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Adhesions

Adhesions can be defined as abnormal connections between two surfaces or two organs. Adhesions are made of tissue that closely resembles scar tissue and they often occur after patients have had previous surgery or infection in the abdomen.

Inside an abdomen that has never had any surgery, or never had any infection, there are no adhesions. People who have had previous infections inside their abdomen are at risk of adhesions when the infection heals. This has been because there has been the presence of pus or inflammatory tissue which irritates the surface of organs within the abdomen. That tissue becomes “sticky”, then other surfaces and nearby organs or tissues can become adherent to those areas and then a mature adhesion develops. Mature adhesions act like permanent connections between those two surfaces and this is what causes the symptoms.

Contents within the abdomen usually enjoy relatively free movement, so that during digestion, organs can contract and move as they wish for their proper function. Adhesions impede this because they act like anchors preventing organs to freely move. This is what causes the pain and dragging sensation that patients with adhesions seem to experience. Of course, many patients have adhesions and are not at all aware of them and they have no symptoms, however, some patients with adhesions have considerable symptoms depending on where those adhesions are and how the organs nearby are affected.

Sometimes medications are required to prevent adhered bowel having spasms. Sometimes surgery is required to divide the adhesions and in severe cases this is often resorted to even though there is a risk of further adhesions forming with further surgery. Currently there is no medical way to prevent adhesions developing, but lots of research is being done into various washes and gels that can be applied to the abdomen when surgery is being performed in order to try and prevent adhesions developing in the future. Such materials will become available in the near future for use at routine surgery. The main risk of adhesions is the development of obstruction of the gut. This can be an emergency and require operation swiftly. Some patients with adhesions have to rely on pain killers so that they can function normally.