How Do You Know if You Have Bowel Adhesions

Intestinal and pelvic adhesions

Expert reviewer, Mr Christian Macutkiewicz, Consultant Full general & Hepatobiliary Surgeon
Next review due Jan 2025

Adhesions are bands of scar tissue that tin make the tissues and organs inside your trunk stick together. They often class later you've had an operation inside your stomach (abdomen) or pelvis.

Nearly adhesions

Your body makes scar tissue when it heals. Scar tissue can happen if the tissues inside your tummy or pelvis get damaged.

Adhesions are bands of scar tissue that form between unlike organs or tissues. They can brand your organs or tissues stick together. You may get adhesions:

• after any type of surgery in your tummy or pelvis – for case, bowel surgery
• afterwards an infection in your tummy
• if y'all take an ongoing inflammatory condition such as endometriosis

Y'all're more likely to get adhesions subsequently open surgery than later on laparoscopic (keyhole) surgery.

Nearly adhesions don't crusade any symptoms, and so you may not know you have them. Just sometimes, they can crusade some bug – for more information, see our section on symptoms of adhesions.

Symptoms of adhesions

Adhesions touch on everyone differently. Many people don't accept any symptoms at all. Some people have a few symptoms that don't carp them too much. Others have symptoms that affect their daily life. If you lot do go symptoms, you may non notice these for a few months or even years after your adhesions course.

You may kickoff noticing symptoms if your adhesions are causing the following issues.

• A blocked bowel (bowel obstruction) may happen if dissimilar parts of your bowel stick together. Your bowel tin get partly or completely blocked. This can crusade cramping pains in your stomach, bloating, feeling sick and being ill. You may also have constipation – that is when you find it hard to poo. A consummate obstruction is a medical emergency. For more than information, see our section on complications of adhesions.
• Ongoing pain in your breadbasket or pelvis.
• Problems getting meaning may happen if your adhesions affect your ovaries or fallopian tubes.

These issues aren't always caused by adhesions. So, if hurting in your breadbasket or pelvis isn't getting any amend, see your GP. Or, if you've recently had an operation, contact the infirmary where yous had it. If you take sudden breadbasket pain, yous should seek urgent medical advice.

Diagnosis of adhesions

Adhesions can exist difficult to diagnose because they don't cause whatever specific symptoms. And there are no specific tests to show you have adhesions.

If you accept tum pain, your doctor will ask you about:

• your symptoms
• your medical history
• whatever medicines yous're taking
• any surgery you've had in the past

They may also:

• examine you – using their easily to feel around your tum and pelvis
• use a stethoscope to listen for sounds in your bowel

They'll usually do several checks, including taking your temperature, pulse rate and claret force per unit area. They may too ask y'all for a urine sample and suggest you lot have some claret tests.

Imaging tests

Yous may demand to take some imaging tests. Adhesions don't always prove up in tests and scans – but having these may help to rule out other conditions. These tests may include:

• a CT browse – often with a contrast dye, which your doctor can see going through your bowel
• an X-ray
• an ultrasound
• an MRI scan

Fertility tests

If you haven't been able to become pregnant after trying for a year or more than, your GP may refer y'all to a doctor who specialises in reproductive health or fertility bug. They may suggest tests to cheque whether yous're having problems getting significant because you've got adhesions.

Self-aid for adhesions

If your adhesions are causing pain, you can take over-the-counter painkillers such every bit paracetamol or ibuprofen. E'er read the patient information leaflet that comes with your medicine. If you have whatever questions, ask your pharmacist for communication. If over-the-counter painkillers aren't helping, make an appointment to run into your GP.

Your GP may propose yous to make some changes to your diet. This may aid food pass through your bowels more easily. It may likewise ease the pain. You may be advised to:

• eat softer foods
• eat foods low in fibre
• potable more fluids

If you're finding it difficult to poo, your GP may prescribe a laxative for a short while. This will help to soften your poo so it'south easier to pass. Your GP may besides prescribe some medicines to ease your stomach hurting.

Treatment of adhesions

Adhesions don't usually cause problems, and most people don't demand any specific handling. Only you lot may need to go into infirmary if:

• your doc thinks you have a blocked (obstructed) bowel
• yous have astringent pain because of an adhesion

Not-surgical treatment for an obstructed bowel

If you have a blocked bowel, the hospital will keep an eye on yous until the blockage clears. They'll usually advise y'all don't eat or drink anything for a day or two. This will give your bowel a rest, then it hopefully won't get completely blocked. You'll be put on a drip to make certain you get enough fluids and salts. They'll besides put a tube into your nose. This will release gas and fluid from your stomach.

You'll be offered pain relief with a stronger painkiller (such as morphine) while y'all're in hospital. Gradually, you'll be able to showtime having sips of drinks, followed by soft nutrient and and so more than solid nutrient.

These measures will usually be enough to clear a partially blocked bowel. Simply if y'all're not getting better after a few days, your medico may propose you to accept surgery.

Surgery

Surgery for adhesions is called adhesiolysis. This cuts through and separates the adhesions. Your physician may suggest you lot have surgery for several reasons.

• You take signs of a complete bowel blockage. In this case, the surgery may be washed as an emergency process to clear your bowel.
• Yous've been having handling for a partly blocked bowel for a couple of days merely aren't getting better.
• You're having ongoing tummy or pelvic pain, thought to exist caused by adhesions.

Having whatever blazon of surgery may mean you lot get more adhesions afterwards. So, your surgeon volition talk through the risks, benefits and possible alternatives. They'll just advise you to take an performance if they think information technology'll help you.

Your surgeon may be able to exercise the operation using keyhole surgery. This means putting surgical tools and instruments through small cuts into your tummy to meet inside and cut the scar tissue. You're less likely to become new adhesions after keyhole surgery than afterward open surgery. But if you have certain complications or a lot of your bowel is blocked, you may need open surgery instead. Open surgery is when a surgeon makes a single large cutting into your tum.

Causes of adhesions

You tin can get adhesions after whatsoever blazon of surgery in your tummy or pelvis, including:

• operations to remove parts of your digestive system
• appendix removal (appendicectomy)
• gallbladder removal (cholecystectomy)
• hysterectomy
• surgery for ectopic pregnancy

You may also go adhesions:

• later an infection in your breadbasket, such as pelvic inflammatory affliction or diverticulitis
• if you have an ongoing inflammatory status such equally endometriosis
• if you lot have inflammatory bowel disease, such as Crohn's illness
• afterwards treatment with radiotherapy

Complications of adhesions

Consummate bowel obstacle

A partial bowel obstruction may be treated without surgery. Simply a complete bowel obstacle is a medical emergency because it can be life-threatening.

If your bowel is completely blocked, your bowels will stop working. Y'all may:

• accept a lot of pain
• not be able to pass air current or poo

Seek urgent medical attention if yous take these symptoms.

Strangulated bowel

If part of your bowel gets twisted tightly around a band of adhesions, this can cut off the blood supply. This is chosen a strangulated bowel. It'due south life-threatening if you don't become treatment – so it'due south vital to get aid.

Symptoms of bowel strangulation include:

• severe and abiding pain in your stomach
• bleeding from your lesser
• a fever (loftier temperature)

If you have these symptoms, call for an ambulance or go to your nearest blow and emergency department.

Prevention of adhesions

Adhesions may form if you have an operation. This is how your trunk sometimes reacts to surgery on your tummy and isn't due to the skill of your surgeon. If you lot have lots of operations, you're more probable to take more adhesions.

Scientists are trying to make substances and fluids that tin can be used during surgery to terminate adhesions forming. Only these products don't prevent adhesions completely, so most surgeons don't use them.

Keyhole surgery usually leads to fewer adhesions than open up surgery. So, if you lot're having an operation, ask your surgeon if keyhole surgery is an choice for yous.

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Source: https://www.bupa.co.uk/health-information/digestive-gut-health/adhesions