Strangled by Scarves: What to Do with Abdominal Adhesions?
Jan 01, 2024
Feeling a mysterious pain or discomfort in your abdomen? Abdominal adhesions may be the cause. They commonly occur as a complication of abdominal surgery. However, you may not experience consequences until many years later.
In this article, we will investigate this hidden cause of abdominal pain and explore the latest strategies on how to get relief.
Postoperative abdominal adhesion (PAA) is one of the most common complications, which accounts for more than 90% of patients who had abdominal surgery, and approximately 30% of patients require a second surgery for PAA. Complications generated by PAA can result in numerous problems, such as chronic abdominal pain, small bowel obstruction, infertility in women, and even secondary surgery. Furthermore, 40% of intestinal obstruction is caused by PAA.
Gut-Wrenching Troubles: What Are Abdominal Adhesions?
Abdominal adhesions are bands of scar tissue that form between abdominal organs or between organs and the abdominal wall. Normally, the surfaces of the abdominal organs and the abdominal wall do not stick together and can move freely. Abdominal adhesions cause tissues to stick together, which can lead to multiple health problems and complications.
But what exactly is scar tissue? Scar tissue is a connective tissue that forms as a natural response of the body to an injury, surgery, or inflammation. Its goal is to repair and replace damaged tissue in a healing process. Scar tissue is mostly composed of collagen. Collagen is a protein that provides strength and structure to tissues. While scar tissue is strong, it lacks the flexibility of the tissue it replaces.
Unmasking the Problem: What Causes Abdominal Adhesions?
The most common cause of abdominal adhesions is abdominal surgery. Nine out of ten people who undergo abdominal surgery will develop abdominal adhesions. Most often, adhesions won’t cause any problems. But if they do, those problems can seriously affect a patient’s health and quality of life.
Adhesions can also be a result of an infection or inflammation inside the abdomen. Conditions that can cause them could be Crohn’s disease, diverticular disease, endometriosis, pelvic inflammatory disease, and peritonitis. Long-term peritoneal dialysis for kidney failure and radiation therapy for cancer could also be the cause of abdominal adhesions.
Stuck in Discomfort: The Complications of Abdominal Adhesions
Abdominal adhesions can cause very severe problems. The most common complications of abdominal adhesions are:
- Intestinal obstruction – a partial or complete blockage in the small or large intestine that prevents the normal passage of food, fluids, gas, or stool. The pain of a full obstruction is said to be more severe than childbirth (although I have no idea how one would measure this or validate this claim).
- Female infertility – abdominal adhesions in the pelvis or uterus can block parts of the reproductive system and cause infertility
In 2006 and 2007, I underwent challenging surgeries for metastatic cancer. These initial procedures led to additional surgeries in 2011 and 2015. The reason for these surgeries was complications caused by abdominal adhesions. Over a decade, I faced a range of problems, including pain, constipation, depression, PTSD, job loss, and a feeling of hopelessness.
Every month, because of the partial obstruction, I endured 2-3 days of vomiting up bile while lying on my bathroom floor, desperately hoping for relief. The full obstruction resulted in emergency room or elective surgery. I reached out to my gastroenterologist and urologists for help and hope, but they couldn't offer any. These were undoubtedly dark times, as you can well imagine.
The Allopathic Treatments: Facing the Knife Again
Since most adhesions don’t cause any symptoms, they don’t require any treatment. When it comes to abdominal adhesions which cause problems, the situation is very tricky. Doctors tend to offer only one solution – another surgery. Yet, surgery to treat adhesions very often leads to the formation of new adhesions.
There is a considerable risk that the solution will create more problems. Therefore, both doctors and patients tend to avoid surgeries unless there is an emergency, like in the case of a complete intestinal blockage. That is a life-threatening situation and surgical removal of scar tissue may be the only option.
The best allopathic treatment for abdominal adhesions is laparoscopic surgery. It is minimally invasive, more precise, and less disruptive to tissues. The risk of further adhesions and infections is lower compared to open surgery. In 2015, I did have one of these procedures at Mount Sinai Hospital on the Upper East Side in NYC, but I found myself in pain again within just 7-8 weeks.
Hunting for Hope: Can Abdominal Adhesions Be Prevented?
Preventive strategies are, unfortunately, limited to barrier technologies (which I am not a fan of since a foreign project impacted on the body will often have a cost associated with its interaction with the innate immune system) Surgeons are recommended to:
- Perform laparoscopic surgery whenever possible
- Handle tissue as gently as possible
- Wear powder-free gloves and lint-free-tool to prevent inflammation
- Cover damaged tissues with a film-like barrier to keep tissues separated until they heal. * Barrier technologies and mesh may create unique issues due to the presence of a foreign object in the patient's body. These have not proven to be extremely effective and I personally would not use mesh or a barrier in future surgeries if it was deemed necessary.
Recent research on the healing process and adhesion formation gives some hope. New discoveries open the possibility of targeting molecular pathways and key fibrotic mediators involved in creating adhesions.
Therefore, certain chemical agents may prevent the formation of abdominal adhesion. For example, anti-inflammatory drugs, antioxidants, fibrinolytic agents, and selective immune-suppressors. Unfortunately, very few drugs have reached the expected effect and provided the desirable outcome. Also, the side effects present a considerable problem.
Beyond Surgery: Alternative Approaches for Abdominal Adhesions
It is obvious that new, reliable preventive strategies are urgently needed. More research is absolutely necessary, as well as looking into alternative methods and therapies.
Traditional Chinese Medicine
One recent study, Application of Traditional Chinese Medicines in Postoperative Abdominal Adhesion, published in 2020, discusses the most common TCM treatments for abdominal adhesions. Their review focuses on:
- Chinese medicinal herbs
- TCM formulas
- Acupuncture treatments
-
Moxibustion
Even though no single approach is completely successful in reducing adhesions, TCM provides a lot of essential information on the use of natural products. Thus, it presents a great resource for drug innovation and innovative solutions.
Manual Therapy and Massage
Manual therapy can prevent the formation of adhesions by stimulating organ movement within the abdominal cavity. It can also increase the flexibility of tissues and reduce the tension on existing adhesions.
Abdominal massage that involves pressing, deep strokes, and friction can have a great impact on abdominal adhesions. The goal of the massage is to restore a flexible and mobile state of the organs and provide the circulation and nutrients they need. Deep tissue massage has shown considerable results in breaking down adhesions and collagen fibers of the scar tissue.
Gentle stretching increases the blood flow and improves circulation. It may reduce inflammation and provide nutrients to the affected tissues. Core-strengthening exercise can improve the muscle tone and core strength of the abdomen and provide better support for abdominal organs.
I once took a one-week trip to Clear Passage, a renowned center in Florida known for its impressive history of treating abdominal adhesions. They use a unique system of prolonged holds, stretches, and self-management tools like special balls and plastic wands you lie on. Although I have immense respect for their staff and believe in their method, the results for my body were limited.
Out-of-the-Box Solutions: Biohacking Technologies for Abdominal Adhesions
Biohacking technologies and regenerative medicine preventative strategies have great potential to solve this problem. A scientific article published last year Regenerative Medicine Therapies for Prevention of Abdominal Adhesions: A Scoping Review provides an insight into regenerative medicine preventive strategies that deserve to be in the focus of future clinical investigation.
We’ll mention here just a few possible solutions:
- Proteolytic enzyme therapy: Currently using FIBRENZA
- Stem cell therapy
- Small molecule therapy
Proteolytic enzyme therapy uses proteolytic enzymes to prevent or reduce the formation of abdominal adhesions. These enzymes are capable of breaking down proteins, including those in scar tissues and adhesions. They also have anti-inflammatory properties and can reduce inflammation associated with adhesion formation. I committed tho this for over 2 years and found it very helpful.
Stem cell therapy is well known for its success in repairing damaged tissues due to ischemia, inflammation, and autoimmunity. The available data on stem cell therapies for abdominal adhesions is very promising. However, these therapies are not without risk and have certain practical challenges. Without a doubt beneficial, this type of therapy needs more studies and clinical trials.
Small molecule therapy uses small molecules to target specific molecular pathways and processes in the body. There is ongoing research into the possibility of using this type of therapy for abdominal adhesions. Certain small molecules can break down fibrin and dissolve adhesions due to their anti-inflammatory properties. They also have the ability to inhibit the fibrotic process, which leads to the formation of adhesions.
My PERSONAL Victory: Freddie's Win
Pulsed Electromagnetic Therapy
A Roadmap to Smooth Recovery: Lifestyle Adjustments
Is there something we can do to prevent the formation of abdominal adhesions after the surgery? There are many steps we can take. They include lifestyle adjustments and new routines. While these small lifestyle adjustments are important, recovery is not always straightforward.
Here are some suggestions:
- Movement: Get moving as soon as possible to prevent tissues from sticking together
- Breathing Exercises: Practice deep breathing to improve the flow of oxygen
- Balanced Diet: Eat a healthy, balanced diet, rich in nutrients to lower the risk of inflammation
- Post-Surgical Fasting: Some experts claim that post-surgical fasting may reduce the risk of adhesions
- Hydration: Stay hydrated to maintain the fluidity of abdominal tissues
- Avoid Heavy-Lifting: Refrain from heavy lifting or strenuous activities
Knowledge Is Power!
Abdominal adhesion risk is based on many factors. So, bear in mind that knowledge is power! By learning about abdominal adhesions, their causes, and available treatments, you are taking control of your health and your life.
Begin your recovery journey by arming yourself with the right information and making informed choices. I promise to share exactly what I did to get complete relief from adhesions in a separate article. With this one, I just want to raise awareness and highlight the current medical literature. Stay informed and stay proactive!
