Concerns About Post-Surgical Abdominal Adhesions and Obstructions

To make a long story short, yesterday my husband was sent home from his work because he was having a dull, niggling pain that was focused in his lower back on one side, just above the hip bone. The discomfort was also in the front of his body, to a lesser degree. We were worried it might be kidney related (he has a history of kidney stones), so he ended up in the ER because our primary physician wasn't available. After many blood tests, urine samples, and abdominal x-rays, it was determined that there was "nothing wrong with him." The ER doctor seemed competent, and she assured us that all emergency conditions had been ruled out. We inquired about possible obstructions, kidney stones, hernias, etc, and she said that there was no indication that any of those issues were apparent.

The doctor did mention that my husband might have some abdominal adhesions as a result of the colectomy he underwent a little over a year ago. When I got home, I did some reading online about adhesions, and learned that these are a very common effect of open abdominal surgery.

This isn't what scared me.

What frightened me and sent me into a serious panic attack is when I also learned that one major complication of internal adhesions is the chance of a small bowel obstruction occurring. I read that small bowel obstructions are a medical emergency, and can result in death. What worries me to no end is the fact that in some cases, small bowel obstructions can have seemingly minor symptoms to begin with; nothing more major than what might appear to be an acute case of gas.

Since my husband's operation, I have gone out of my way to ensure that he is well hydrated, and chews his food carefully in order to avoid obstructions. Now I learn that he may develop an obstruction regardless of any precautions we take, just because he may have internal adhesions. This is terrible. Not only that, but now I'm terrified that he might experience ongoing discomfort and pain of a chronic nature if it is in fact adhesions that caused the issues he experienced last night. What am I to do? I know I have a tendency to overreact to these things, and last night I couldn't stop bawling my eyes out even though I wanted nothing more than to appear strong and confident for his benefit. He ended up comforting me, and telling me that all this worrying was needless. According to him, his output has been normal and is still normal this morning, and he feels just fine.

But still, I am obsessing over what adhesions could mean for his quality of life.

Does anyone here know anything about post-surgical adhesions? How worried should I be about this possibility? How common are small bowel obstructions due to adhesions? Am I planning his funeral and my life without him for nothing?

We are making an appointment to see his primary physician ASAP, just to put our minds at rest and have some questions answered, if nothing else.

I don't know how I'll get through work today. My heart is depleted and I could cry again at any moment.

Please help!

I had adhesions and a blocked bowel caught up in the internal scarring. Should it be serious, then you and your husband will certainly know about it as the pain will be unbearable. I went to the hospital, and it was five days before a surgery time became available - emergency ops took priority, so clearly adhesions weren't causing them any worry.

You say your husband is still passing as usual - that is a very good sign. Only when nothing comes out does it become a bit more serious, and that is what happened to me. Nil by mouth for five days until after the op.

As for dying from adhesions - I think that would take some doing! If the adhesion was that serious, he would be straight into surgery and sorted. I'd recommend staying away from Google as all that happens is you keep looking until you find what you don't want to read.

I was told by my surgeon that if you are going to get adhesion(s), it will happen within two years of surgery.

So forget about planning funerals and a life without your husband - it ain't gonna happen.

As I said - if the adhesions are serious, he will know about it. For me, it kicked off halfway through a flight back from Italy, and as I said, I knew about it big time. Under my breath, I was demanding the pilots land this ####ing plane within ten ####ing minutes or I'll have them dragged off the #### plane and ####ing shot!

So, yeah, if it was bad, he would know!!

Thank you thank you thank you!

Okay, well your take on things did make me feel at least a bit better, which is what I needed this morning. My husband and I will be seeing his primary doctor this Friday just to clear up some of our questions and ideas. We still aren't even sure that he has adhesions, but it's better to be safe than sorry.

So, since you suffered with adhesions, can you tell me if you had/have chronic pain as a result of them? Did you end up getting surgery to fix the adhesions, or did the surgeon just go in there and remove your blockage? A lot of people say that they won't have surgery for adhesions because another surgical intervention might just create new adhesions. What is your opinion on the matter?

And yes, Google is evil.

Cyber-chondria is a devastating condition.

Tiggy

Hey Tiggy, I get blockages quite often. Most of the time, they unblock themselves. If that fails, a hot shower and stomach massage. I was told by my doctor to go on a liquid diet if I get a blockage I can't get unblocked. If I start feeling nausea or vomit, then go to emergency.

Hi Tiggy,

Lobster's words are bang-on and focused like a laser on what needs to be said.

A few words about adhesions: My daughter's abdomen is full of adhesions after multiple surgeries 3-4 years ago, and yet she is now strong, healthy, free of pain, and back to 135 lbs from a low of 80 lbs when she almost died. The human body has amazing resilience.

Pain calls us to action. The difficult thing is often the process of determining the required action. It seems like most of your actions are moving in the right direction; however, unrestrained worrying is also an "action" and only you can decide if it's helpful in any way.

Best wishes,
Three

PS. I will send you our number in case you want to discuss the strategies my daughter's doctors are using when dealing with her adhesions.

How to Get Back to Fitness After Ostomy Surgery with Ryan | Hollister

Pundy and Three, thank you for your replies!

Three, your offer is so kind-hearted and generous, I just might take you up on that if it turns out this is going to be an ongoing issue. In the meantime, my husband and I have an appointment to see his primary doctor on Friday, so hopefully some of my questions and concerns can be addressed at that time.

Three, how does/did your daughter cope with her discomfort due to adhesions?

I know you're 100% correct with your thoughts on anxiety and worrying. I actually have my own health issues that revolve around chronic anxiety/OCD/depression, and having situations like what happened last night only exacerbates it for me. UGH! How awful! I realize I am most likely fretting and obsessing over this for no good reason at all, and that it doesn't actually *help* the situation, it's just so difficult to think positive and focus on other things once my worries start. It's kind of like a snowball effect.

I will keep everyone posted, and if there's anyone else with some experiences or thoughts they'd like to share, please keep the replies coming.

Hi Tiggy,

You asked, "How does/did your daughter cope with her discomfort due to adhesions?"
My daughter has been almost completely free of pain for more than a year. When she used to experience pain often in the middle of the night, we would look at each other and try to "sense" whether we should once again drive 20 minutes to the emergency ward to repeat the amazing song-and-dance routine that always happened there. When we did go, we would usually be sent home hours later after the pain went away on its own. She would only occasionally take a pain medication.

In response to you mentioning "It's just so difficult to think positive and focus on other things once my worries start," I would like to share the following point of view: When I worked with the Vancouver Police Department Victim Services Unit, we attended scenes of sudden deaths, suicides, car accidents, hostage takings, domestic abuse, and other situations with victims. In my experience, positive thinking is not that helpful. What is helpful are techniques that help a person focus on the inner calm that always lies at the center of the whirling storm of emotions and worries.

Three;

I am very happy to hear that your daughter has been pain-free for a good while now, and I sincerely hope it stays that way! I'm not entirely confident that we're both thinking of the same "inner calm", but I know that for most of my life I've had little secret techniques I've used in order to relax myself, especially at night when I have to sleep. Most of these tricks revolve around using my imagination to create a sacred place, and visualizing it in great detail. And when I'm not feeling all that creative, I typically count my breaths to the point where it's almost comparable to self-hypnotism.

It always helps me get to sleep, but it hasn't always been terribly useful during my waking hours.

Cheers;

Tiggy

Dear Tiggy,

You mentioned that you were not sure if "we're both thinking of the same inner calm". Every one of the 6.8 billion of us on this planet has the same need for the same "inner calm" feeling; however, we sometimes get lost in different words for the same thing.

You also mentioned that the visualization/counting technique you practice helps you "get to sleep, but it hasn't always been terribly useful during waking hours". The type of techniques I refer to are not based on visualization or thought-based processes, but are as tangible as the paramedic's technique of applying direct pressure to stop bleeding from a wound, or the acrobat's technique of using a long horizontal pole to lower his center of gravity and help him balance on the tightrope.


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Three;

Thank you - I'm always looking for new methods to try out so that I may avoid complete insanity.

I spoke to my hubby at lunchtime and he said his discomfort was still there, but still mild, so I guess we should be counting our blessings.

Cheers;

Tiggy

I believe nothing was cut out - just the bowel cut free from where it was caught up in the muscles, etc. It never occurred to me that the scarring on the outside was mirrored on the inside (but then I never was the sharpest tool in the box!)

As for pain since - nothing at all and everything seems fine, and I recovered quite quickly. To sort me out was a 3 1/2-hour operation, but that included a look around for any signs of cancer. As for surgery for adhesions and creating the possibility of more adhesions, I don't know - deal with that should it arise again, but as all seems fine at the moment...

Thanks for sharing some more of your story, Lobster. It really is a genuine help to know that there are so many people out there who have experienced situations and aren't afraid to share their wisdom in order to help emotional wrecks like me.

Cheers! I hope you have a lovely day.

Hi Tiggy - Lots of good advice here about paying attention to the intensity of the pain. I had horrendous adhesions of the small bowel from multiple past surgeries and intraperitoneal chemotherapy, which were only discovered when I went in for the permanent colostomy in Feb '09. The pain from the adhesions (and other things) was masked for 3 years by pain medication.

As was said, the adhesions don't strangle the small bowel so much as they make it adhere to the abdominal wall, which decreases its mobility/motility, causing a lot of pain in the front of the abdomen. The bowel has to be cut away from the abdominal wall and the hole sewn up. My surgeon said he had to do this "about a hundred times" turning a 5.5-hour surgery into an 11.5-hour marathon!

I don't think these adhesions can be visualized by X-ray, CT, or MRI - or I would have been in for surgery much sooner. I think I still have them forming because I do still get abdominal pain which I overcome now with (as mentioned by someone earlier) gentle massage and hot baths.

Hope you get some good answers tomorrow at your appointment.

Here's an excerpt from an article posted at http://www.itmonline.org/arts/adhesions.htm:

Abdominal Adhesions: Prevention and Treatment
Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine, Portland, Oregon

Adhesions are strands of scar tissue (fibrin bands: see illustration below) that form in response to abdominal surgery, and extend beyond the specific site of incision, sometimes forming separately from the incision site within the peritoneum. Scar tissue that mends the incision is normal, but the adhesions form additionally under some circumstances that are not fully understood. There are specific features of a surgical procedure that help induce the formation of adhesions. For example, drying of the tissues during surgery increases adhesion formation, a situation remedied by paying attention to the arid conditions and correcting them during the procedure. Intentional drying of the tissues, by applying gauze, is an otherwise desirable procedure to aid the surgeon's view of the area, but because of increased adhesions, it must be minimized. Tissues that become dry should be quickly moistened and the air (carbon dioxide) that is passed over the surgery site to maintain cleanliness must also contain adequate moisture to prevent rapid drying of the exposed fluids. Laparotomy (open abdominal surgery) is more likely to produce adhesions than surgery performed via laparoscopy in which a small scope with attached microsurgical instruments is inserted through a slit in the abdomen (1-3).


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Left: a representation of a normal peritoneum, the transparent membrane that wraps the pelvic and abdominal organs. Right: after surgical trauma, fibrous bands of collagen grow as part of the normal healing process and form adhesions. Adhesions connect tissues or structures that are normally separate. Adhesions in the abdomen or pelvic area can lead to infertility, pelvic pain, small bowel obstruction, or the need for repeat surgery (1).

Tiggy
I am going to give you this fast and hard. Because I want an impression made on your mind.

Yes, adhesions can cause blockages. When a blockage starts to get serious, vomiting usually occurs.

A person can go many days with a blockage. Painful? Yes. End of the world? Not even close!

Stop the crying, get off your butt, and get the husband to a colorectal surgeon.

Small bites will help, small bites with intermittent water will help more. Chew the food until it is simply a liquid. He is going to have to learn a new way to eat, it is hard at first.
Simply hydrating, although good for a person, will not aid in stool passage. This is a popular misconception that just about all doctors preach.

Here is the big one, NO FIBER, period. Stay with protein. You can use a children's chewable vitamin and take other supplements for the vitamins and minerals. In some cases, V-8 vegetable juice will help, however it can cause some gas, which in many cases causes cramping of the small intestine.

Blockages and adhesions can be and are dealt with all the time. The problem often is this: when they go back in to remove the tissue, often they run into a "spider web" of scar tissue.
Many times the patient ends up worse off because the surgery itself creates even more scar tissue.

Good luck

Rick.....

Thanks for the awesome info everyone!

We're going to be seeing our doctor today to hear some of his thoughts on what my husband has been feeling. So far we're on day four and my husband says he still "feels something", but it certainly isn't significantly painful or inhibiting his life in any way.

Keeping our fingers crossed!

I have had 4 operations for scar tissue. I had an operation 4 weeks ago. It does get better.

It's great to know that there are so many people in our little community who care enough to tell me when I need to worry, when I need to relax, and when I need to give my head a shake!

Tyler and I saw his doctor on Friday, and after a pretty thorough interview and hands-on exam, we were told pretty much what we already knew; there is nothing serious wrong with Tyler at this time, and the doctor doesn't see any need to delve further into the matter if it isn't bothering Tyler too much. He did order an ultrasound, probably to get a glimpse at some of his internal organs, and that's about it.

We're happy for the moment.

Tyler says he feels great, and that while he still has that "weird" feeling in his abdomen/back/side from time to time, it never gets worse than a 3/10 on the discomfort scale. Furthermore, it's inconsistent and not constant, and he doesn't feel it inhibits him in any way. I feel pretty good too; Tyler and I spent our weekend going for long walks and wrestling, tickling, just being generally silly with each other as per the norm, which tells me that things are okay.

8 months after I had my first operation for adhesions, I had the second one. The surgeon told me modern medicine, but he could not tell what was wrong until he opened me up. The first one was caused by an operation on colon cancer. My stool was like water, and I used to put my finger down my throat to relieve pain. Good luck! I've been good now for 3 years.

Hi Tiggy
I have had quite a few blockages the past 2 years which luckily cleared by themselves. The doctors think it may be down to adhesions but nothing is certain. And in spite of a good diet, I am always constipated and uncomfortable. My surgeon recommended I try irrigation. I am 2 weeks irrigating every day and it does work. I do not know if this is an option for your husband. I put off trying it for a long time but it is not as bad as it sounds.
Hope your husband is well.
Maureen

Thanks for the info, Scarlet! I'm not sure that irrigation would be an answer for Tyler because he has an ileostomy and I've only heard of irrigation in the case of colostomies.

I really appreciate you sharing your experiences!

Thankfully, those mysterious pains seem to have disappeared for the moment. I'm keeping my fingers crossed!

Hey Three, could you please tell me what your daughter did to relieve her adhesions?

Hi Jon-Solo,
Nothing specific has ever been done for her adhesions. Occasionally she'll return to the hospital with the pain of a blockage, but it usually passes within a day or so; however, September of 2016 was an exception and she spent a month on TPN. For the most part, she lives life fully and few ever suspect anything is amiss with her health.

Hey Three, thanks so much for replying! So she still has the bad adhesions but just lives with them? Is there a special diet she is on? Thanks so much for your time!

Jon-Solo, one thing about my daughter is that she throws caution to the wind and eats whatever she wants — it seems she feels the enjoyment of freedom is worth the sometimes painful consequences.

I am worried about adhesions also. I had a hysterectomy due to a cantaloupe-sized fibroid tumor that had colon cancer cells in it and ileocolostomy from colon cancer this past May. There were adhesions when they did the surgery, I believe. Now for the last 2 weeks, I have had nausea and abdominal cramps. I have lower back pain all of the time. It seems the back pain is worse when I am in bed or sit a lot. It has been worse the last 2 weeks. I have started taking ibuprofen along with morphine, as Tylenol and aspirin do not work. I was trying to avoid the ibuprofen as it gave me stomach issues before, but had to start again. I am still having output, mostly liquid but also thicker when I eat more. So if I am still having output, do I need to be concerned? I also have 2 hernias and a huge prolapse. Thanks for all of the info.

There is a remarkable way to reduce adhesions. They are made of fibrinogen, a non-living material. Although this is nature's way of healing, you don't have to continue to suffer.
Surgery will only produce more adhesions.
So, here is what you do. I do it and it works.
Adhesions, through a specialized visceral manipulation, can be stretched to allow a more normal mobility to occur, reducing pain and the potential for dangerous obstruction.
Go to a site called www.clearpassage.com.
Expensive but it works. However, if you find a physical therapist who works for them, you can use your Medicare to cover it along with the approved treatment for that old shoulder injury you have had for years.
If you can afford them, go for it.
I will drive to the coast for my treatment with my wonderful PT who has really made a difference. Now you have hope!

Hi hun....I am no doctor but from your post my first advice is to stop researching on the internet. It will scare the crap out of you....make an appointment with his surgeon and address your concerns with a medical expert..... Be strong and trust your hubby to let you know if something is wrong....I am an ileostomy person and we have to watch what we eat and chew, chew, chew, and chew some more. But we all differ, so what will pass easily and be tolerated for some puts others in the ER....Keep doing what you have been doing for this last year and see how far he has come since day 1 of this journey....Stay off the net, keep smiling, you got this.....