Abdominal adhesions – Causes, symptoms, and more
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Abdominal adhesions – Causes, symptoms, and more

Abdominal adhesions are the fibrous scar tissue bands that develop on organs in the abdomen. These can make the organs stick to the abdomen wall or one another. Typically, abdominal adhesions form after surgery. The abdominal organs tackled by the surgical team are temporarily moved from their usual position. It causes excessive scar tissue formation, leading to abdominal adhesions. This article explains its causes, symptoms, diagnosis, preventive measures, and possible treatment methods.

Causes
Abdominal surgery is one of the leading causes of adhesions. Studies suggest that almost anyone who undergoes surgeries involving the abdomen develops adhesions. But the risk post-surgery (usually gynecological and bowel surgery) is more on the pelvis and the lower abdomen. As time passes, these adhesions tend to grow bigger and tighter. Hence, in most people, symptoms show years after the surgery. Some of the surgery-related abdominal adhesion causes are:

  1. Handling the internal organs
  2. Blood clots or blood that were not rinsed out during the surgery
  3. The tissues and internal organs drying out
  4. Internal tissues coming in contact with foreign substances like surgical gloves, gauze, and stitches
  5. Tissue incisions, particularly those that involve internal organs

A less prevalent reason for adhesions is inflammation from sources other than the surgery. These include:

  1. Abdominal infections
  2. Appendicitis or appendix rupture
  3. Gynecological infections
  4. Cancer treatment involving radiation

Symptoms
Scar tissue is a natural outcome of the body’s healing mechanism after an injury or surgical procedure. The resulting scar tissue is usually thicker than the original tissue and may curtail movement in your abdomen. Consequently, the adhesions develop a few days after the abdominal surgery and worsen over time. While most adhesions do not result in any noticeable symptoms, some may trigger the following signs:

  1. Abdominal pain is one of the most prevalent signs of abdominal adhesion, as they join the organs that typically move freely, which pulls or twists the organs as you move. Depending on the severity of the adhesions, the pain may be intense.
  2. Bloating- Adhesions that form on or around your intestines may intervene with your digestive system, curtailing your ability to pass gas. It may further lead to abdominal bloating, uncomfortable cramps, and gas pains.
  3. Constipation is another sign of digestive system adhesion. Constipated individuals experience fewer bowel movements than typical. Further, it’s painful or difficult to pass stools. Adhesions leading to constipation are a sign of bowel obstruction.
  4. Vomiting and nausea – In extreme cases, adhesions may trigger vomiting and nausea. Sometimes, the abdominal pain is so severe that it may make you nauseous. These are also bowel obstruction symptoms.

Diagnosis
To confirm and treat abdominal adhesions, a thorough diagnosis is necessary. For this, your medical expert may perform the following tests or assessments:

  1. Medical history – The doctor will first take a complete medical history of your prior abdominal surgery or any other probable cause of the adhesion. Further, a history of any disorder or disease depicting similar signs is also needed.
  2. Physical examination – The doctor will assess the pain or tenderness in the abdomen on tapping.
  3. Blood tests – Even though blood tests do not diagnose abdominal adhesions, they help eliminate other diseases that may produce symptoms similar to adhesions. Blood examinations also help assess the nature of obstruction for intestinal obstruction.
  4. Imaging tests – These tests help study the intestinal obstruction and include the following:
  5. X-rays
  • A combination of computers and X-rays form images to observe and assess the severity, site, and reason for intestinal obstruction.
  • Water soluble contrast medium and X-rays, a particular liquid is employed to increase the visibility of the digestive tract in X-rays. It helps understand whether the reason for obstruction is abdominal adhesion. This water-soluble medium can also relieve the obstruction.
  • Open Surgery or Laparoscopy – Sometimes, the doctor may look inside the abdomen by forming a large or small incision. These surgeries are also standard treatment options.

Treatment options
When the abdominal adhesions are asymptomatic, you do not need any specialized treatment. However, when you are experiencing some signs, doctors may suggest treatment options like open surgery or laparoscopy. But these surgeries may further lead to new abdominal adhesions.
When you have abdominal adhesions bundled with intestinal obstruction, the surgeries help overcome the obstruction depending upon its location and severity. But if it is not severe, doctors may suggest treatment options that do not involve surgery. You will be given intravenous fluids via a nasal tube going into the stomach. It helps eliminate all the food content and relieves you from obstruction.

Preventive measures

  1. Delicately handling the tissue to avoid damage.
  2. Performing laparoscopy over open surgery wherever possible
  3. Take proper precautions to avoid contact with any foreign material, such as using powder-free gloves and lint-free tools.
  4. Placing an absorbable film-like barrier in the abdomen post-surgery to keep the tissue separated as you heal.