars can often create abnormal bonds or “adhesions” between structures that are not meant to be joined. These adhesions are typically trivia and asymptomatic but problems do occur and people can develop pain and even bowel obstructions as a consequence.
Typically or internal organs are fixed into position but our bowel has some motility as it works to push food along to facilitate digestion and elimination ( bowel movements). We call this peristalsis. If the bowel is adherent via scar formation to other structures in the abdomen pain can be created as it moves and tugs on these points of fixation. Some areas in the abdomen are more sensitive than others and as a consequence more pain is generated. Because the bowel is essentially moving around while partially encased in a web of scar and adhesions it may become partially or completely obstructed from time to time as it becomes kinked or narrowed. These partial obstructions are characterized by bloating, nausea, severe pain and vomiting. Obstructions can resolve with a short passage of time but they can become so severe that we call them “complete” obstructions which requires urgent and often emergency surgery to prevent ischemia or necrosis of the bowel.
Even though we have some understanding of why adhesions form we are unable to treat them with medication. They represent a structural problem that requires a surgical/physical intervention when they become severe.
There is a relationship between the amount of trauma and damage created during a surgery and the formation of adhesions after that procedure. Surgeries with large incisions that leave the bowel exposed for hours are notorious for creating adhesions. Using gentle techniques in handling the bowel and organs and the development of minimally invasive surgeries like those used by this practice are excellent strategies for reducing inflammation, scar and adhesions after surgery.