About Adhesions

What are Adhesions?

Adhesions are internal bands of scar tissue that form between organs, most of ten in the pelvic area. They are caused by infection, inflammation, or endometriosis, or as areas heal from surgery. They are the most inevitable outcome of surgery, and sometimes severe. Adhesions can connect organs and tissues that are not normally attached. When this happens it causes disturbances in function, chronic pelvic or abdominal pain, infertility, bowel obstruction and other complications.

Even if adhesions are cut, in an attempt to separate the attached organs they will inevitably form again. Patients face a life of pain and suffering punctuated by temporary periods of respite that lysis (cutting) of the adhesions sometimes allows.

Laparoscopic photograph of Adhesions between the diaphram and liver	Laparoscopic photograph of Adhesions betweenbowel

Pelvic adhesions can be filmy or thick and some even contain small blood vessels. Adhesions affect millions of people, although many patients are unaware that adhesions may be the cause of their pain. They go from doctor to doctor seeking not only medical advice and treatment, but support as well, which they may not find. This is a very real and destructive disease. In acute cases it destroys its victims lives.

Click on thumbnail photos below to enlarge.
(special thanks to Dr. Harry Reich of Shavertown P.A. for providing the images)

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How to Diagnose and Treat Adhesions

Adhesions are very difficult to diagnose because they do not show up readily on X-ray or other tests such as MRI, CT, ultrasound or colonoscopy.

The only way to detect adhesions definitively is by exploratory surgery. Adhesions can cause complete bowel obstructions. Although tests may show this obstruction, the cause is unknown until the surgeon performs surgery. There are many people who have had partial bowel obstructions despite having negative tests!

Adhesions are treated by cutting. Unfortunately they often return and further surgery is needed. Special surgical devices called adhesion barriers can be used to minimize adhesion reformation.

Most organs of the body will produce scar tissue when irritated. For this reason great card should be taken in handling tissues during surgery to minimize the chance of scar tissue or adhesion formation.

Cutting an adhesion

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Minimizing Adhesion Development

Even the best surgeons with the most meticulous surgical technique cannot eliminate the formation of adhesions. However, a number of steps can be taken to reduce the chances of adhesion development which include: handling tissue gently, keeping tissue moist, avoiding dry or linting sponges, using powderless gloves, meticulously controlling bleeding, judicious use of cautery, using fine non-reactive sutures and use of adhesions barriers.

Unfortunately much ignorance prevails and many well-meaning health professionals do not appreciate adhesions and the problems they cause. Consequently, patients go undiagnosed of misdiagnosed as having nervous or psychological problems or irritable bowel syndrome. Many surgeons are, understandably, reluctant to cut the adhesions and do the risky procedure. Other doctors are reluctant to provide adequate pain relief for the fear that the patient may become an addict. But seeing a pain management doctor can help.

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Video of Adhesions Surgery

This is a short video clip of a surgery cutting at the adhesions. The adhesions are the web-like, stringy tissues and are being cut away to separate the organs.

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