What are Adhesions?

Adhesions are internal bands of scar tissue that form between organs, most of ten in the pelvic area. They are caused by infection, inflammation, or endometriosis, or as areas heal from surgery. They are the most inevitable outcome of surgery, and sometimes severe. Adhesions can connect organs and tissues that are not normally attached. When this happens it causes disturbances in function, chronic pelvic or abdominal pain, infertility, bowel obstruction and other complications.

Even if adhesions are cut, in an attempt to separate the attached organs they will inevitably form again. Patients face a life of pain and suffering punctuated by temporary periods of respite that lysis (cutting) of the adhesions sometimes allows.


Laparoscopic photograph of Adhesions between the diaphram and liver Laparoscopic photograph of Adhesions betweenbowel 

Pelvic adhesions can be filmy or thick and some even contain small blood vessels. Adhesions affect millions of people, although many patients are unaware that adhesions may be the cause of their pain. They go from doctor to doctor seeking not only medical advice and treatment, but support as well, which they may not find. This is a very real and destructive disease. In acute cases it destroys its victims lives.

How to Diagnose and Treat Adhesions

Adhesions are very difficult to diagnose because they do not show up readily on X-ray or other tests such as MRI, CT, ultrasound or colonoscopy. 

The only way to detect adhesions definitively is by exploratory surgery. Adhesions can cause complete bowel obstructions. Although tests may show this obstruction, the cause is unknown until the surgeon performs surgery. There are many people who have had partial bowel obstructions despite having negative tests!

Adhesions are treated by cutting. Unfortunately they often return and further surgery is needed. Special surgical devices called adhesion barriers can be used to minimize adhesion reformation.

Most organs of the body will produce scar tissue when irritated. For this reason great care should be taken in handling tissues during surgery to minimize the chance of scar tissue or adhesion formation.