Abdominal adhesion is a band of scar tissue that forms inside the abdomen as part of the healing process, after surgery, infection, bleeding, or endometriosis involving the abdominal or pelvic cavity.
You can think of an adhesion as you would scar tissue that remains on the skin after a wound heals.
The difference is that an abdominal adhesion tends to form into cord-like structures that can wrap around bowels or other abdominal organs, causing them to stick together, or stick to the abdominal wall itself.
When this happens, an adhesion can cause chronic abdominal or pelvic pain and other complications such as female infertility, difficulties voiding urine, and intestinal obstruction (Obstetrics and Gynecology International).
Do you suffer with central or lower abdominal pain of many months or years duration?
Have you had surgery to your abdomen or pelvis before the onset of this chronic pain?
There is a very high chance that your chronic abdominal or pelvic pain is caused by abdominal adhesion.
Let's examine how common this condition is, what causes it, available treatment options and what can be done to prevent abdominal adhesions after surgery.
Adhesion is relatively common, showing up in about 93% of patients who undergo some form of abdominal surgery, and affecting 1 in 10 patients who have never had any surgery or abdominal procedure.
Abdominal adhesion is more common in patients who have had appendectomy, bowel surgery, hysterectomy or cesarean section.
Adhesion formation following surgery is also referred to as postoperative peritoneal adhesions (PPAs) or postsurgical intra-abdominal adhesion.
It is the most common cause of bowel obstruction in the developed world.
Every abdominal or pelvic surgery carries a 90 to 100% risk of adhesion occurring and it is increasingly necessary for doctors to warn patients of this risk and the subsequent complications of developing adhesions before any such surgery is undertaken. Let's examine a few conditions and procedures that are more associated with the development of adhesion.
An abdominal adhesion is usually the result of some form of trauma to the abdomen. Such trauma could result from external injuries or intra-abdominal or pelvic surgery.
In rare cases, abdominal adhesions can be congenital (present at birth) or occur as the result of a non-invasive procedure like radiotherapy.
As well, traits such as a patient’s genetic predisposition to adhesion formation, age, the presence of infection of an operated site, and other factors can also contribute to a patient’s likelihood of developing abdominal adhesions.
In most people, an abdominal adhesion will be caused by one or more of the following:
The risk of adhesion is higher for open abdominal or pelvic surgery than it is for laparoscopic surgery.
If you have had any of the above listed procedure and suffer with chronic abdominal or pelvic pain, speak with your healthcare provider about the possibility of abdominal adhesion as the cause of your pain.
It is possible to have abdominal adhesions and have no symptoms at all.
In fact, only about one-third of people with adhesion eventually develop symptoms. While pelvic adhesions form 4 to 6 weeks after abdominal trauma or surgery, it can take several months to years before symptoms manifest.
Symptoms of pelvic adhesions can include:
Abdominal pain is the most common symptom of pelvic adhesion.
In a recent study, abdominal or pelvic adhesion were found at laparoscopy in more than 25% of women suffering from chronic pelvic pain. Only 10% of women without chronic abdominal or pelvic pain were found to have abdominal adhesion.
The pain in the abdomen occurs because over time, adhesion bands can develop their own nerve fibres and blood vessels, which cause pain when these nerves are stretched by bowel movements or other factors inside the abdominal cavity. This pain can be sharp and intermittent or dull and more persistent.
Bowel or Intestinal Obstruction
The October 2012 issue of Frontiers in Medicine, reports that adhesive small bowel obstruction is a frequent cause of hospital admission. More recent studies show that postoperative abdominal adhesion is the most common cause of bowel obstruction in the Western world.
Adhesions can spread in a spider web-like formation inside the abdominal cavity and restrict the normal movement of the bowels or intestines, trapping and entangling loops of bowel and causing obstruction.
Symptoms of bowel obstruction include colicky abdominal pain, feeling bloated, nausea, vomiting and constipation or inability to empty your bowels. Occasionally, the bowel is able to "free" itself from the grip of adhesions and symptoms may resolve on their own.
Infertility can be the result of abdominal adhesion in those who have had a major abdominal operation, who suffer with endometriosis, or who are known to have had an abdominal or pelvic infection like PID, salpingitis, or peritonitis. The bands form by abdominal adhesions an affect the architecture of the abdomen, interfering with the release of eggs from the ovary, or the migration of a fertilized ovum into the fallopian tubes and womb (uterine adhesions).
Pain During Intercourse
Pain during intercourse, also called dyspareunia is another common symptoms resulting from abdominal adhesions.
There is no definite cure for adhesion.
The best available treatment for repair abdominal adhesion is by keyhole surgery or laparoscopy to break and remove pelvic adhesions in a procedure called adhesiolysis.
Many patients report significant improvement in their overall health, as well as a very low incidence of recurrence.
There are risks, however. Since abdominal surgery is one of the primary causes of pelvic adhesions, it is possible for patients who have adhesiolysis to need more procedures in the future, sometimes as often as every two years. This occurs in few than 2 in 10 cases.
Some adhesiolysis surgeons will opt to delay the surgery 12 to 24 hours to inject the abdominal cavity with liquids containing carboxymethylcellulose (CMC), hyaluronic acid, or icodextrin ahead of surgery in hopes of reducing the chances of the abdominal adhesions forming after the corrective surgeries.
Because of the risk and uncertainty of cure with adhesiolysis, it is not a procedure that is recommended for everyone who suffers with symptoms of abdominal adhesion.
The following are conditions in patients that would make them more likely to qualify for surgery for removal of postoperative adhesions:
Does any of the above describe you? If so, you can look for doctors who specialise in the removal of postoperative intra-abdominal adhesions for a consultation.
A recent study finds that taking a fish oil supplement may be an effective adjuvant therapy to reduce the development of postsurgical adhesions related to endometriosis. This is according to Fertility and sterility, (25 October 2012, 1556-5653).
Unless patients have congenital adhesions, the formation of adhesions can be controlled, or minimized to some extent, if patients are willing to take certain measures before, during, and after a surgical procedure.
Preventative measures include:
Patients who are preparing for abdominal surgery should discuss what measures are being taken to minimize the chance of an abdominal adhesion forming after surgery.
Last updated on the 25th of February 2018.
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.
Click below to see contributions from other visitors to this page...
CHRONIC Upper midline abdominal pain
Hello, my name is Colleen and I'm 45 years old. 2 years ago I was admitted to the hospital with the most severe abdominal pain I had ever experienced. …
lap band times 2
Name marissa im 24 i have had the lap band 2 times and had the lap band removed 2 times. it been a year now and i am getting abdominal pain, bloating, …
Adhesions - Organ strangulation
I have suspected adhesions, due to wo operations I had, one a back op and two a hysterectomy, which involved radiation therapy. I have severe pain …
Not operating - Abdominal adhesions
I am 37 years old and have been struggling with all the symptoms as discussed above due to more than one surgery involving the abdomen including the removal …
CHRONIC STOMACH AND BACK PAIN
I have been suffering with severe stomach and back pain for the last 4 months following a number of major stomach operations. I am waiting to see the surgeon …
Living with Abdominal Adhesions
Cathy Spires, age 55. As of age 16, I had an ovarian cyst the size of a grapefruit that ruptured. This of course required emergency surgery. Thereafter …
Jeannie in G. Town
My name is Jeannie. Age 46. At age twelve I had an acute appendix rupture. I died on the operating table, and was in a coma for 6 weeks at Ontario Community …
pain in my stomach
Hello! Help me! Article because I am misunderstanding. What do I do? For some time I have pain in my stomach start to feel pain on the left and …
I have undergone C-section two and a half years back. From last six months whenever I am getting strained I am getting severe abdominal pain. It …
lower right ab pain Not rated yet
I have been having lower right ab pain for three weeks now! I have had my gall bladder removed, had kidney stones on right side back in June if 2012. Went …
lower abdominal pain for three days Not rated yet
hi, I am 31years, about 2years ago i had a myomectomi done. i have been trying to get pregnant ever since with no luck. now my left lower abdomen is hurting …
abdominal adhesions and pregnancy Not rated yet
I am a 26 year old female. I had an emergency splenectomy after an MVA 7 years ago, which resulted in many complications including adhesions leading to …
undiagnosed lower right abdomen pain Not rated yet
I am a 62 year old woman and have had this worsening pain for over 2 months. I first started out with right sided chest pain,and sharp pain in upper,right …
Julie Bellairs Despereate Not rated yet
Hi, I am 48 years old and summer chronic pain deep in the right hand side of my pelvis. I have had the pain since having my children all by c section …
abdomen pain with vomiting and constipation Not rated yet
Hi I'm john I'm nearly 32, had my appendix out 14 yrs ago, for the last 7 year's I have been suffering abdomen pain with vomiting and constipation, the …
tremendous abdominal pain Not rated yet
I have had 3 csections,appendix removal, hysterctomy. The hysterctomy lead to DIC and 4 more abdominal surgeries. Since the last surgeries, i …
II want to be free: Not rated yet
Hi; I,Marilyn I have had a eventfull past two month.I,ve decided I was not going to take this pain any longer. I stared investigating why I,m in so …
ruptured incisional hernias? Not rated yet
In 2008, after 20 months of undiagnosed pain, a golf ball size gallstone was removed from my abdomin. The stone had left an open hole in my gallbadder …
CHRIS/PA Not rated yet
IN 1991 I HAD EMERGENCY CHOLECYSTECTOMY- DUE TO STONES IN MY BILDE DUCT AND PANCREAS- IT WAS A TERRIBLE SURGERY- I HAVE A 12 INCH SCAR AND HOLES IN …
julie alexander Not rated yet
hi i am a 47 yr old mum of 4.. all 4 of my babie were delivered by c-section and i have had my appendix and gall bladder removed. last section was in in …
CONGENITAL ADHESIONS Not rated yet
G BURRELL AGE 65 - ECTOPIC PREGNANCY AGE 40, NO OTHER MEDICAL PROBLEMS, ON NO MEDICATIONS. AGE 63 SUDDEN ONSET SEVERE ABDOMINAL PAINS FOLLOWED BY VOMITING. …
Possible bladder adhesion following appendectomy? Not rated yet
I had a laparascopic appendecomy nearly 5 months ago. Shortly thereafter, I had soe urinary symptoms, including hesitancy, slowness of stream, and the …
Sharp Pelvic pains after key hole surgury & my appendix removed. Not rated yet
I was diagnosed with Pelvic Inflammatory Disease & had to undergo key hole surgery to make sure there were no lesions or scar tissue on my uterus but they …
Abdominal pain after 2nd c-section. Not rated yet
Hi, My name is Cindy Solomon, I am 32 yrs old, with a 3 yr old son and just had my 2nd son who is just about 3 weeks old. I live in the caribbean, …
Thank you for an excellent article...and a couple of questions... Not rated yet
I have recently been diagnosed with adhesions. I had a long, complicated (4-hour-plus) robotically-assisted laparoscopic left renal diverticulectomy about …
constant period pain Not rated yet
Hi im 36 and l have had 2 c sections. I have also had a coil fitted. I am experiencing a persistent mild pain/discomfort not unlike period pains. Any …
Unexplainable pain Not rated yet
I have had a sharp constant pain in my right side for over a year now. If you start at my belly button and go to the right about an inch that is where …
How are these types of adhesions diagnosed? Not rated yet
I have had a series of strange medical issues since my youngest daughter was born in 1981 including serious chronic infections (including a large abscess …
Adhesion after 3 c sections Not rated yet
I had 3 c-sections. I had a laparoscopy/hysteroscopy/mirena coil. Having had pelvic pain and 'contracture' like abdo pains. An ultrasound said poss polyp. …
Mr Stephen Not rated yet
Im 44 and have a pain in my right lower stomach and at times round my back. The pain is sharp and comes and goes. I've had my gall bladder removed about …
adhesions after c-sections Not rated yet
Hello, My name is Nicola and im 34 years old. I have had 3 c-sections, a sub-total hysterectomy, my cervix removed and a few key-hole surgeries and …
abdominal pain during intercourse Not rated yet
i'm a 30 yr old female who had a c section a year and a half ago and i've had progressively worsening abdominal symptoms since. my obgyn hasn't seen …
Help Keep This Site Going