Intestinal Adhesions

What are intestinal adhesions?

Intestinal adhesions are bands of fibrous scar tissue that can connect parts of the bowel (intestines) to other parts of the bowel. Or they may connect the bowel to other organs or to the wall of the abdomen.

Adhesions usually do not cause any problems, but they can cause intestinal blockage. The intestines may become blocked when a band of tissue presses on the bowel or pulls a loop of bowel out of place. The bowel may be blocked because it has become kinked and trapped in a small space.

How do they occur?

Most adhesions form after abdominal surgery or infection in the abdomen or pelvis. Sometimes adhesions are present at birth.

What are the symptoms?

Adhesions in the abdomen usually do not cause symptoms. If they cause a blockage, symptoms may include:

• pain that comes and goes (crampy abdominal pain)
• vomiting
• swelling of the abdomen
• inability to pass gas
• not having any bowel movements.

How are they diagnosed?

Your healthcare provider will ask about your symptoms and check your abdomen for tenderness, swelling, and bowel sounds (normal gurgling sounds). Tests you may have are:

• X-rays
• contrast studies, which use a barium liquid or water-soluble contrast liquid and X-rays to examine your bowel
• lab tests of your blood.

Adhesions are often hard to diagnose. You may need surgery to find the cause of your pain.

How are they treated?

If your intestines are just partly blocked, your surgeon may place the bowel at rest. This is done with a nasogastric tube, which is a tube placed through the nose and into the stomach. The tube removes excess gas and fluid. If this relieves the blockage, then you may be able to return to normal bowel function.

In most cases surgery is needed to release the bowel from adhesions that are causing blockage. Laparoscopic surgery (using tiny cuts and small tools controlled by a camera) can often relieve the blockage and decrease the chances of new adhesions. Severe adhesions are best relieved with open surgery.

How long do the effects last?

Any abdominal operation or abdominal infection can cause adhesions, but most adhesions do not cause symptoms or blockage. However, there is always a risk that adhesions will cause problems, sometimes many years after surgery or an infection.

How can I take care of myself?

• Follow your healthcare provider's instructions.
• Take all prescribed medicine as directed.
• Follow your provider's recommendations about diet.
• If you have surgery, get up and walk as soon after surgery as is reasonable. Walking helps get the bowel moving again.
• If you have had surgery or an infection in your abdomen and develop any new symptoms, tell your healthcare provider.

How can I help prevent adhesions?

Because development of adhesions depends on many factors, it cannot be prevented completely.