Adhesions

Hi everyone,

I am 3 weeks post-op from my RNY gastric bypass.  This past week I was readmitted to the hospital because of some severe abdominal pain that came in waves and had surgery on Wednesday.  They saw a small hernia by my belly button and some swelling in my intestines on the CT scan, so they went in with the laproscope to take a look around first.  They found I had a lot of inflammation in my intestines by my JJ (the second hook-up they make during the RNY) and adhesions there as well.  They removed the adhesions and stitched up the hernia.

Since then I've been doing a lot of reading on adhesions.  I am surprised that they were never mentioned by anyone to me pre-op because according to the reading I've done online, they occur in 93% of abdominal surgeries.  In most cases they are harmless, though.  They become a problem when they are attached to the intestines because they can cause blockages over time.  They cause cramp-like pain that comes in waves, lasting seconds to minutes, and usually gets worse after eating (exactly what I went to the ER for).

What concerns me is that there is no way to prevent them and they are caused by surgery itself.  I'm left worrying that although they were removed, they could form again.  I haven't been able to find material online talking about reoccuring cases and so I was wondering if any of you had problems with adhesions after surgery and if you did, was it a one-time problem or a reoccuring problem?

Thanks in advance for your help.

Take care,
Amy

Yes, they could form again, either quickly or over a long period of time. I have some, and they hurt bad for a few minutes, then the pain dissipates.

I'm going to live with it so long as I can. I figure I can get adhesions from the removal of the adhesions, you know?

A working theory is that if you form scar tissue easily, the higher your chances might be to form adhesions. 93% of abdominal surgeries form them seems way too high of a number...doesn't seem right. If that were the true numbers, our hospitals would be taken to task (ie medicare dollars) for high incidents of resurgical explorations. Just saying...

Can you tell me how often you would get these pains?  All the time or once in a while?  I've been having similiar pain that comes in waves but only once a month or so.  It really, really hurts.  When I went to my surgeon, he looked at me like I had two heads.  He couldn't tell me why I was having the pain.  You mean to tell me that of all the patients at this COE that they have operated on, no one has had this type of pain?!  It came about 45 minutes after eating.  Pain was like labor pains.  Really painful cramps and then it went slowly away, but lasted around 2 hours.  He said maybe I ate something bad (no one else in the family got sick) or that I didn't chew well enough.  I had a protein shake, so that makes no sense.  I'd just like to know what the cause of my discomfort is.  Thanks!

 Sandy,

I'm so sorry I haven't responded until now.  I did not know there were any responses to this thread - I don't use OH very often and didn't know there was a place that I could find all my prior posts.  So, I just found your reply.  I hope that you are okay.  It turns out that I have not had any pain at all since my second surgery (when they removed the adhesions), so I think that all is well with me now.

As far as your questions go, I only had the pain that one night (it came in waves every 2 minutes or so) and I called my doctor right away and he had me go to the ER and they took care of it right away (through the second surgery).  It never came back after the surgery, so I can't tell you if it would have repeated for me or not.  But I can tell you from what I've read online that it would be a good idea to pay attention to what you eat on the days that you do get the pain.  I had eaten corn on the cob for the first time the night that I had gotten my pain.  The theory is that since the adhesions are on your intestines, if you eat something bulky for really fibrous that your intestines have a hard time breaking down, and you have adhesions that are constricting the intestines in the first place, that is when you'd get the pain - as your intestines are trying to break down the food and move it through toward the colon, hence the pain that comes in waves.  Make sense?

I hope that you are well.  Have you had any luck since this post in finding out what was causing your pain?

Take care,
Amy

I had three open abdominal surgeries  (RNY, hernia repair, and tummy tuck) and a lap gallbladder removal in 4 years.  After almost 18 months of intermittent, severe pain that was becoming increasingly frequent (and 4 CT scans that all showed nothing), I finally had ANOTHER open surgery on Aug 30th and the surgeon found two issues, both the results of adhesions.

In one spot the adhesions had the intestine attached to the abdomninal wall.  The more serious problem, however, was that adhesions played a role in the intestine being attached to and growing into the mesh that was placed in there during my hernia repair 3 years ago.

I had to see three surgeons over a period of many months before my original RNY (and hernia repair) surgeon agreed (after originally refusing about a year ago) to go in surgically to see what was going on.  Everyone KNEW there were probably lots of adhesions from all the other surgeries, and even if you do surgery to REMOVE adhesions, the process of removing them actually causes new adhesions... so it is a vicious cycle and some surgerons are very reluctant to do surgery unless they know exactly why they are going in and that the problem warrants risking more adhesions.  Unfortunately, in my case -- and in the case of several others here -- the problems that can be caused by adhesions do NOT show up on scans so it can be very difficult to get someone to take any surgical action to find and fix the problem (even if teh patient is in a lot of pain).

One of the advantages of lap surgery is that it generally results in fewer adhesions than the same procedure done open.

Lora