Saanichton, BC

Dr. Miguel A. Lipka

Abdominal Adhesions

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Abdominal adhesions are bands of tissue that form between abdominal tissues and organs. Normally, internal tissues and organs have slippery surfaces, which allow them to shift easily as the body moves. Adhesions cause tissues and organs to stick together.

Abdominal surgery is the most frequent cause of abdominal adhesions. Almost everyone who undergoes abdominal surgery develops adhesions; however, the risk is greater after operations on the lower abdomen and pelvis, including bowel and gynecological surgeries. Adhesions can become larger and tighter as time passes, causing problems years after surgery.

Surgery-induced causes of abdominal adhesions include:

  • Tissue incisions, especially those involving internal organs
  • The handling of internal organs
  • The drying out of internal organs and tissues
  • Contact of internal tissues with foreign materials, such as gauze, surgical gloves, and stitches
  • Blood or blood clots that were not rinsed out during surgery

A less common cause of abdominal adhesions is inflammation from sources not related to surgery, including:

  • Appendicitis — appendix rupture in particular
  • Radiation treatment for cancer
  • Gynecological infections
  • Abdominal infections

Rarely, abdominal adhesions form without apparent cause.

Although most adhesions cause no symptoms or problems, others cause the following problems:

Intestinal obstruction - Abdominal adhesions can kink, twist, or pull the intestines out of place, causing an intestinal obstruction. An intestinal obstruction partially or completely restricts the movement of food or stool through the intestines. A complete intestinal obstruction is life threatening and requires immediate medical attention and often surgery.

Symptoms of an intestinal obstruction include:

  • Severe abdominal pain or cramping
  • Vomiting
  • Bloating
  • Loud bowel sounds
  • Swelling of the abdomen
  • Inability to pass gas
  • Constipation

Female infertility - Abdominal adhesions cause female infertility by preventing fertilized eggs from reaching the uterus, where fetal development takes place. Adhesions can kink, twist, or pull out of place the fallopian tubes, which carry eggs from the ovaries to the uterus.

Although most abdominal adhesions go unnoticed, the most common symptom is chronic abdominal or pelvic pain. The pain often mimics that of other conditions, including appendicitis, endometriosis, and diverticulitis.

Treatment for abdominal adhesions is usually not necessary, as most do not cause problems. Surgery is currently the only way to break adhesions that cause pain, intestinal obstruction, or fertility problems. More surgery, however, carries the risk of additional adhesions and is avoided when possible.

A complete intestinal obstruction usually requires immediate surgery. A partial obstruction can sometimes be relieved with a liquid or low-residue diet. A low-residue diet is:

  • High in dairy products
  • Low in fiber
  • More easily broken down into smaller particles by the digestive system