Abdominal adhesions are scar-like tissue bands that develop in either two organs or the abdominal wall and an organ. In some people, abdominal adhesions do not trigger any symptoms, but when they show, the earliest sign is typically chronic abdominal pain. The adhesions may also result in twisting or pulling of the organs, like the intestines. These can result in grave complications, like intestinal blockage. Here are the causes, symptoms, and treatments for the condition.

Causes
One of the most common causes of abdominal adhesions is abdominal surgery. Most people who undergo abdominal surgery develop these adhesions, but the risk is more prevalent when operations on the pelvis and lower abdomen are performed, including gynecological and bowel surgeries. Over time, the adhesions can become tighter and more significant, resulting in problems years after the surgery. Some common surgery-induced abdominal adhesions include:

Residual blood or unflushed blood clots post-surgery
Incisions within tissues, especially those in internal organs
Improper handling of internal organs during surgeries
Internal organs and tissues desiccating
Interaction of internal tissues with foreign agents like stitches, gauze, and surgical gloves

Beyond this, some less common abdominal adhesion causes (not linked to surgery) include inflammation from sources like:

Abdominal infections
Gynecological infections
Radiation therapy for cancer treatment
Appendicitis, particularly appendix rupture

In rare circumstances, abdominal adhesions may develop without any apparent cause.

Symptoms
People usually do not experience any symptoms from abdominal adhesions. However, as the adhesions block the intestine, it triggers sporadic abdominal pain and cramp episodes. When the intestinal obstruction is more severe, it can trigger the below-listed symptoms:

Vomiting
Nausea
Severe cramps
Abdominal pain
Abdominal distension or swelling
Signs of dehydration, like dry mouth, skin, and tongue, infrequent urination, severe thirst, low blood pressure, and fast heart rate
Infrequent bowel movements
Inability to pass gas

When the bowel becomes strangulated, people experience severe abdominal pain, which may be constant or crampy. The abdomen swells and is tender to even light touches. Those with a strangulated bowel typically show signs of body-wide or systemic illness, like low blood pressure, fast heart rate, and fever.

Diagnosis
Your doctor may order a physical examination for the diagnosis. They will then discuss your complete health history, primarily to know if you have had any abdominal surgeries. Unfortunately, there are no tests to identify abdominal adhesions, but some examinations can help rule out other possible causes. In addition, these examinations enable the doctor to understand the extent of obstruction. A few tests that your doctor may order are:

Imaging tests like X-rays and computed tomography scans with special contrasts like barium
Blood tests to eliminate other possible causes or to understand the intestinal obstruction’s severity
Open surgery or laparoscopic to identify the abdominal adhesions or other issues like intestinal obstruction

It is essential to discuss these tests in detail with your doctor and ask your queries beforehand.

Treatment
Treatment for abdominal adhesions is often not mandatory, as most adhesions do not cause problems. Currently, surgery is the only way to seek relief from adhesions that cause fertility concerns, intestinal obstructions, and pain. However, this surgery also puts you at the risk of developing more adhesions. Hence, it is best to avoid it if possible. Doctors typically recommend other ways to treat obstruction in people who do not need emergency surgery. For example, one may be given intravenous (IV) fluids and a tube may be inserted via one’s nose that travels to one’s stomach to eliminate the contents of the digestive tract above the obstruction. Often, this may provide relief, and the obstruction may go away. However, if this does not work and the obstruction remains, the doctors recommend surgery to release the adhesions.

Prevention
Abdominal adhesions are tricky to prevent, but with surgical techniques, you can reduce the adhesions. Undergoing a laparoscopic surgery wherein the doctors do not have to open up the abdomen via a large incision is one of the best ways to prevent abdominal adhesions. In this surgery, the doctors inflate the abdomen with gas, and a video camera and special surgical tools are threaded through small but few abdominal incisions. When the abdomen is inflated, it gives the surgeon enough room for operation. However, if the large abdominal incision is mandatory, one’s doctor can consider using adhesion barriers. This is a specialized film-like material that goes between the organs and the abdominal incision or the two organs at the end of the surgery. The product resembles wax paper, which the body usually absorbs within a week. Beyond this, the doctor can take other steps to lower the susceptibility of abdominal adhesions. These include using latex-free and starch gloves, shortening the surgery time, carefully handling the organs and the tissues, and not letting the tissues dry out.