Woe to the woman who suffers in illness, unrelenting illness. Though medicine and science has made great strides in the battle against many illnesses, there is an illness that is hushed; shrouded in silence among many physicians. Far from being rare, this illness carries with it staggering statistics, yet the public at large is not privy to this-often debilitating-disorder: adhesions. Adhesions, the body's natural response to infection, inflammation or injury, are bands of scar tissue that can form inside the body causing the internal organs to fuse together.

*Over 93% of patients who undergo major abdominal or pelvic surgery will develop adhesions. Adhesions, quite common, are known to form in as many as 60 to more than 90% of women undergoing gynecologic surgery.

In the medical world, adhesions are foremost known to be an iatrogenic disorder-meaning caused by the physician or by medical treatment (or both)-yet prior to surgery, the surgeon rarely informs his patient of the risk of developing adhesions. For the fortunate person who is not scheduled for surgery, the risk of adhesions is still a concern. Adhesions can develop as a result of infection or an inflammatory condition. Endometriosis, PID (pelvic inflammatory disease), appendicitis, peritonitis, trauma to the body (including surgical trauma), and even radiation, are all examples of health conditions or treatments that produce favorable conditions for the development of adhesions.

*Adhesions were first documented in 1872.....yes, 1872, yet most people, when asked, have never heard of adhesions. Thomas Bryant made that first documentation when he reported a fatality due to adhesion-related bowel obstruction after gynecologic surgery. Over the next 130 years, adhesions have maintained prominence in the medical literature, both as a study topic and as a factor influencing various treatments and outcomes.

Though adhesions have maintained prominence in medical literature as a study topic and a factor that influences various treatments and outcomes, adhesions have, for the most part, remained hidden to the public at large. The doctors may be studying, but they're sure not talking-at least not to their patients. When a person is suffering from the dreaded disorder, adhesions, it is likely the last thing on the list that a doctor will mention as a plausible cause of the pain and problems that are going on within the body. And, more often than not, the condition will never be mentioned at all, although the person may be presenting with all the symptoms of adhesions, or adhesion related disorder. Of course, this sends the sufferer roaming the beautiful globe in search of a doctor who gives a big rat's whisker about their condition. On the average, a woman will suffer 7-10 years, going in and out of doctors' offices in search of an answer to their pain and symptoms.

Adding insult to injury is the fact that adhesions elude the probing eye of standard medical tests, such as X-rays, scans, MRI's, etc. Diagnostic laparoscopy (minimally invasive surgery) is the only means by which to properly diagnose adhesions.

How can you determine if you might be suffering from adhesions? Adhesion sufferers describe their pain as intense, stabbing, sharp, and/or pulling. Some sufferers cannot walk uprightly, as adhesions restrict mobility. Simple movement such as bending and stretching can be compromised. Many sufferers experience frequent nausea, which often leads to vomiting. Many sufferers state that they feel "worse" after eating a meal-though they were hungry-often lamenting having eaten at all. When the intestines are involved with adhesions, a bowel obstruction can occur. A bowel obstruction is described as intense abdominal pain, nausea, and often, vomiting. A bowel obstruction is a life-threatening emergency, requiring immediate medical care. (Keep in mind that others may experience different symptoms than those that are described here.) In addition: though this article is geared toward women, men can also suffer from adhesions. Trauma to the body (a blow to the abdomen, for instance) surgery, or even a seat belt injury, can cause intestinal adhesions in men.

For the adhesion sufferer, it is time for knowledge of this disorder to be at the forefront of medicine. For the doctor and surgeon, it is time to talk-to your patient.

Sources:

*Confluent Surgical

*Bryant T. Clinical lectures on intestinal obstruction. Med Tim Gaz 1872;1:363-5.