Blaines Adhesions Information

An adhesion is the union of two surfaces by scar tissues that are usually separate. Adhesions may be thin sheets or thick fibrous bands, and occur in the tissues healing phase following surgery, trauma, infection or radiation.

Following any form of trauma to the tissues in the body the cells will repair themselves. These cells are unable to distinguish between different organs so if they come in contact with another organ or another part of the already injured organ whilst the repair process is in progress they will adhere to that organ as well. The two organs then become joined.

Adhesions most common in abdomen, pelvis and heart

An adhesion can occur anywhere in the body but is most common in the abdomen, pelvis and heart. In fact up to 93% of people having abdominal surgery will develop adhesions. An adhesion typically starts to develop in the first days after surgery, but is usually painless and does not cause complications.

In some cases, months or years after the adhesion started to form symptoms will start to appear. The scar tissue of the adhesion may restrict movement of internal organs leading to problems with digestion, small bowel obstructions and infertility when the fallopian tubes are obstructed. In severe cases adhesions may form a fibrous band around a segment of the intestine, restricting blood flow and ultimately causing tissue death.

Rheumatic fever causes heart adhesions

Adhesions of the heart develop when scar tissues form within the membranes of the pericardial sac (surrounding the heart). Infections such as rheumatic fever may lead to adhesions, which will restrict heart function and decrease heart efficiency.

Adhesions often have no symptoms and go unnoticed. However some may cause problems. The type of symptoms experienced will vary depending on where the adhesion is located.

• Abdominal adhesions above the liver may cause pain during deep breathing.
• Lower abdominal adhesions affecting the intestines may cause pain during stretching or exercise.
• Adhesions of the heart may cause chest pain
• Adhesion of the vagina or uterus may cause pain during intercourse.

Any unusual pain should be investigated but not all pains are the cause of adhesions and not all adhesions will cause pain.

Adhesions causing bowel obstructions

Some abdominal adhesions affect the bowel and over time may cause the bowel to obstruct. A bowel obstruction is a medical emergency and will require urgent surgery. A bowel obstruction presents as waves of abdominal cramps, worsening on eating and becoming constant and severe. Vomiting may temporarily reduce the pain. The stomach will become bloated and tender. Gas and bowel sounds may increase but if left untreated will eventually disappear.

As already mentioned this is a serious condition requiring prompt surgical intervention. Failure to do so may lead to the bowel rupturing, spilling its contents into the sterile abdominal cavity creating a life-threatening situation.

Only the symptoms treated

Treatment of adhesions depends on the location and severity of the symptoms. Many adhesions improve without surgery. A doctor may therefore choose to treat the presenting symptoms rather than the underlying cause (the adhesion) unless a medical emergency arises from the adhesions.

It is also worth remembering that removing adhesions caused by surgery via further surgery is often not effective, as the repair surgery itself may cause more adhesions.