Adhesions after abdominal surgery: what they are and what to watch for

Call 911 or go to an emergency department if you have abdominal pain and you are passing no fluids, no stool and no gas. NIDDK identifies that combination as indicating complete blockage requiring emergency care.

Seek medical help right away if you have abdominal pain with bloating, constipation, an inability to pass gas, nausea or vomiting. NIDDK lists those as the symptoms of intestinal obstruction, which is the serious complication adhesions can cause, and says to seek help right away rather than waiting.

A blockage caught early can often be treated without surgery. One left alone can cause tissue death. It can also cause peritonitis, an infection inside the abdomen.

NIDDK describes abdominal adhesions as bands of scar-like tissue. They form inside your abdomen. They connect two or more organs to each other, or organs to the abdominal wall.

Inside the abdomen, organs are meant to slide past one another. Adhesions tie them down instead. NIDDK explains these bands can kink, twist, pull, or squeeze the intestines and other parts.

Think of it as scar tissue in the wrong place. It glues together things that should move freely.

This number surprises people. NIDDK says adhesions form in more than 90% of people who have surgery that opens the abdomen.

Having adhesions is close to routine after open abdominal surgery. Having problems from them is not.

NIDDK notes adhesions happen less often after laparoscopic surgery than after open surgery. Higher-risk groups include people who had emergency abdominal surgery. They also include people who had surgery on the pelvis or lower digestive tract.

For anyone treated for colorectal, ovarian, uterine, or other abdominal and pelvic cancers, that last point matters a lot.

Surgery is the main cause, but not the only one. NIDDK's list also includes:

• Inflammatory conditions such as Crohn's disease, diverticular disease, endometriosis, and pelvic inflammatory disease
• Peritonitis
• Long-term peritoneal dialysis
• Radiation therapy for cancer
• Rarely, adhesions present from birth

Radiation being on this list matters for people who had both surgery and radiation to the abdomen or pelvis.

NIDDK is clear that many people feel no symptoms at all. Adhesions can sit quietly. They never announce themselves.

When symptoms do show up, chronic abdominal pain is the most common one.

That is a real problem after cancer treatment. Chronic abdominal pain has many possible causes. Adhesions are also hard to see on a scan. Do not try to diagnose this yourself. Take ongoing pain to your team. Let them work through the options.

Intestinal obstruction is the main risk. NIDDK describes its symptoms as abdominal pain, bloating, constipation, an inability to pass gas, nausea, and vomiting.

People most often forget to mention that they cannot pass gas. It is one of the most telling signs. If nothing is moving through at all, say so out loud.

NIDDK notes that treatment for obstruction often starts gently. It usually means IV fluids and a nasogastric tube. Surgery follows only if the blockage does not clear.

NIDDK also lists infertility in women as a complication. Adhesions in the pelvis or uterus can press on or block reproductive organs.

You might reasonably ask why doctors do not just cut the adhesions away.

NIDDK gives an honest answer. Surgeons can release adhesions through laparoscopic or open surgery. But doing so may create new adhesions. Fixing scar tissue with surgery can set the stage for more scar tissue.

That is why NIDDK says adhesions without symptoms usually need no treatment. It is also why doctors weigh the choice to operate for adhesion pain very carefully. It is never a quick call.

Take that as reassurance, not as a shrug. It means your surgeon is weighing real factors on both sides.