Adhesions? (PLEASE HELP)!

To make a long story short, yesterday my husband was sent home from his work because he was having a dull, niggling pain that was focused in his lower back on one side, just above the hip bone. The discomfort was also in the front of his body, to a lesser degree. We were worried it might be kidney related (he has a history of kidney stones), so he ended up in the ER because our primary physician wasn't available. After many blood tests, urine samples, and abdominal x-rays, it was determined that there was "nothing wrong with him." The ER doctor seemed competant, and she assured us that all emergency conditions had been ruled out. We enquired about possible obstructions, kidney stones, hernias, etc, and she said that there was no indication that any of those issues were apparent.

The doctor did mention that my husband might have some abdominal adhesions as a result of the colectomy he underwent a little over a year ago. When I got home, I did some reading online about adhesions, and learned that these are a very common effect of open abdominal surgery.

This isn't what scared me.

What frightened me and sent me into a serious panic attack, is when I also learned that one major complication of internal adhesions is the chance of a small bowel obstruction occuring. I read that small bowel obstructions are a medical emergency, and can result in death.  What worries me to no end is the fact that in some cases, small bowel obstructions can have seemingly minor symptoms to begin with; nothing more major that what might appear to be an acute case of gas.

Since my husbands operation, I have gone out of my way to ensure that he is well hydrated, and chews his food carefully in order to avoid obstructions. Now I learn that he may develop an obstruction regardless of any precautions we take, just because he may have internal adhesions. This is terrible. Not only that, but now I'm terrified that he might experience ongoing discomfort and pain of a chronic nature if it is in fact adhesions that caused the issues he experienced last night. What am I to do? I know I have a tendency to overreact to these things, and last night I couldn't stop bawling my eyes out even though I wanted nothing more than to appear strong and confident for his benefit. He ended up comforting me, and telling me that all this worrying was needless. According to him, his output has been normal and is still normal this morning, and he feels just fine.

But still, I am obsessing over what adhesions could mean for his quality of life.

Does anyone here know anything about post surgical adhesions? How worried should I be about this possibility? How common are small bowel obstructions due to adhesions? Am I planning his funeral and my life without him for nothing?

We are making an appointment to see his primary physician ASAP, just to put our minds to rest and have some questions answered, if nothing else.

I don't know how I'll get through work today. My heart is depleted and I could cry again at any moment.

Please help

I agree; you are overreacting.

This is one of those instances where reading on the internet can make you insane. Yes, most people that have had abdominal surgery have adhesions. Some people, very few, have complications due to adhesions. Complications that may involve more blockages or pain. Most of us have occasional pain due to adhesions. There's no way to know if your husband's condition will worsen or get better but you won't be having a funeral for him anytime soon.

Sue

Tiggy3,

I can tell you of MY case and MINE alone. The others on this forum do no seem to have an issue with internal (small intestinal) adhesions, but I am one who did.

VERY long story short, I had a sigmoid colon resection for what I was told by 3 colorectal surgeons was a sigmoidocele (Sigmoid colon curling and blocking off top of rectum). I was having some evacuation issues but in multiple trips I did a good bowel move every day. SHould have kept my problem, but it took 2-4 hours every morning to finish and this routine got old. and made me late for work. Turns out the defecogram was misread by a resident radiologist, surgeons saw in surgery I did not have a redundant sigmoid colon, then removed it anyway, then did multiple other unconsented uneeded procedures. ie: bladder surgery for a bladder not botheriing me, etc.

So after 7 procedures, scar tissue closed in my colon at the area of the sigmoid resection so I couldn't pass any stool. AND I had repeated small bowel obstructions on only jello and chicken broth. THese would present as sudden projectile vomiting. In my case, there was no doubt I was having an S.b.o. Took me 13 months to find help. saw 11 docs at 7 major hospitals. The CT entercoloysis test showed the narrowing of two loops of small bowel in my low pelvis. THat major medical center (in the mid-west) said adhesions were too dangerous to lyse. They just said to keep on with my PEG nutrition tube. (Which I did not have.) I had to live on jello, and Enlive clear liquid nutrition for 13 months and lost 25% of my body weight.

I'm not telling you this to scare you. I'm telling to this to let you know that adhesions are real, they are not picked up on normal imaging tests, and they are not "all in your mind." AND you can get small bowel obstructions from them and if you don't get an NG tube you can get into very serious trouble. It is EXTREMELY hard to find surgeons who lyse adhesions wrapped around small intestines as it is very technically demanding. I finally found help at the Lahey Clinic in Burlington, MA if you are near there. I had to have a permanent ileostomy and lysing of severly dense adhesions. This was 3 years ago now and (WRAP WOOD TEN TIMES) I have been OK since. So there is help, but in my experience many of the major hospitals do not deal with adhesions.

There is a book called "Doctors Bound by Secrecy Patients Bound by Pain" by Karen steward. It is one of the only books I've found on adhesion related disorder. I plan to write one too, but I have to wait until my case against my original surgeons is settled which will take years. Unknown to me they had about 8 cases behind them at the time. I did not know to look at their local court house which is where you find out the real info on docs you are going to be dealing with. Who knew? I trusted as most do. My case is unusual. Your hubby's adhesions (if that is the case) were likely from a needed surgery done correctly and if he has adhesions, they just form more in some people than in others. So his and my cases are very different. In my lysis of adhesions and ileostomy surgery they used Seprafilm at Lahey Clinic. That is supposed to lessen the number and density of new adhesions that form. So far anyway, it has worked.

So anyway, that is just my experience with small bowel adhesions. Something patients are never warned of prior to surgery (or at least I wasn't) or I wouldn't have had my original surgery. If your hubby's was an emergency surgery, it is usual protocol not to scare the patient who is facing an emergency op. Again, my original surgery was elective, so I should have been warned.

Good luck. Rosemary

Post Edited (esoR) : 8/11/2010 11:10:16 AM (GMT-6)

Hi susans53,

Did they lyse your adhesions lapro also? or did they have to open you to lyse the adhesions. Just curious.

I also was under the impression that if all your surgeries were lapro that one did not form adhesions. Interesting!

(All my surgeries were open.)

Thanks for adding your experience. Rosemary

I too think you may be overreacting a bit.

I have adhesions that cause me pain at times-sometimes it's pretty bad, and i have to lie down for the pain to pass. And they may be what has caused my few obstructions.

BUT

I don't think you can live your life thinking about all the what-ifs. You'll just drive yourself crazy! You might still die in a car wreck, even if you're wearing your seat belt.
You just have to push those thoughts away. You have to.
It's good to know what the risks are, but there are risks associated with EVERYTHING.

I know you and your husband have been through a lot. We all have.
If it is still bothering you, look up the incidence of that happening. Because, you should take ALL the information in, before you have a panic attack. I'm sure the likely hood of that happening is very very small.

We are ALL at risk for adhesions, and abscesses, and blood clots, and obstructions, etc.
And we are at risk for getting struck by lightening.

susans53,

I know this is an old post, but I am just curious as to what part of the country you are from where the doc at one point told you lysis of adhesions was a very common thing. So different from the reactions I got as I searched about for help with this. So far still good. JUst curious. Rosemary

I realize this post is 6 years old, but others might still benefit from knowing they are not alone in their suffering. Since her hubby is male, however, he won't go through as much doubt or as many years undiagnosed as I did if this does become a chronic problem. Docs always tend to blame the female for over reacting or hysteria and depression. If you are particularly susceptible to problems and pain from adhesions, you can just keep a diary of when and how much it hurts and what helps with regards to diet and exercise and take it to your PCP. And remember, activity is an important natural pain reliever that we shut down when we quit moving when we hurt. Stretching and physical therapy is a great idea - myofacial release is one such. Also, rest the bowel with a bland diet when it is hurting, which might help. But one trip to the ER is not a chronic problem. If it becomes chronic, it can be managed. We all react differently. Most people don't have any pain, but adhesions can cause pain for some, so just investigate if it continues and you'll get thru this. Don't give up even when they say you're wrong. Adhesions are the culprit in my pain odyssey. I'm not fear mongering, but talking from actual experience. Some of you are being too dismissive about adhesions when you are trying to calm her slightly excessive worst case projections of fear instead. My pain can be as bad as a full obstruction every day. I've looked everywhere for 30 years for help and have had 17 surgeries that only made it worse. I can't work and am bed-ridden since I was 30. I may be on the tip end of the scale, but my experience is not unheard of. Surgeons don't want to admit their livelihood could be compromised. If we knew adhesions can be a real problem for a certain part of the population we might not have an elected surgery. Since they don't hurt everyone then their logic is they don't hurt anyone. And they say adhesions don't have many pain receptors. That is plain ridiculous. It is not the adhesion itself that hurts. It is the very strong spasms the intestinal muscles have to perform to push the food thru a restricted area. Intestines are designed to stretch and slide. Adhesions interfere with that. Sometimes they attach to organs that they pull on during digestion which causes pain to those organs. All of this can cause excruciating pain, debilitating nausea, bloating, inflammation, constipation and/or diahrrea. The most common complication is a later obstruction. It may be a small percentage, but not an insignificant amount, some say from 20 to 40% of mostly women will have some pain and or complications at some point in their life from abdominal surgeries. When you must have a surgery then it is the risk you have to take. If it is elected surgery, then you should know the truth. Doctors admit to adhesions being common when pushed, but don't want to admit to the pain they can cause. If you suffered from the daily pain or the difficulty getting an honest diagnosis much less proper treatment, you would be less dismissive. Don't add to the suppression of truth