Consultant Gastro-Intestinal Surgeon, Sir Ganga Ram Hospital, New Delhi
What are adhesions?
Adhesions are pieces of scar tissue, which cause the organs in the abdomen such as the bowel, liver, uterus or fallopian tubes to stick to one another.
How are they caused?
They most commonly occur after abdominal surgery as a part of the healing process. Adhesions can also form after inflammation of an organ in the abdomen or pelvis e.g., due to infections such as Tuberculosis.
Laparoscopic surgery is associated with fewer adhesions, as there is less tissue damage during the procedure. Rarely, adhesions may be present from birth and are thought to be due to abdominal infection in the foetus.
What are the symptoms?
The mere presence of adhesions does not cause the symptoms but because they shorten and contract, they lead to pressure on the internal organs. For instance, adhesions in the abdomen may pull on parts of the intestines and cause an obstruction resulting in crampy pain, vomiting, difficulty passing gas and swelling of the abdomen.
How are they diagnosed?
An X-ray of the abdomen will show enlarged bowel loops full of gas. At times, surgery may be required to make the diagnosis.
What is the treatment?
In 80% of cases when the bowel is obstructed by adhesions, medical treatment is given by emptying the stomach via a tube passed through the nose and by giving fluids into the vein. This may cause the bowel to untwist. If it is not effective, surgery may be required to cut away the bands of adhesions and release the obstruction in the bowel.
How long do the effects of adhesions last?
The effects of adhesions depend on their location and the extent. Even after treatment, they may recur as new adhesions after a surgery for existing adhesions.