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Abdominal Adhesions: Causes, Complications and Treatments
Written by Medicover Team and Medically Reviewed by Dr Anand Auti , General Surgeon
Abdominal adhesions are bands of scar tissue that form between abdominal organs or between an organ and the inner wall of the abdomen. These bands can cause normally separate organs to stick together, which may lead to pain, complications like bowel obstruction, or even infertility in some cases.
Adhesions most commonly occur after abdominal or pelvic surgery, but they can also form as a result of infections or inflammation inside the abdomen. While many adhesions are harmless, some can interfere with the normal movement of your organs and may require medical attention.
What Are Abdominal Adhesions?
Abdominal adhesions are bands of fibrous scar tissue that develop between organs and tissues inside your abdominal or pelvic cavity. These bands can cause the surfaces of organs, such as the intestines, uterus, bladder, or abdominal wall, to stick together in ways they normally wouldn't. This limits organ mobility and can potentially lead to pain, infertility, or intestinal blockages.
How Do They Form?
When the body undergoes injury, surgery, or inflammation, the immune system responds by creating scar tissue as part of the healing process. While scar tissue on the skin heals externally, internal scar tissue can form in areas where tissues should remain separate. Over time, this scar tissue may form adhesions, tethering organs together and reducing their natural movement.
Where Can Adhesions Form?
Adhesions can occur anywhere in the abdomen or pelvis, but they commonly affect:
- Small intestines, especially after surgery
- Peritoneal lining, the inner lining of the abdominal cavity
- Uterus and fallopian tubes, particularly after gynecological procedures
- Bladder
- Large intestine (colon)
Over time, these adhesions may tighten or restrict movement in the affected organs, which can lead to pain or complications like intestinal blockages.
What Are the Common Causes of Abdominal Adhesions?
Adhesions are the result of the body's natural healing process. When tissues inside the abdomen become inflamed or damaged, the immune system responds by sending healing cells to the site. As these tissues repair themselves, scar tissue may form. If this scar tissue connects tissues that are normally separate, it creates an adhesion.
Most Common Causes
- Surgery: About 75% of abdominal adhesions form after abdominal or pelvic surgeries. This includes operations such as appendectomies, cesarean sections (C-sections), hernia repairs, and hysterectomies.
- Infections: Conditions like appendicitis, pelvic inflammatory disease (PID), and peritonitis (inflammation of the abdominal lining) can trigger adhesion formation.
- Inflammatory diseases: Chronic conditions like Crohn's disease, diverticulitis, and endometriosis increase the risk of adhesions.
- Radiation therapy: Treatment for cancers in the pelvic or abdominal area may damage tissues and lead to scar formation.
- Peritoneal dialysis: A treatment for kidney failure that may irritate the peritoneum and cause adhesions over time.
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Get Second OpinionWhat are the Abdominal Adhesions Symptoms and Warning Signs?
Many people who have abdominal adhesions experience no symptoms at all. These adhesions may go undetected for years or even decades. However, in some cases, they can cause serious health problems.
Common Symptoms
- Chronic abdominal or pelvic pain, dull, cramping, or sharp pain, often intermittent
- Bloating or swelling, especially after eating
- Nausea and vomiting
- Constipation or difficulty passing gas
- Changes in bowel movements, such as fewer or more difficult bowel movements
Severe Symptoms Indicating a Possible Bowel Obstruction
- Intense, sudden abdominal cramps
- Inability to pass gas or have a bowel movement
- Swollen, distended abdomen
- Persistent vomiting
- Signs of dehydration or shock
Seek emergency medical care immediately if you suspect a bowel obstruction. It can become life-threatening without prompt treatment.
What Are the Risk Factors of Abdominal Adhesions?
While anyone can develop adhesions, certain situations increase your risk:
Key Risk Factors
- Open abdominal surgery (laparotomy): Involves a large incision and higher tissue exposure, significantly increasing adhesion risk.
- Multiple abdominal surgeries: Repeated surgical procedures heighten the chance of developing problematic scar tissue.
- Emergency surgery: Surgeries performed without preparation or under severe conditions often result in greater tissue trauma.
- Surgeries involving the reproductive or digestive organs: These areas are particularly prone to adhesion formation.
How is Abdominal Adhesions Diagnosed?
Adhesions are difficult to detect because they are made of soft tissue that typically doesn't show up on X-rays, CT scans, or MRIs.
Medical history and symptoms
A history of abdominal surgery combined with unexplained pain or digestive issues may raise suspicion.
Imaging tests
Specialized Tests
Hysterosalpingogram (HSG) for women with fertility concerns, An X-ray of the uterus and fallopian tubes used to detect blockages caused by adhesions.
Laparoscopy
- A minimally invasive surgery that allows doctors to see and treat adhesions directly.
- Often used when other causes have been ruled out and symptoms are persistent.
What Are the Treatment Options for Abdominal Adhesions?
In most cases, no treatment is required unless adhesions cause significant symptoms or lead to complications like infertility or obstruction.
Non-Surgical Management
- Pain medications for mild, chronic discomfort.
- Dietary changes (low-residue diet) to ease mild digestive issues.
- Observation and monitoring if symptoms are intermittent and not severe.
Surgical Treatment
Adhesiolysis: A procedure where the surgeon cuts and separates the scar tissue. This can be done through:
- Laparoscopy (minimally invasive, preferred)
- Laparotomy (open surgery, used for severe cases)
Any additional surgery may lead to new adhesions, so surgical treatment is typically only used when absolutely necessary.
When to See a Doctor?
Abdominal adhesions are bands of scar tissue that can form inside your belly after surgery, infection, or inflammation. They may connect organs or tissues that should not be stuck together. While many people have no symptoms, some may experience pain or digestion problems.
You should see a doctor if you have:
- Have belly pain that keeps coming back
- Feel bloated or full often
- Feel sick to your stomach (nausea) or throw up
- Have trouble passing gas or having a bowel movement
- Can't eat much or feel full quickly
Get medical help immediately if:
- Your belly pain is sudden or very strong
- You can't pass gas or poop at all
- You have a fever with stomach pain
These could be signs of a serious complication like a bowel obstruction, which needs urgent care.
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What Precautions Can Help Prevent Abdominal Adhesions?
While complete prevention isn't possible, there are strategies surgeons use to reduce the risk of adhesion formation:
- Laparoscopic surgery: Using small incisions and cameras instead of open surgery lowers trauma and reduces scar formation.
- Adhesion barriers: Special gels, sprays, or films placed between tissues during surgery can help prevent them from sticking together as they heal.
- Gentle tissue handling: Surgeons using careful, minimally traumatic techniques may reduce inflammation and adhesion risk.
Living with Abdominal Adhesions
For individuals living with abdominal adhesions, managing symptoms and maintaining a good quality of life is paramount. Here are some strategies:
Surgical Techniques That Minimize Risk
- Laparoscopic (minimally invasive) surgery whenever possible.
- Gentle handling of tissues during procedures.
- Irrigation and cleaning of the abdominal cavity to remove blood and foreign materials.
- Use of adhesion barriers, thin films, gels, or liquids placed between organs during surgery to help prevent sticking.
What re the Complications of Abdominal Adhesions?
Although many adhesions are harmless, they can occasionally lead to serious complications that may require urgent medical attention or surgery.
- Small Bowel Obstruction (SBO): Scar tissue can block the flow of food, fluid, and gas through the intestines. This can cause severe pain, vomiting, and even infection.
- Chronic Abdominal or Pelvic Pain: Adhesions can restrict organ movement, leading to persistent or recurrent discomfort that may affect your quality of life.
- Infertility in Women: Adhesions around the ovaries, fallopian tubes, or uterus can block the normal movement of eggs, preventing fertilization or implantation.
- Asherman's Syndrome: This condition involves intrauterine adhesions that can result in menstrual irregularities or infertility.
Our Experience Treating Abdominal Adhesions
At Medicover, we help many people with abdominal adhesions feel better. We understand how painful and frustrating belly problems can be.
Our doctors use:
- Accurate diagnosis using imaging tests and physical exams
- Simple treatments to manage pain and help digestion
- Gentle surgery if needed to remove scar tissue
- Advice on food and habits to keep your stomach working well
- Follow-up care to prevent problems from coming back
We are here to support you with kind, expert care so you can feel good again and live more comfortably.
