Adhesions are scar tissue bands that join organs or tissues to each other. These look like thick fibrous bands or like thin plastic films. Abdominal adhesions are often formed following surgical procedures. They are common in patients who have undergone pelvic or abdominal procedures. Although, some patients show the presence of abdominal adhesions despite never undergoing any surgeries. This article provides a brief outline of the what, why, and how of abdominal adhesions.

What causes abdominal adhesions?

Adhesions are formed in the presence of inflammation on the abdominal wall or the peritoneal lining of the abdominal cavity. They form due to the body’s self-healing mechanism. Since the cells are unable to differentiate between organs, they may form adhesions when organs come in contact. The cause of this inflammation is indirectly responsible for the formation of adhesions. Here are some reasons for the presence of inflammation in the abdominal cavity

• Inflammation of appendicitis, cholecystitis, peritonitis, and more
• The presence of foreign objects in the abdominal cavity following a surgical procedure can lead to the formation of scar tissue.
• Pelvic inflammatory conditions
• Bleeding in the peritoneal cavity

What are the symptoms of abdominal adhesions?

Abdominal pain is one of the most common symptoms of abdominal adhesions. It is followed by intestinal obstruction and infertility in women. The increased risk of infertility is caused by the presence of adhesions around the fallopian tubes, obstructing the transfer of eggs.

Some other symptoms observed in patients are dependent on the location and the effect of adhesions. Not all patients experience the same symptoms. Typically, the signs and symptoms of obstruction include cramp-like abdominal discomfort, worsening discomfort following eating, abdominal distention, and increased obstruction of gas and stools.

Problems with bowel movements can be accompanied by nausea and vomiting. Although, the severity of these symptoms is based on the adhesion.

How are abdominal adhesions diagnosed?

Abdominal adhesions are often diagnosed by doctors during surgical procedures. Alternatively, if a doctor suspects, they can confirm their diagnosis laparoscopically by inserting a camera into the patient’s body. These adhesions can be released during the same diagnostic laparoscopy by the doctor.

Imaging techniques like ultrasound, MRI, CT scan, and X-rays are ineffective in the diagnosis of abdominal adhesions. However, they prove helpful in the detection of obstructions related to adhesions. Similarly, blood tests and other pathology results can help medical professionals diagnose the extent of damage caused by adhesions.

What are the treatment options for abdominal adhesions?

Non-surgical intervention

Non-surgical treatment options for abdominal adhesions include the use of pain medications as the first line of treatment. However, pain medications are not equally effective in all patients, especially ones with chronic pain. Patients can seek help from a pain specialist and figure out a treatment plan that meets their needs and provides effective results. Other non-surgical treatment options include physical activity, exercise, and lifestyle changes.

Laparoscopic intervention

Laparoscopic adhesiolysis is also a possible treatment option in patients with abdominal adhesions. The surgery only requires a small incision as opposed to open surgeries and subsequently has a shorter recovery time. It also decreases the risk of the formation of new adhesions after the surgery. It is a gold standard treatment option for women who experience chronic pelvic pain due to the presence of adhesions. Most patients that undergo laparoscopic adhesiolysis have a lesser risk of complications post-surgery, are faster to recover and can resume their day-to-day activities sooner. Not to mention, they pose a smaller and single scar instead of a long abdominal scar.

Surgical intervention

Adhesions could often result from surgical procedures; therefore, they might not be worth the effort. However, in cases like bowel obstruction, it is necessary to undergo surgery in order to correct the obstruction. Surgery is a necessary evil in such cases. Therefore, it is essential to go through all the possible options before deciding to go ahead with the surgery.

When to seek a medical professional’s help?

It is possible to manage certain symptoms of abdominal adhesions at home. However, if the patient is experiencing unmanageable pain, nausea, infrequent or irregular bowel movements, and/or fever, it might be best to contact a doctor. Additionally, patients who have recently undergone a surgical procedure, have a history of medical illness, and are experiencing abdominal pain, pelvic pain, and/or unexplained fever should also consult their doctor.

What is the prognosis?

The cause of adhesions, abdominal or otherwise, is surgery. Every surgery that is performed to eliminate any adhesions present and correct obstructions can also act as a cause for the formation of new adhesions. Adhesions are a recurring concern.