Intestinal Adhesions

What are intestinal adhesions?

Intestinal adhesions are bands of 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 are a major cause of 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
• trouble having a bowel movement.

How are they diagnosed?

Your healthcare provider will ask about your symptoms and check your abdomen for tenderness and swelling. Tests you may have are:

• X-rays
• a CT scan (a scan that uses X-rays and a computer to produce pictures of the organs in your abdomen)
• barium contrast studies, which uses a barium liquid and X-rays to examine your bowel

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 healthcare provider may recommend a diet low in fiber, called a low-residue diet. This diet allows food to move more easily through your intestines. Make sure that you chew your food completely.

In some cases surgery is necessary to release the bowel from adhesions that are causing blockage. But there is a risk of developing more adhesions each time you have surgery. Laparoscopic surgery (using tiny incisions and small tools) can decrease the chances of new adhesions, but it is not always possible to do it that way.

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. Some products are available that may decrease the chance of adhesions, but the benefits of these products are still questionable.