Treating Intestinal Adhesions: Understanding the Best Approach

Intestinal adhesions are a common complication following abdominal surgeries such as gallbladder removal, gastric procedures, appendectomies, and other open surgeries. During these procedures, the intestinal tissues are exposed to the external environment, which can cause irritation and damage to the serosal lining. As the body heals, small adhesion bands may form between the intestines and other abdominal structures.

Do Intestinal Adhesions Require Treatment?

In most cases, intestinal adhesions do not cause symptoms and do not require any treatment. These bands of scar tissue are often minor and do not interfere with normal digestive function. However, in some individuals, they can disrupt the natural movement and sequence of intestinal contractions, potentially leading to more serious complications such as bowel obstruction.

Recognizing Bowel Obstruction Symptoms

When adhesions lead to bowel obstruction, the symptoms can be quite noticeable. Common signs include severe abdominal pain, bloating, nausea, vomiting, and the inability to pass gas or have a bowel movement. These symptoms indicate a partial or complete blockage of the intestines and require prompt medical attention.

Managing Bowel Obstruction

If a bowel obstruction occurs and conservative treatments such as fasting, intravenous fluids, and decompression with a nasogastric tube fail to provide relief, surgical intervention may be necessary. Procedures such as adhesiolysis (removal of adhesions) or intestinal repositioning surgery might be considered to restore normal bowel function.

The Risks of Surgical Intervention

However, surgery itself carries the risk of creating new adhesions due to further damage to the intestinal serosa. Because of this, surgeons are often cautious about recommending additional procedures unless absolutely necessary. In many cases, a "watch and wait" approach is preferred, especially for patients with mild or no symptoms.