Have you ever had abdominal surgery? Or has any of your friends or relatives had it? Sometimes, people like that can develop small adhesions inside their stomachs. Today, we're going to talk about a condition called Abdominal Adhesions .
What are these abdominal adhesions? Let's explain exactly!
Simply put, adhesions are bands of scar tissue that form inside your abdomen, between organs in your abdominal cavity, or between an organ and the abdominal wall. To be precise, they form when another wound heals, just as a scar forms when our skin is injured.
Imagine, there are many important organs inside your stomach.
- Our digestive system , that is, things like the stomach , small intestine, and large intestine.
- Female reproductive organs are the organs of the female reproductive system .
- Kidneys, adrenal glands.
- Liver .
- Pancreas .
- Spleen .
These are the areas where adhesions often form. They are especially common in the small intestine . These adhesions form when there is an injury, infection, or inflammation inside the abdomen. Don't be surprised, sometimes they can even form during surgery, even when the organs are being touched. In fact, these adhesions are most commonly seen after abdominal surgery. This scar tissue forms as part of the body's natural healing process, and sometimes the tissues begin to stick together.
How common are these addictions? Do everyone get them?
In fact, many people who have abdominal surgery develop these adhesions. It's the most common side effect . However, many people don't have any symptoms and don't need treatment.
But, there's something else. These adhesions are the main cause of small bowel obstruction . Small bowel obstruction is a serious condition that requires emergency medical attention. It means that the intestine becomes completely or partially blocked.
What symptoms can occur if there are adhesions in the stomach?
Most of the time, as I said before, these adhesions don't cause any symptoms . You may not even know you have them.
However, sometimes these adhesions can cause your intestines to become twisted together. It's like a water pipe getting stuck. This can happen quickly after surgery, or it can happen years later. This is when the small bowel obstruction I mentioned occurs.
If your intestines become blocked, food, water, air, and waste can't pass through them. You may experience symptoms like:
- You may get a severe stomach ache .
- You may feel cramping or pain in your stomach.
- Bloating may occur.
- Nausea and vomiting may occur.
- The stomach may bulge forward (abdominal distension).
- Conditions such as the inability to pass air and the inability to defecate (obstipation) may occur.
Important: If you have these symptoms of intestinal obstruction, you should go to a hospital's emergency department (ETU) immediately . This can be life-threatening if not treated immediately.
Why do these stomach adhesions form? What are the causes?
Abdominal adhesions form when your body repairs damaged tissue inside your abdominal cavity. They are like scars that form inside your body. If any organ or tissue inside your abdomen is damaged, your immune system will cause inflammation to repair that tissue. As part of this healing process, scar tissue forms over the damaged tissue.
Imagine, if you scrape your knee and get a cut, the scar will fade away after a while and you won't even notice it was there. But these adhesions that form inside the stomach don't just go away. Instead, the damaged surfaces can stick together.
It is said that about 75% of diagnosed adhesions are caused by abdominal surgery . However, they can develop as a response to any injury, medical condition, or treatment that causes swelling inside the abdomen. For example:
- Abdominal or pelvic infections.
- Appendicitis.
- Crohn's disease.
- Diverticulitis.
- Endometriosis.
- Pelvic inflammatory disease (PID).
- Radiation therapy to your abdomen (a cancer treatment).
- Peritoneal dialysis (a treatment for kidney failure).
Who is more at risk of developing these?
The biggest risk factor for developing abdominal adhesions is having abdominal surgery . Specifically:
- Open surgery (Laparotomy): In these, a single large incision is made. These adhesions occur in more than 90% of open surgeries.
- The risk of these adhesions occurring is slightly lower during laparoscopic surgery , because during laparoscopic surgery, surgeons perform the surgery through several small incisions instead of one large one.
- Surgeries performed on organs in the lower part of your digestive system, such as the colon and rectum .
- How many times have you had abdominal surgery?
- Emergency surgery.
What complications can occur from these abdominal adhesions? Are they dangerous?
Most adhesions do not cause any problems. However, if a problem does occur, the complications can be quite serious.
Complications can include:
- Small bowel obstruction: This scar tissue can cause the loops of the small intestine to become twisted or narrowed, causing a blockage. If not treated immediately, this blockage can lead to a life-threatening infection called peritonitis .
- Chronic pain: These adhesions can prevent your organs from moving freely. This can cause long-term visceral pain in your pelvic cavity or abdomen.
- Infertility: Adhesions can also cause infertility. This scar tissue can prevent the egg and sperm from meeting, preventing conception. Scar tissue inside the uterus can prevent a fertilized egg (embryo) from implanting in the uterine wall. These adhesions inside the uterus are also called intrauterine adhesions , or Asherman's syndrome .
How do doctors detect this?
Your doctor will ask you about your symptoms and your medical history. If you have symptoms like abdominal pain, and if you have had previous abdominal surgery, your doctor may suspect these adhesions.
However, imaging technology, i.e. scans, cannot directly detect adhesions in the stomach. However, these tests can detect intestinal obstructions that may be related to adhesions.
- X-rays and CT scans of your abdomen can show blockages in your small intestine. A CT scan can also determine the severity of the blockage.
- A test called a hysterosalpingogram (HSG) can show blockages in your uterus or fallopian tubes.
The only way to know for sure if you actually have adhesions is to have surgery .
Do you need treatment for stomach adhesions?
Many adhesions do not show symptoms and therefore do not require treatment.
Also, more surgeries can cause more adhesions. Think about it this way: Your surgeon can cut and "untie" the bands of tissue that are stuck together. However, once the surgery is over, there is no way to prevent the tissue from sticking together again.
Therefore, your doctor will likely avoid surgery unless there is a serious medical problem, such as a bowel obstruction. You may also need surgery to remove uterine adhesions that are preventing you from having a baby.
Is there a way to prevent these stomach adhesions from forming?
To be honest, there is nothing specific that you or your surgeon can do to prevent stomach adhesions from forming.
However, the incisions are smaller during laparoscopic surgery, so adhesions are less likely to form. Therefore, surgeons are now choosing laparoscopic surgery over open surgery for many abdominal surgeries.
Also, your surgeon may place barriers between the tissue surfaces during surgery to prevent them from sticking together due to scar tissue. These barriers come in solids, liquids, gels, and sprays that dissolve inside the body. However, even with these barriers, scar tissue formation is an unavoidable part of the healing process.
Research continues to find solutions that can reduce the complications caused by these adhesions.
What is the future for someone with this condition?
Even if you have many adhesions in your stomach, you may never have any symptoms. However, if you have persistent intestinal blockages, or if you have a complete blockage, you may need surgery.
Do stomach adhesions go away over time?
Some stomach adhesions can get better over time. And, unless they're causing problems, doctors usually don't remove them.
However, sometimes, surgery is necessary, even if there is a risk of further adhesions. Your doctor will help you decide on the pros and cons of surgery, depending on your symptoms.
What can be done for pain caused by abdominal adhesions?
Your doctor may recommend painkillers that you can buy at the pharmacy.
Some studies suggest that a physical therapy technique called soft tissue mobilization may help reduce pain associated with adhesions. However, more research is needed to understand the benefits of this treatment.
Can this scar tissue (adhesions) on the stomach be removed?
The only way to break up this scar tissue, or adhesions, is to have surgery . Your doctor will talk to you about the potential benefits and risks of surgery, depending on your symptoms.
Are there any foods or drinks that you should avoid if you have allergies?
There are no specific "bad" foods that you should avoid if you have constipation. However, if you have a condition like a partial bowel obstruction, your doctor may tell you to eat soft foods or foods low in fiber . These foods are easier to pass through your intestines.
When should I seek medical advice?
If you have unexplained stomach pain, or if you have difficulty passing stool or passing gas, see your doctor immediately. You may have adhesions or a blockage in your intestine.
A complete intestinal blockage is life-threatening! If you have any of the following symptoms, seek emergency medical attention immediately:
- Severe stomach pain or cramps.
- Significant bloating or swelling.
- Nausea or vomiting.
It's common to develop adhesions in the stomach after abdominal surgery. Fortunately, most adhesions never cause any problems. However, if you experience signs of intestinal obstruction, such as abdominal pain, difficulty passing gas, or having a bowel movement, seek emergency medical attention right away. This scar-like tissue can still cause problems years after surgery. Knowing the warning signs can help you get help quickly.
Finally, the most important thing for you to remember (Take-Home Message)
Okay, so, from what we've talked about, these are the most important things you need to remember:
- It is very common for adhesions like this to form after abdominal surgery.
- However, most people do not experience any symptoms or problems from this, so don't worry.
- The most important thing is to be aware of the warning signs (severe abdominal pain, bloating, vomiting, and constipation) that may occur if these adhesions cause something like bowel obstruction.
- If such symptoms occur, it can be life-saving to seek medical advice immediately without wasting time .
- Before having surgery, talk to your doctor about these adhesions. Ask if procedures like laparoscopy can reduce the risk.
So, I hope this information was useful to you. Stay healthy!
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