Bowel adhesions

An overview of bowel adhesions, their causes, symptoms, diagnosis, and treatment.

Bowel adhesions are fibrous bands that form between tissues and organs in the abdominal cavity, often as a result of surgery, infection, or inflammation. These adhesions can cause organs to stick together, potentially leading to complications such as bowel obstruction.

Causes

Bowel adhesions typically form after abdominal surgery, as the healing process can lead to the development of scar tissue. Other causes include:

• Peritonitis, an inflammation of the peritoneum.
• Endometriosis, where tissue similar to the lining inside the uterus grows outside it.
• Inflammatory bowel disease (IBD), such as Crohn's disease or ulcerative colitis.
• Infections within the abdominal cavity.

Symptoms

While many adhesions are asymptomatic, they can sometimes lead to:

• Abdominal pain or discomfort.
• Bowel obstruction, characterized by symptoms such as nausea, vomiting, and inability to pass gas or stool.
• Changes in bowel habits, including diarrhea or constipation.

Diagnosis

Diagnosing bowel adhesions can be challenging, as they are not visible on standard imaging tests. However, the following methods may be used:

• CT scan or MRI to rule out other causes of symptoms.
• X-ray with contrast, such as a barium swallow or enema, to assess bowel function.
• Laparoscopy, a minimally invasive surgical procedure, can be used to directly visualize and diagnose adhesions.

Treatment

Treatment for bowel adhesions depends on the severity of symptoms:

• Conservative management: Includes dietary changes, medications to relieve symptoms, and monitoring.
• Surgical intervention: In cases of bowel obstruction or severe pain, surgery may be necessary to cut the adhesions (adhesiolysis). However, surgery can lead to the formation of new adhesions.

Prevention

While it is not always possible to prevent adhesions, certain surgical techniques and postoperative care strategies can minimize their formation:

• Using minimally invasive surgical techniques, such as laparoscopy.
• Applying adhesion barriers during surgery.
• Ensuring meticulous surgical technique to reduce tissue trauma.

Prognosis

The prognosis for individuals with bowel adhesions varies. Many people live with adhesions without any symptoms, while others may experience recurrent bowel obstructions requiring multiple surgeries.

Also see

• Abdominal surgery
• Bowel obstruction
• Scar tissue
• Peritoneum