Intestinal Adhesions and Bowel Obstruction

Tumors, scar tissue (adhesions), or twisting or narrowing of the intestines can cause a bowel obstruction. These are called mechanical obstructions. Intestinal adhesions are bands of fibrous tissue that connect the loops of the intestines to each other, to other abdominal organs, or to the abdominal wall. These bands can pull sections of the intestines out of place which can block food from passing through. Adhesions are a major cause of intestinal bowel obstruction.

Adhesions may be present at birth (congenital), may form after abdominal surgery or after a bout of inflammation. The most common are that the adhesions form after surgery. They are more common after procedures on the colon, appendix, or uterus. Paradoxically, the risk of developing adhesions increases with the passage of time after the surgery.

Symptoms

Some adhesions will cause no symptoms. If the adhesions cause partial or complete obstruction of the intestines, the symptoms one would feel would depend on the degree and the location of the obstruction. They include crampy abdominal pain, vomiting, bloating, an inability to pass gas, and constipation.

Diagnosis

X rays (computed tomography) or barium contrast studies may be used to locate the obstruction. Exploratory surgery can also locate the adhesions and the source of pain.

Treatment

Some adhesions will cause no symptoms and go away by themselves. For people whose intestines are only partially blocked, a diet low in fiber, called a low-residue diet, allows food to move more easily through the affected area. In some cases, surgery may be necessary to remove the adhesions, reposition the intestine, and relieve symptoms. But the risk of developing more adhesions increases with each additional surgery.

Prevention

Methods to prevent adhesions include using biodegradable membranes or gels to separate organs at the end of surgery or performing laparoscopic (keyhole) surgery, which reduces the size of the incision and the handling of the organs.

Reference:
Diagram Courtesy of Pharmaceuticals, Inc.