Adhesions in the abdomen

What are adhesions in the abdomen?

Adhesions in the abdomen are tissue bridges that connect organs to each other or organs to the abdominal wall. Physiologically, these are not present and often arise after surgical interventions in the abdomen. In technical terminology, adhesions are known as adhesions

What are the causes of adhesions in the abdomen?

Adhesions often occur after operations in the abdomen and are the most common cause of adhesions in this area. Like a skin wound, the protein fibrin closes intraoperative wounds. The breakdown of fibrin is often delayed after an operation. During this time, connective tissue cells migrate and form solid strands, the adhesions. According to the current state of knowledge, it is not yet known how to prevent adhesions after an operation. Postoperative adhesions can often be minimized using the keyhole technique (minimally invasive).
Other causes of adhesions can be inflammation of the fallopian tubes or ovaries, or endometriosis. As part of this, the peritoneum can become inflamed and adhesions can also form.
The causes of adhesions can also be infections, chemotherapy, radiation or malignant diseases.

How are adhesions diagnosed?

Adhesions can only be reliably diagnosed intraoperatively. As part of a new operation, which is often carried out using the keyhole technique, the adhesions can also be resolved in addition to the reliable diagnosis.
Alternatively, information about existing adhesions can be given by means of ultrasound or MRI.

Which symptoms indicate adhesions in the abdomen?

Often adhesions in the abdomen do not cause any symptoms and go unnoticed.

Symptoms of adhesions in the abdomen can include:

• Disturbance of the intestinal activity up to an intestinal obstruction (rare)
• Stool irregularities
• Feeling of pressure
• Painful intercourse
• Chronic pain in the lower abdomen
• infertility
• Drawing pain in the back or shoulder

Back pain

Adhesions in the abdomen can cause pain that can lead to a relieving posture. Most of the time, some muscles become tense, which can result in back pain.
Pain due to adhesions in the abdomen can also radiate to the back or shoulder.

Surgery as a therapy option

An operation, which can usually be performed using the keyhole technique (minimally invasive), can identify and at the same time also loosen adhesions. It is the only way to safely remove adhesions. The minimally invasive procedure means that only small incisions are necessary, so this surgical procedure is less traumatic than open surgery. Only in rare cases is an open surgical procedure necessary to loosen adhesions. During the operation, the surgeon takes a close look at the organs and the abdominal wall, looks for possible adhesions and tries to completely loosen them. Such an operation is called adhesiolysis. In rare cases it may be necessary to remove part of the bowel.
A renewed formation of adhesions after an adhesiolysis is possible. There is currently no way to completely prevent the formation of possible adhesions.

Would you like to find out more about the operative procedure? Then read more on the subject here: Laparoscopy

Can adhesions be loosened without surgery?

There is no way to reliably loosen adhesions without a new operation.

If you do not want to undergo another operation, there is the possibility to try other therapy methods, for example to relieve the pain.
These include:

• Thermal therapies
• Physiotherapy
• acupuncture
• psychotherapy
• Ostheopathy
• Nutritional advice (create a nutrition protocol)
• Multimodal pain therapy (uses the points mentioned above)

forecast

Adhesions can also reappear after adhesiolysis, i.e. an operation in which the adhesions were loosened. Sometimes there is also the case that the symptoms persist despite the loosening of the adhesions.