The Causes and Prevention of Intestinal Adhesions

By: james sameul

Intestinal adhesions are bands of fibrous tissue that can connect the loops of the intestines to each other, or the intestines to other abdominal organs, or the intestines to the abdominal wall. These bands can pull sections of the intestines out of place and may block passage of food. Adhesions are a major cause of intestinal obstruction.

Adhesions may be present at birth (congenital) or may form after abdominal surgery or inflammation. Most form after surgery. They are more common after procedures on the colon, appendix, or uterus than after surgery on the stomach, gall bladder, or pancreas.
The risk of developing adhesions increases with the passage of time after the surgery.

The causes and prevention of intestinal adhesions.
Although intestinal obstruction from intra-abdominal adhesions is a relatively common surgical emergency, the vast majority of adhesions are harmless and may be protective or even life-saving. The causes of intestinal adhesions are presented, and various methods advocated to prevent adhesions are discussed. The surgeon is advised to reduce unnecessary adhesion formation by meticulous
surgical technique, control those adhesions which inevitably form to obtain their beneficial effects, and to avoid the risk of subsequent obstruction.

Diagnosis
X rays (computed tomography) or barium contrast studies may be used to locate the obstruction. Exploratory surgery can also locate the adhesions and the source of pain.

CHINESE HERB MEDICINE FOR ADHESIONS
The problem of developing abdominal adhesions is noted in the Chinese medical literature. Dr. Fu Kezhi, at the Harbin office of ITM, carried out a literature search, yielding several studies summarized here.
Chinese medicine has been applied both to prevention of adhesions and to their treatment when they cause bowel blockage.

The preventive measure involves relatively immediate post-surgical intervention. The basis of the preventive therapy is to treat the abdominal stasis that occurs following surgery. Normally, after an abdominal surgery, the bowels are virtually paralyzed for many hours, up to two days in older patients and complicated surgeries. Doctors and nurses check for the return of bowel sounds (indicating movements) after the surgery, to make sure recovery is proceeding. Since obstructive constipation is one of the primary responses to developing adhesions, concern about bowel stasis is a clear concern.

Symptoms
Some adhesions will cause no symptoms. If the adhesions cause partial or complete obstruction of the intestines, the symptoms one would feel would depend on the degree and the location of the obstruction. They include crampy abdominal pain, vomiting, bloating, an inability to pass gas, and constipation.
Adhesions and Intestinal Blockages After intestinal surgery adhesions (extra scar tissue, connective tissue that should not be there) may restrict the passage of food through the gut. If the GI tract becomes obstructed, nothing can pass through, and this becomes a medical emergency.

Bowel adhesions can cause chronic pain and dysfunction. Bowel adhesions form after trauma to the tissues, caused by the body's inflammatory response to tissue damage. As the body's tissues heal, bowel adhesions are formed.

Medical issues to consider
Since adhesions are likely to form after certain surgical procedures, adhesiolysis (surgical removal of adhesions), except for serious problems like bowel obstruction may be pointless. In around 70 per cent of cases, the operation to remove the original adhesions will cause more adhesions to develop. The risks, benefits and alternatives to surgery must be discussed thoroughly before any decision is made.

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