Ezine Articles related to adhesions

Woe to the woman who suffers in illness, unrelenting illness. Though medicine and science has made great strides in the battle against many illnesses, there is an illness that is hushed; shrouded in silence among many physicians. Far from being rare, this illness carries with it staggering statistics, yet the public at large is not privy to this-often debilitating-disorder: adhesions. Adhesions, the body's natural response to infection, inflammation or injury, are bands of scar tissue that can form inside the body causing the internal organs to fuse together.

*Over 93% of patients who undergo major abdominal or pelvic surgery will develop adhesions. Adhesions, quite common, are known to form in as many as 60 to more than 90% of women undergoing gynecologic surgery.

In the medical world, adhesions are foremost known to be an iatrogenic disorder-meaning caused by the physician or by medical treatment (or both)-yet prior to surgery, the surgeon rarely informs his patient of the risk of developing adhesions. For the fortunate person who is not scheduled for surgery, the risk of adhesions is still a concern. Adhesions can develop as a result of infection or an inflammatory condition. Endometriosis, PID (pelvic inflammatory disease), appendicitis, peritonitis, trauma to the body (including surgical trauma), and even radiation, are all examples of health conditions or treatments that produce favorable conditions for the development of adhesions.

*Adhesions were first documented in 1872…..yes, 1872, yet most people, when asked, have never heard of adhesions. Thomas Bryant made that first documentation when he reported a fatality due to adhesion-related bowel obstruction after gynecologic surgery. Over the next 130 years, adhesions have maintained prominence in the medical literature, both as a study topic and as a factor influencing various treatments and outcomes.

Though adhesions have maintained prominence in medical literature as a study topic and a factor that influences various treatments and outcomes, adhesions have, for the most part, remained hidden to the public at large. The doctors may be studying, but they're sure not talking-at least not to their patients. When a person is suffering from the dreaded disorder, adhesions, it is likely the last thing on the list that a doctor will mention as a plausible cause of the pain and problems that are going on within the body. And, more often than not, the condition will never be mentioned at all, although the person may be presenting with all the symptoms of adhesions, or adhesion related disorder. Of course, this sends the sufferer roaming the beautiful globe in search of a doctor who gives a big rat's whisker about their condition. On the average, a woman will suffer 7-10 years, going in and out of doctors' offices in search of an answer to their pain and symptoms.

Adding insult to injury is the fact that adhesions elude the probing eye of standard medical tests, such as X-rays, scans, MRI's, etc. Diagnostic laparoscopy (minimally invasive surgery) is the only means by which to properly diagnose adhesions.

How can you determine if you might be suffering from adhesions? Adhesion sufferers describe their pain as intense, stabbing, sharp, and/or pulling. Some sufferers cannot walk uprightly, as adhesions restrict mobility. Simple movement such as bending and stretching can be compromised. Many sufferers experience frequent nausea, which often leads to vomiting. Many sufferers state that they feel "worse" after eating a meal-though they were hungry-often lamenting having eaten at all. When the intestines are involved with adhesions, a bowel obstruction can occur. A bowel obstruction is described as intense abdominal pain, nausea, and often, vomiting. A bowel obstruction is a life-threatening emergency, requiring immediate medical care. (Keep in mind that others may experience different symptoms than those that are described here.) In addition: though this article is geared toward women, men can also suffer from adhesions. Trauma to the body (a blow to the abdomen, for instance) surgery, or even a seat belt injury, can cause intestinal adhesions in men.

For the adhesion sufferer, it is time for knowledge of this disorder to be at the forefront of medicine. For the doctor and surgeon, it is time to talk-to your patient.

Sources:

*Confluent Surgical

*Bryant T. Clinical lectures on intestinal obstruction. Med Tim Gaz 1872;1:363-5.

At some point in life we have all experienced the "why didn't you tell me?" scenario. Whether we've just downed a bowl of homemade potato salad, enjoying every last bite, only to have the best potato salad maker in the world walk into the kitchen–a look of horror on her face–and state: "I left that on the counter because I intended to throw it out! Don't tell me you just ate it!" (Well, of course we ate it. Isn't that how it always goes?)

"Why?" the satisfied, but now worried eater asks, "don't tell me it is spoiled!"

"Well, no it's not spoiled," the cook answers nervously, "well, yes, I guess it is spoiled…okay..yes, it is spoiled."

"Well, great! That's just great! You leave it on the counter all day and then I come in, thinking you just made it, and now you're telling me that I'm going to die from that weird salmon poisoning?"

"Salmonella. And for your information, I did just make it…I didn't leave it on the counter all day. And even better news: I don't think you'll die."

The eater stares at the cook.

"Okay, so tell me! What's the deal with the potato salad?"

"No deal. It's just that…well, you know that overgrown dog of yours? The four-legged hairy creature that you just adore? The one you call Outlaw? The one I despise because he has no manners?"

"Don't tell me…"

"Yep; he loves potato salad just as much as you."

In that moment, we gag…for we have gained knowledge after the fact. Oh how we wish we had only known.

In moments like these, when one person has knowledge that another person does not have, we realize our vulnerability. In the above scenario, the cook can't really be blamed. She had good intentions. She intended to dump the potato salad. So, we realize we need to forgive, even though we gag. But, what if the cook had ill intentions? Or, what if she just didn't care, so she withheld information? What if she knew the dog wolfed down half the potato salad, but she allowed her boyfriend to come in, eat what was left, yet never uttered a word to him? We might call her a cold, calloused miscreant. We all know that anyone who cares about another human being is going to say: "Don't eat the potato salad! The dog got into it!"

Today, there are major surgical procedures being performed and, more often than not, women are not being informed of the high risk of future health issues that might arise due to these procedures.

C-section procedures have become all the norm in the USA, with the National Center for Health Statistics reporting a preliminary US national cesarean rate of 31.1% in 2006. In times past, a c-section was only performed if the life of the mother or baby, or both, were at stake. Today, however, c-sections as an elective procedure seem only to be rising.

More and more women, most often at the urging of their doctor, are scheduling surgery as a means by which to bring their unborn child into the world. Though many doctors are pushing c-sections births, these same doctors are not informing their patient that a c-section is not only major abdominal surgery, (risky; as well as a much longer recovery time, while trying to care for the new baby) but that a laparotomy (open abdominal incision) puts a woman at a high risk for developing adhesions.

Adhesions (scar tissue that forms as a result of the incision) can cause internal organs to become fused together. *In fact, 93% of patients undergoing major abdominal surgery will develop adhesions, with 53% of those people developing (at some point in their lives) a problematic condition known as adhesion related disorder (ARD). If women only knew that the c-section they schedule today might result into a condition that can be a life-altering and debilitating disorder later, they might very well insist that their baby be born the old-fashioned way: vaginal birth.

The patient (and all mother's-to-be) should be informed patients. The patient should be allowed the chance to weigh the benefit of surgery against the risk of developing a debilitating disorder. Unfortunately, many women who are now suffering the devastating effects of Adhesion Related Disorder learned about adhesions after the fact.Since doctors and surgeons are keenly aware that open abdominal surgery creates scar tissue (adhesions), it is reprehensible that any woman become the victim of adhesion related disorder as an after the fact illness.

Source:

*EndoGyn 

©Karen Steward

If you have never experienced a bowel obstruction, count yourself blessed. For years I watched my daughter suffer in intense, incredible, (at times, screaming) pain, yet she was ignored by countless physicians. These physicians never once stated that she was suffering from a bowel obstruction -rather, we (her parents) were told she must LIVE with the pain and agony of Crohn's disease.

The solution to her misery was always the same: up her steroid. Little did it matter that she spent days, weeks, sometimes months on end, hovering over the toilet….begging God to help her, crying in pain. The same physicians used simple terminology for these agonizing episodes: narrowed bowels. They showed us x-rays to prove their theory. And yes, we could see the bowel had many areas that were narrowed – portions of the bowel appearing to have a string-like appearance.

I always had the same question: Does my daughter truly have Crohn's? Based on studies I had done, I doubted the diagnosis; thus we spent years roaming the USA in search of an answer that I could believe. Along the way, I learned that she was suffering from bowel obstructions, brought on by these "narrowed bowels."

Perseverance paid off, and paid off big. Today, my daughter is well. We now know that she was suffering from adhesions. Those "narrowed bowels" were actually adhesions (scar tissue) that were encased around her large and small bowel, strangling the bowel to the point of little function, while leaving her in debilitating pain.

The surgeon in Europe who was able to restore our daughter's health said he saw no sign of Crohn's disease. Though we may never know the true culprit behind our daughter's illness, we speculate that the adhesions were the result of an infection or inflammation in the body. Since she had suffered from ovarian cysts at the beginning of her menses, it is likely that scar tissue began forming as a result.

Since bowel obstructions (caused by formation of adhesions) are the most common complication in Crohn's disease, it is easy for the physician to sum up a patient as a Crohn's sufferer when x-rays reveal "narrowed bowels." For the person who is incorrectly labeled with Crohn's disease, the road to a correct diagnosis, as well as recovery of illness, is one that is treacherous indeed. The payoff, however, can be worth every ounce of required effort.

For the many people who suffer from abdominal adhesions or have lost years of their life due to this medical malady, the recent Internet hoax about Subway spokesman, Jared Fogel's death (due to abdominal adhesions), is less than humorous. However, since it is best to look on the bright side of life, perhaps Jared's faked death will help bring awareness to the plight and very dismal world of the adhesion sufferer. (As a token of thanks, I'm hoping Jared will write me so I can send him an ARD awareness pin!)

Adhesions are known to develop in 93% of people who undergo major abdominal or pelvic surgery with 53% of those people developing health related complications at some point in their lives due to adhesion formation. Adhesions can cause the internal organs to become fused together, leaving the victim to suffer incredible–often agonizing–pain, while searching in vain for a doctor who will diagnose the correct ailment that is going on in his or her body. On the average, a person will suffer 7-10 years before learning that they are actually suffering from adhesion formation. And yes, gastric bypass surgery, as any surgery, can result in adhesion formation that can be severe, even life-altering, in some cases.

Adhesion sufferers lives are often swallowed up–lost in a world of pain–which costs them everything: jobs, friends and often, even family. Adding insult to injury is the fact that adhesions elude the eye of standard medical tests (x-rays, scans, MRI's, etc), leaving many doctors to misdiagnose a patient or, worse yet, diagnose those who suffer as 'depressed' individuals; totally ignoring the fact that the patient's pain is REAL.

Adhesions, foremost known among the medical world as an iatrogenic disorder, is an illness that is a hot topic among physicians but one that is often shrouded in silence when a doctor meets with a patient who presents with all the "symptoms" of adhesion related disorder. Simply put: most doctors do not want to deal with an adhesion sufferer, thus a diagnosis of "depression" can also be a ploy by which the physician can be assured that he (she) has washed his (her) hands of this problematic patient (condition). For the adhesion sufferer, perhaps the only thing more devastating than living in horrid pain is meeting the many physicians whose quick analysis of her (his) condition is: psychosomatic illness.

Unfortunately for the adhesion sufferer, the written prescription for an antidepressant can be used to the physician's advantage. That insulting piece of paper-"depression discharge slip"- frees the doctor from the dread ailment/patient–and is an effective means to push the adhesion sufferer out the door and on to the next doctor who will likely follow the same course of action.

For the adhesion sufferer, a "diagnosis" of depression and a quickly scribbled RX for an antidepressant is a heartwrenching and emotional low blow for the person who is merely existing in a body that is entrapped by pain. The depression discharge paper sets in motion the tiresome and weary journey of going from one doctor to the next; thus years of quality life are lost to adhesion related disorder (ARD).

The Little Pain That Could – An Uphill Journey Toward Adhesion Awareness

I think I can. I think I can. I think I can.

Sadly, much as we'd like to believe otherwise, some obstacles can't be overcome by willpower alone. That pain in your belly won't go away simply because you're being brave and doing your best not to let it overtake your life. In fact, you don't feel at all like a courageous little engine when your doctor tells you it's just "all in your head." Clearly the pain is quite a bit lower than your head, but when all the tests come back normal, a tiny piece of you may wonder whether you really should give up and just deal with it.

But what would the Little Blue Engine do in your circumstances? The savvy little locomotive would consider alternatives! You know your pain isn't IBS because you've already gone through the treatments and they haven't helped. Neither have the treatments for Crohn's disease, spastic colon and bowel obstructions. Could the pain you're feeling be adhesions?

Adhesions, otherwise known as scar tissue, are fibrous bands that form at the site of injury. The scar tissue can fuse internal organs together, pulling them away from their normal positions. This causes loss of flexibility by preventing the intended and natural fluid movement of the organs and results in excruciating and often debilitating pain. Since surgery is injury (trauma) to the body, adhesions can form at the site of the incision. Adhesions also can form in the body as a result of infection or inflammation such as appendicitis, peritonitis, sexually transmitted disease and radiation.

Because adhesions do not show up on standard medical tests such as X-rays, scans, and MRI's, the condition is often misdiagnosed. Adhesion sufferers spend an average of 7-10 years before they find an answer to their pain. Currently, diagnostic laparoscopy (minimally invasive surgery) is the only effective means by which to properly diagnose adhesions.

What can you do when the treatment you're undergoing is not yielding results? Be proactive in your own care! Learn as much as you can about your disease and network with others who share your pain. Don't settle for a first, second, or even third opinion if you're dissatisfied with your treatment. There is hope! Although the journey to a solution may not be an easy one, sometimes taking the route around an obstacle can be even more effective than trying to climb over it.

Adhesion sufferers have felt the spin. Medical spin, that is. Like the child who waits for the parent to take him off the merry go round (I've had enough fun, thank you) the person who suffers from adhesions often feels trapped in a vicious cycle of pain, repeated medical tests, yet no answers. Most adhesion sufferers see doctor after doctor, with each one giving the ill patient the proverbial medical whirl. Time passes, pain continues, yet most sufferers feel compelled to seek out another doctor, i.e.: jump on a new carousel. Sick, (often in terrible pain) they muster up the strength and continue the search for that special doctor…hopes held high that he or she has a new manner (EUREKA!) in which to rotate that infuriating medical platform. For some strange reason, the optimistic person who suffers…and suffers…and suffers…holds high expectation that somewhere along the way there will be that one-in-a-million doctor who will turn them in the right direction; the doctor who will know how to lead them out of their life of misery by doing what no other doctor has done.

Unfortunately, many adhesion sufferers learn the hard way that though many doctors will have the opportunity to grab the wheel and throw them for a spin, they often continue going the same direction they have been a thousand times before! Is the sufferer simply daft? After all, Albert Einstein said: the definition of insanity is doing the same thing over and over again while expecting a different result. However, the person who suffers in illness certainly has no desire to ride the medical merry-go-round; rather they realize they have one of two choices:

1. Give up and succumb to a life of pain and misery.

2. Cling to hope while desperately grasping for that elusive medical thread that surely hangs somewhere across the vast expanse of the universe!

For the adhesion sufferer, education is the key factor to understanding the complexity of this horrid illness. Many physicians admit their defeat to this illness, while others deny that adhesions cause pain. (OUCH!) (Of course, those who deny that adhesions cause pain obviously do not have their internal organs stuck together.) The majority-yes majority-of physicians will never mention the possibility of adhesions when the patient presents with painful abdominal or pelvic complaints. Rather, most adhesion sufferers walk away with suggestions of IBS, Crohn's disease, depression, spastic colon, or…

This medical spin of the ill is why most adhesion sufferers search 7-10 years for an answer to their pain. And, many, many patients diagnose themselves. Which leaves us with one question: Is there a doctor in the house?

Adhesions. Many people have never heard the word, yet may be suffering from the many disorders they cause. Adhesions, otherwise known as scar tissue, are fibrous bands that form at the site of injury. Since surgery is injury (trauma) to the body, adhesions form at the site of incision. Though adhesions can cause no problems for some post surgery patients, other patients may find themselves experiencing excruciating, often debilitating pain due to adhesions that have not only formed at the site of incision, but have continued to develop, sometimes years after surgery, causing internal organs to become fused together.

Adhesions can cause loss of flexibility by preventing the intended and natural fluid movement of internal organs. The scar tissue pulls the organs together and away from their normal positions.

When the intestines become involved, the victim of this disorder may experience abdominal pain, nausea, and vomiting. Adhesions are the number one cause of bowel obstructions, as the scar tissue kinks or twists around the bowel, preventing the flow of content through the digestive tract. When a bowel obstruction occurs, pain (often excruciating), nausea and vomiting will likely follow as the content moves its way back up, unable to flow freely through the constricted bowel. A bowel obstruction is a medical emergency which could result in death without medical intervention.

Unfortunately, many people suffer from this painful disorder for years on end, not knowing what is truly going on inside their bodies. Since surgery is the #1 cause of adhesions, doctors (and surgeons) are reluctant to discuss this all- too- common ailment. Moreover, in cases of bowel involvement, doctors may refer to constricted bowel tissue as "narrowed bowel" or "narrowing of the bowel," rather than using the medical term adhesions or scar tissue. Improper medical terminology can leave the victim uninformed as to the true cause of the "narrowed bowel." Unfortunately, misinformation can leave some victims of adhesion related disorder with the belief that their painful condition is simply their sad lot in life.

1. Endometriosis is a condition where tissue similar to the tissue which lines the uterus is found elsewhere in the body. This misplaced tissue–endometrium–develops into growths or lesions that can be found in the abdomen and (or) pelvic cavity. The tissue responds to the menstrual cycle in the same way that the tissue in the uterine lining does: by building up, breaking down and shedding. Though menstrual blood flows from the uterus and out of the body via the vagina, blood and tissue from endometrial growths have no way to leave the body.

The study of endometriosis often produces a common theme: Endo causes pain and endo causes adhesions (scar tissue).

What is not found (or is rarely found) is this: Adhesions cause pain and endo causes adhesions.

Though there would be no argument that misplaced tissue in the body that is reacting in the same manner as one's monthly cycle could certainly cause pain, there seems to be little emphasis and explanation given to the overall debilitating impact that adhesion formation can play in the illness of a woman who has been labeled as an "endometriosis sufferer."

Let's consider what we do know: when we study endometriosis, we learn that when misplaced endometrial tissue become trapped, the surrounding tissues become inflamed and irritated. We often read about scar tissue (adhesions) forming at the site of these misplaced (implanted) tissues. However, more often than not, the information about the scar tissue (adhesions) often ends as quickly as it is mentioned. As the reader continues on, the emphasis returns back to the disease of endometriosis and how the disease can progress to severe pain, scar tissue, infertility, bowel problems, nausea, vomiting, intestinal pain, back pain, etc.

But wait a minute. Adhesions, are bands of scar tissue, known to cause: severe pain, infertility, bowel problems, nausea, vomiting, intestinal pain, back pain, etc.

Adhesions form as a result of inflammation or injury, and can cause organs to become fused together.

This particular condition: adhesions–an illness that is often in and of itself–is rarely a topic of discussion among doctors to their patient. Endometriosis, on the other hand, an illness that has gripped the lives of 89 million women worldwide, is readily discussed as a topic of disease and pain from doctor to patient.

Now, we must wonder: how many people worldwide are suffering from adhesions? Who has the magic number? Is there a magic number? I haven't found one. It seems no one is tallying the poor souls who suffer from adhesions. This must mean that adhesions are not prevalent; not worth the census. However, if this is an illness that is shrouded in silence–and it is–who is to say the demographic impact of adhesions?

Do we negate the fact that the disease known as "endometriosis" gives way to inflammation and that inflammation gives way to adhesion formation? Do we negate the fact that adhesion formation can cause the the internal organs to fuse together, leading to a painful condition known as adhesion related disorder?

In addition, do we negate the fact that 93% of patients who undergo major abdominal or pelvic surgery will develop adhesions, with over 50% of those people finding themselves facing a problematic condition known as adhesion related disorder? Do we negate the fact that c-sections are trauma to the body, as is any surgery, and that the body responds to this trauma by adhesion formation at the site of injury? Do we negate the fact that any inflammatory condition within the body can create favorable conditions for the formation of adhesions? (Endometriosis, ovarian cysts, PCOS, PID, are just some to consider).

For the woman who has been told that she suffers from endometriosis, it is often difficult to find the 'ME' who is caught in the middle of an illness that doctors refer to as: puzzling, perplexing, and baffling, as well as one for which they have no answer.

Perhaps one piece of the puzzle that clearly fits, but many doctors fail (or refuse) to connect (or discuss), is the fact that adhesions can be a major contributor of debilitating pain and symptoms, and in some cases THE major cause of pain and symptoms in many cases that have been labeled as "endometriosis."

Could it be that there are women who are living with a painful and debilitating condition known as ADHESIONS, yet they have been told they must live with the pain of ENDOMETRIOSIS?

Each person must be her own best doctor by studying the illnesses that seem to puzzle and perplex health professionals. For once a disease is termed: puzzling, perplexing, baffling, this terminology alone can set a precedence of hopelessness in the minds of those who suffer. This hopelessness can cause many to succumb to a life of pain and suffering with the hope that one day the medical world will find an answer to the perplexing and baffling illness of endometriosis.

When trying to find the 'ME' in endometriosis, it behooves the sufferer to also study the illness of adhesion related disorder, as well as the impact adhesion formation can have upon the body when an inflammatory condition such as endometriosis has been determined.

Note from the author: The intention of this article is not to minimize or lessen the serious illness of endometriosis. I recognize the fact that some cases of endometriosis present with little to no adhesion formation. I also recognize the fact that some women have been diagnosed with endometriosis only to later learn that they were (are) actually suffering from adhesions. This article is written to emphasize the adhesion factor that is often overlooked and perhaps never discussed between a woman and her doctor.

1. Sources:

The Endometriosis Association 
Women's Health. Gov