Abdominal adhesions – Symptoms, causes, and management

Abdominal adhesions can lead to various signs and symptoms, among which abdominal pain is the most common one. They can also cause bowel obstructions and blockages, which can be a life-threatening condition. Even though not all adhesions result in symptoms, it is crucial to seek medical attention if there are severe abdominal cramps or pain. This article provides an overview of the signs and symptoms, causes, treatment options, and prevention of abdominal adhesions.

Abdominal adhesions: An overview
Abdominal adhesions refer to the formation of scar tissue bands between abdominal organs, particularly the small intestine. This condition typically occurs post abdominal surgery, causing the tissues to stick together. Normally, these tissues move freely, but adhesions restrict their movement. Additionally, adhesions can also form between loops of the small and large intestine.

Signs and symptoms
Abdominal adhesions can develop without any noticeable signs or symptoms, but they can have varying signals that range from non-specific to typical or specific. In some cases, these adhesions may cause the twisting of the intestines, which can occur shortly after surgery or even years after. This can result in complete or partial intestinal obstruction, also known as small bowel obstruction, which prevents food, liquids, and gas from passing through the digestive system. However, when the intestinal obstruction is more severe, one may notice the following symptoms:

Severe abdominal pain
Vomiting and nausea
Abdominal swelling

However, the symptoms are usually less severe when the obstruction is incomplete. These may range from abdominal pain to cramps that occur only after eating.

Abdominal surgery, especially between the small bowel loops, is one of the main causes of adhesions in the abdomen. Other possible reasons include conditions such as endometriosis, appendicitis, Crohn’s disease, peritonitis, and others that cause infection or inflammation in the abdomen. Additionally, radiation therapy and long-term peritoneal dialysis can also lead to adhesions.

To diagnose abdominal adhesions, a doctor will conduct a physical examination and review the patient’s complete medical history, specifically looking for any previous abdominal surgeries. While there are no specific tests available for identifying abdominal adhesions, some tests can help rule out other potential causes or assess the level of obstruction. Examples of these tests include:

  • Imaging tests, such as computed tomography scan and X-rays with special contrasts, such as barium
  • Blood tests to rule out other possible causes or to assess the severity of intestinal obstruction
  • Laparoscopic or open surgery to look for abdominal adhesions and other problems, such as intestinal obstruction

Adhesions typically don’t show any symptoms and don’t require treatment. Healthcare providers try to avoid surgery because additional surgeries can lead to more adhesions.

However, if treatment is deemed necessary, a procedure called Adhesiolysis may be recommended. Surgeons prefer to use a laparoscopic approach as it is minimally invasive and reduces the likelihood of additional adhesions. This approach also shortens the patient’s hospital stay.

The surgical removal of scar tissue can be an option for adhesions that lead to obstructions, including complete blockages or acute and chronic cases that persist independently.

In case of intestinal obstruction, the healthcare provider may recommend a specific meal plan and changes in eating habits before the operation to remove the blockage. A low-fiber, liquid-based meal plan may be recommended to alleviate the symptoms. The healthcare provider may also suggest consulting a nutritionist to ensure that all necessary nutrients are being included in the meal plan.

To reduce the risk of developing adhesions after surgery, the surgeon may take certain precautions, such as:

  • Opting for laparoscopic surgery instead of open surgery whenever possible.
  • Using lint-free tools and power-free gloves
  • Handling the tissue with care to reduce the risk of tissue damage
  • Covering the damaged tissue after the procedure to keep it separated during the healing process.

These measures are aimed at promoting a smoother and faster recovery for the patient. However, it is crucial to consult the healthcare provider and nutritionist before making any changes to the meal plan and implementing preventive measures.

When should one see a doctor?
Abdominal adhesions are often a result of abdominal surgery or infection that causes inflammation. These adhesions can cause chronic abdominal pain, bowel obstruction, and other symptoms in some individuals. If the pain is mild, treatment may not be necessary, but if there is intestinal obstruction, a doctor may recommend surgery to provide relief. It is essential to contact a healthcare provider if there are any concerns about this condition for the best advice. They may suggest tests for a proper diagnosis and recommend appropriate treatment.