Abdominal Adhesions
Causes, Symptoms, Diagnosis & Treatment



Abdominal adhesions are like this.

Abdominal adhesions are scar tissues formed inside the abdomen that causes the surface of bowels or other organs within the abdominal cavity to stick to one another or to the wall of the abdomen.

The adhesion tissue, apart from causing organs or bowels stick to one another, they may also act as a band for the bowel to twist around, leading to loss of blood supply to the loop of bowel, abdominal pain and bowel obstruction.

Adhesions are one of the most common causes of chronic abdominal pain. Apart from causing chronic abdominal pain and bowel obstruction, they are also notorious for causing fertility problems.

Causes of Abdominal Adhesions

Abdominal adhesions are formed as a result of excessive scar tissue formation following a normal healing process after any form of injury inside the abdomen.

These scar tissues may become drawn out like spider webs within the abdomen, leading to the formation of hard fibrous bands upon which the bowels could strangulate themselves, or stick, causing a kink or outright blockade of their lumen.

The most common causes of abdominal adhesion formation are:

1. After An Abdominal Surgical Operation

This is the most common cause of adhesion formation. Following any abdominal or pelvic surgical procedure, the normal healing process follows. In some individuals, excessive scar tissue formation occurs. This might be due to their genetic predisposition - some people naturally scar more than others, or it might be due to extensive surgical operation and tissue damage, or excessive tissue handling by the operating surgeon, or use of gloves or chemical agents during the operation that stimulate excessive scar tissue formation.

One study reveals that between 7 and 9 out of 10 persons undergoing any form of abdominal surgery would develop adhesion.

Common surgical procedures that causes adhesions include:

  • Appendicecetomy
  • Hysterectomy
  • Caesarean section
  • Gallbladder surgery (Cholecystectomy)
  • Bowel surgery
  • Kidney surgery
  • Pancreatic surgery

If you have had any of the above surgery done or indeed any abdominal or pelvic operations and suffer with chronic abdominal pain with bloating, it could be due to abdominal adhesions. It might what discussing with your healthcare provider.

2. Endometriosis

Endometriosis is a condition where the normal lining of the womb is also found outside the womb. It is a very common cause abdominal pain and it is believed that over 15 percent of women with chronic abdominal pain suffer with this condition.

Endometriosis leads to the formation of scar tissues and fibrous bands too, causing abdominal and or pelvic adhesions.

Do you suffer chronic abdominal pain, worse around or just after your menstrual periods, with perhaps heavy menstrual loss and deep seated abdominal or pelvic pain during intercourse? You could be suffering with endometriosis.  It is certainly a treatable condition. Why not discuss with your healthcare provider to explore this line of inquiry?

3. Abdominal Infection

Have you ever suffered with peritonitis? This is an infection spreading and affecting the abdominal cavity. After such an infection, the body normally heals by clearing any pus or bleeding formed in the course of the infective process.

Scar and fibrous band formation may occur as a result, leading to adhesions. Infections that could lead to abdominal adhesions include:

  • Peritonitis
  • Ruptured appendicitis
  • Ruptured infected gallbladder
  • Caecitis
  • Typhoid infection

If you have had a history of an abdominal infection a few or many years ago and suffer with chronic abdominal pain, it is very likely that this might be due to adhesions from that infection.

4. Massive Bleed Into Abdomen

Have you had internal bleeding or bleed into your abdominal cavity in the past? This is often seen following a road traffic accident or other trauma situations where the liver or spleen is ruptured, causing internal bleeding.

A bleed into the abdomen could also follow a ruptured abdominal aortic aneurysm or ruptured ectopic pregnancy.

As the blood is cleared in any of the above conditions, scar tissue formation and adhesions develops and could cause chronic abdominal pain in the future.

5. Radiotherapy

Radiotherapy is the use of x-ray energy in the treatment of certain conditions, especially cancer.

After extensive treatment with radiotherapy, good tissues could be damaged as well as the bad tissue for which the treatment was intended. In the process of healing occurring following the injury, scar tissues could form.

6. Congenital Adhesions

Some people are born with adhesions and these are referred to as congenital adhesions.

Symptoms of Abdominal Adhesions

X-Ray of bowel obstruction from abdominal adhesions

Uche is a 51 year old lady thought to suffer with irritable bowel syndrome. She had two Cesarean sections in the past - one in 1994 and the other in 1998.

She has been on treatment for intermittent abdominal pain, bloating and constipation for many years after the last cesarean section.

She also has had problems conceiving after the last cesarean section and underwent many investigations for infertility with no success at achieving pregnancy.

In the past 24 to 48 hours (16th July 2013), she developed central abdominal pain, intermittent, comes in waves and spastic in character. The pain is described as 8 out of 10 in severity. It spreads to the sides and back.

There is associated retching but no vomiting. She feels very bloated. She denies opening her bowels or passing flatus in the past 48 hours period.

She also denies any recent weight loss. Her appetite remains good. There are no problems with passing urine. No abnormal vaginal bleed or problems with her menstruation.

She was taken to see her normal family doctor. On arrival in the consulting room, she looked very anxious. Her temperature was normal, though she looked dry. Her heart rate was 118 beats per minute. Her blood pressure was 141/89mmHg. She had normal heart sounds. Her respiratory rate was 18 per minute and with normal oxygen saturation and good air entry to both lungs.

On examination of her abdomen, she was visibly bloated with diffusely swollen abdomen, tender all over and her bowel sounds were very loud.

An abdominal x-ray was done which is as shown to the top right.

She was diagnosed with intestinal obstruction, and was promptly taken to the surgical theatre to operate upon.

During surgery, she was found to have an extensive intertwining of her bowels by strong fibrous bands - abdominal adhesions.


The symptoms of abdominal adhesions are non specific. They could mimic those of other conditions like irritable bowel syndrome, trapped wind, constipation, or celiac disease. The key to diagnosis of an abdominal pain due to adhesions is to have a high index of suspicion in anyone who has had an abdominal or pelvic surgery, presenting with recurrent abdominal pain.

If you are known to have had a surgical operation - whether open or keyhole surgery, or suffers with endometriosis, or have had radiotherapy or significant bleed into your abdomen in the past or indeed have had abdominal cavity infection and you suffer with:

  • Intermittent abdominal pain
  • Feeling bloated
  • Sometimes feel nauseated

It is most likely that these symptoms are caused by abdominal or pelvic adhesions.

In severe cases, you could actually develop bowel obstruction characterised by:

  • Abdominal pain
  • Bloating and distension
  • Inability to open your bowel
  • Passage of very little or no flatus
  • Nausea or vomiting.

If you have any or a combination of the above symptoms and you suspect that you may be having this condition, why not book an appointment today to see your doctor?

Abdominal Adhesions - Share Your Experience

Do you have a story about abdominal adhesions? Any question or comment? Share it!

Please feel free to contribute your thoughts here if you read postings by others, and you want to say something.

All postings are read by the abdominal pain team, and we shall respond to some queries directly on this page too.

What Other Visitors Have Said RegardingTheir Experience With Abdominal Adhesion

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right side and abdominal pain 
I am a 43 yr old woman with a total hysterectomy. For about 3 weeks i have been having a dull aching pain in my lower back which radiates to my right …

right side and center pain aches for a week Not rated yet
hi my name is adejoke and am 29 years old. I did a CS to deliver my daugther in 2011. eleven months later I did an etopic surgery and now am having this …

jamie browne Not rated yet
my ame is jamie browne i am a 55 year old female who is currently taking 10 mg. lisinopril once daily for high blood pressure and 300 mg neurontjn three …

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