International Adhesions Society





Adhesions in the News




Interview with ARD Patient & Dr. Wiseman in "The Union Leader", newspaper, New Hampshire USA, December 24, 2007 edition.

Read the latest press on Adhesions & ARD from one of our members & ARD patient, Christine Damon and Dr. David Wiseman, PhD, MRPharmS, Founder, International Adhesions Society.

For woman with adhesion disorder, only pain ahead
Union Leader Correspondent
Monday, Dec. 24, 2007

EPSOM – Christine Damon has always been in pain.
As a teenager, she sought medical treatment for abdominal pain, back pain and vomiting. Doctors dismissed it as a "woman problem" and didn't take her seriously until a doctor finally diagnosed her with endrometriosis, a chronic disease in which the tissue lining the uterus begins growing in other parts of the body. In her early 20s, Damon underwent her first surgery to remove the tissue.

She's now 44 and has had 14 surgeries because the adhesions keep growing back. Damon suffers from Adhesion Related Disorder, in which internal scars -- caused by trauma - bind organs and tissues not normally connected. Ninety to 100 percent of surgery patients develop adhesions, said David Wiseman, who conducts research on ARD.

continued.......Click here.

IAS announces world's first comprehensive "Adhesions-CAPPS Clinic"

The IAS is proud to announce its role in the opening of the world's first center for the integrated diagnosis and treatment of Adhesion Related Disorder (ARD) at Florida Hospital, Celebration Health, Celebration, FL. The founders of this clinic include our long time friend, Dr. Jay Redan, and the IAS’ very own, Dr. David Wiseman.

Although we have dreamed about this clinic since the beginning of the IAS in 1996, the idea began to take root about four years ago when Dr. Redan invited Dr. Wiseman to make a presentation to Celebration Hospital’s management about establishing a center for Adhesion Related Disorder.

Dr. Wiseman recounts:

“As a result of the research done through the IAS web site we realized that the problems of the ARD patient extend well beyond those of adhesions. An ARD patient will have some or all of a number of issues including chronic pelvic and abdominal pain, bowel and bladder disturbances as well as spiritual and psychological imbalances.

There was no one place for long-suffering ARD patients to turn that could tackle these issues in a coordinated manner. Dr. Redan arranged for me to present a proposal to Celebration’s management that would change all of that. What impressed me was the forward-thinking way that Celebration Health conducted every aspect of the patient experience, from the location to the décor of the radiology department to the scent wafting through the air conditioning system. This hospital’s approach may be close to Walt Disney World, but it was no ‘Mickey Mouse’ Since that initial presentation, I have been working closely with Drs. Redan, McCarus and a whole project team that has brought us to this launch.”

But there was a problem in the way the world thinks about this condition. As a result of Dr. Wiseman’s work it became apparent that adhesions and ARD are part of a wider set of overlapping and coalescing conditions including endometriosis, pelvic pain, Interstitial Cystitis (IC), Irritable bowel syndrome (IBS) and even fibromyalgia.

It was just not good enough to think just about adhesions, or just about chronic abdominal pain, or even bowel or bladder problems. We needed to think about it all. Together. And so was born the term "COMPLEX ABDOMINAL AND PELVIC PAIN SYNDROME (CAPPS)" defined as:

“a syndrome, of non-malignant origin consisting of a complex of symptoms of the abdomen or pelvis that includes pain, bowel or bladder dysfunction, of at least 6 months duration.”

Attempting to treat these individual symptoms or conditions as separate entities for the most part is an exercise in frustration. Although they may start out as separate conditions, they end up as essentially one condition - CAPPS.

Now we understand the disease we can get to work to prevent it and to treat it using the multi-disciplinary, integrated and holistic approach that the CAPPS Center is all about.

The Florida Hospital Center for CAPPS ( consists of: Dr. Jay Redan (General, laparoscopic surgeon), Dr. Steve McCarus (Gynecologic Surgeon), Dr. Kathy Jones (Urogynecologist), Dr. David Wiseman (Consultant, Scientific Advisor) backed by a team that will ultimately include care coordinators, specialist nurses, physical therapists, nutritionists, psychologists, social workers, exercise physiologists, psycho-spiritual counselors, pain management specialists and neurologists.

As a separate endeavor, the IAS will establish a sister organization, the:

International Society for Complex Abdomino-Pelvic & Pain Syndrome (ISCAPPS)

Please visit the new CAPPS center at:

PAX Conference to be held in Belgium, September 2006

Learn more about the PAX Society conference being held in Belgium 27-29 September. This conference highlights: Adhesion Formation, Tumor Implantation & Mesh Biology.

Visit the website by clicking the link above or review the conference brochure (pdf).

"Crazy Glue", an article in the New York Daily News regarding adhesions on 28 June 2005.

New York Daily News
Crazy Glue
Tuesday, June 28th, 2005

[Click here for full version]

On most days, Maria de los Reyes, a Port Authority lawyer, feels the pain. "It's like someone's hand is in my guts, squeezing them to death," she says.

It's been like this for 13 years now, ever since she had a hysterectomy, which went smoothly. But then a complication set in, one of the most common but least ­talked about side effects of surgery for millions of American men and women — something doctors call "adhesions."

Getting an adhesion is like having a not-so-elastic band suddenly ­materialize inside your body cavity and connecting ­internal organs that are not normally connected — like loops of intestines, with your uterus at one end and a bend in the fallopian tubes at the other, or joining your intestines and the walls of the abdomen.

The growth can play havoc with your organs, causing excruciating pain and, when the small intestine is involved, ­bowel blockage and obstruction. Says David Wiseman, a researcher and doctor of pharmacology from Dallas, an ­expert on adhesions: "It's like taking a ball of string that you let the cat play with, and get it all knotted up and tangled, and then you pour glue on it and let the glue stay."

Common in men, more so in women

Like hardened glue, adhesions are tough and inflexible, which is why ­doctors liken them to scar tissue. ­Physically resembling plastic wrap, and composed of a tissue called fibrin, they can create a range of different problems. Studies show adhesions can account for up to 74% of small bowel obstructions, up to 20% of female infertility cases, and ­between 20% and 50% of chronic pelvic pain cases.

What's remarkable is how high the risk is for getting adhesions in the first place. They can develop after any surgery — former President Bill ­Clinton developed a ­pleural adhesion that required a separate surgery after his bypass operation. Data show they develop in at least 55% of patients who undergo surgery. The number is as high as 90% for certain types of surgeries, like hysterectomies and C-sections, which is why the majority of patients suffering from adhesions are women.

The truth is that adhesions, first recognized when surgery entered mainstream medicine in the early 1800s, are still not well understood. The best guess is that they result from a kind of overreaction by the body. Dr. Soumitra Eachempati, assistant professor of surgery at Weill Medical ­College in Manhattan, says: "After any type of tissue injury, your body would have an inflammatory response. The more ­vigorous the response, the more likely the adhesions would form."

Some people, he says, are more ­unlucky than others and have "an ­exceptionally vigorous response." They're the ones who get severe adhesions and may suffer from chronic pelvic or abdominal pain.

De los Reyes is one such ­patient. Like many who suffer from ­adhesions, her difficulties with the ­condition began as she recovered from a ­hysterectomy her doctor ­recommended in response to fibroids growing in her uterus. Pain (resulting­ from multiple ­episodes of ­bowel obstruction) was the main ­symptom — pain she says she can ­never get away from for long, even 13 years ­later. "It is basically a day- to-day thing to see what I can do to alleviate — at least to some extent — the ­discomfort."

In addition to having had multiple surgeries for bowel obstruction and what doctors called "adhesiolysis" — cutting of adhesions — she has tried a lot of things to ease the pain, including prayer and meditation. She has even — and she says this seriously — tried jumping up and down on a ­trampoline. Sometimes these measures have helped, but only temporarily. "I'll get relief for a little while," she says, "but sooner or later I wind up having problems again."

Suffering from a lack of belief

Some 35% of all patients who undergo abdominal or pelvic surgery end up back in the hospital because of this recurring pain, with the usual result that they require surgery to remove the adhesions.

It's not just pain that's at issue. ­Certain adhesions can act to tangle up a ­woman's fallopian tubes and ovaries, causing ­infertility.

Others can cause obstructions in the bowel. In these cases the only ­solution is to "go back in" and try to cut the ­adhesion or even cut out the affected part of the ­organ. "If you liken your intestines to a long garden hose," explains Eachem­pati, "then there's a part that's kinked, and we'd try to find that part and cut away the scar tissue that is compressing it."

But even that's not a sure thing. As de los Reyes has learned, adhesions can be cut, but like bad weeds, they can spring up again. She has undergone 14 ­surgeries to deal with her adhesions.

"It's a tremendous emotional toll," she sighs, then mentions the part of the ­experience that really gets to her: "You start to doubt yourself." It's a doubt that comes from having been told, too many times, by too many doctors that "there can't possibly be anything wrong with you."

Indeed, the medical system seems to be in a certain amount of denial about the problem of adhesions. Despite their frequency, few surgeons ever bring them up as a risk factor in pre-surgery discussions with patients. Afterward, once the pain begins, many patients ­encounter scorn and disbelief from the medical ­system.

Wiseman is one of the ­sympathetic ones. President of Dallas-based Synechion, Inc., a consulting company that handles the science and business of adhesion prevention, he also runs a resource Web site, He's heard the lament from patients over and over again, he says. "'No one believes me…everyone says it's in my head… everyone thinks I'm making it up," he says, reciting a long list of patient complaints when they bring up their post-surgery suffering.

Sometimes, he says, all the patient needs is someone to speak to her nicely and say "'Listen, you do have adhesions, you're not making this up, it's not in your head.'"

That's the "good" news. Here's the bad news Wiseman has delivered again and again: "There's not much we can do about it, but let's plan your life."

A more comprehensive approach is what Wiseman and Dr. Jay Redan, a surgeon who is an expert on adhesion ­diagnosis and treatment, believe that ­patients need.

"No one's really looking at the whole picture," says Wiseman. In the fall, the two ­hope to launch what they say is the world's first comprehensive integrated clinic for patients with adhesions, chronic pelvic pain and related problems. The ­center, housed at Florida Hospital Celebration (Fla.) Health in Celebration, will feature a multidisciplinary team of ­surgeons, ­gynecologists, nutritionists and urologists, among others. This has come out of the realization that patients such as de los Reyes need more than just pain management or repeated operations.

The medical world keeps waiting for the breakthrough that will prevent adhesions from forming in the first place. Laparoscopic surgery, which allows surgeons to make tiny incisions, has not proved to be that advance. In fact, research shows adhesions are just as likely to form after keyhole surgery as conventional surgery. Some companies are trying to develop what are called barrier agents, such as ­Seprafilm, a kind of plastic sheeting put in place during surgery to keep the various loops of small intestine from coming into contact with other organs and each other. It has been available in Europe for some time and approved by the FDA in 2002.

Wrapping up a better solution

Other researchers are working on gels and solutions, such as Adhibit and Adept, that insulate body parts against physical contact with one another. Like the barrier agents, these products have reduced the severity of adhesions without eliminating them. Also available in Europe, their use in the U.S. is pending the results of clinical trials.

There's also evidence that a ­surgeon's actual technique may matter. Studies show the risk of adhesions may be reduced when surgeons handle tissue carefully, use powder-free gloves, dissect ­gently, control bleeding, prevent infection, and keep tissues moist, among other measures.

Finally, there is much interest lately in the use of Cox-2 inhibitors (such as Celebrex), the anti-inflammatory drug recalled not long ago for its adverse side effects. A recent study showed a "dramatic" reduction in adhesions in mice treated with Cox-2 inhibitors. According to a press release, investigators Dr. Mark Puder and Dr. Arin Greene from Boston's Children's Hospital are preparing to set up a clinical trial of ­Celebrex in adult surgical patients.

Until more is learned and new ­products become available, de los Reyes hopes more people become aware of the ­issues surrounding surgery and ­adhesions. She teamed with some of her doctors and has been talking to others in her situation.

"Helping other people… really makes a difference. It distracts me from myself," she says. "If I can tell my story and help somebody, at least I am not going through this agony for nothing."

President Clinton to Undergo Medical Procedure on 08 March 2005.

Statement From The Office of President Bill Clinton

President Bill Clinton will be undergoing a medical procedure this week to remove fluid and scar tissue from his left chest cavity. The procedure, which is a recognized, occasional consequence of open-heart surgery, will take place Thursday at NewYork- Presbyterian Hospital/Columbia University Medical Center and he will remain in the hospital for three to ten days.

The procedure is known as a decortication, and will require general anesthesia. The scar tissue developed as a result of fluid and inflammation causing compression and collapse of the lower lobe of the left lung. The surgery will be done either through a small incision or with a video-assisted thoracoscope inserted between ribs. The fluid buildup and lung collapse has caused the President some discomfort in recent weeks, but he has otherwise been in very good condition, recently passed a stress test and is walking up to four miles a day near his home in Chappaqua, NY.

The risk of the procedure is low, and once fully recovered, President Clinton is expected to resume his work without limitations.

IAS Supports HONcode Initiatives

The IAS has received official notification that our application has been accepted by the Health on the Net Foundation (HON) and that our website complies with the major HONcode principles.

The HONcode initiative is dedicated to improving the quality of medical & health information on the internet. As a qualifying member, the IAS can now proudly display the HONcode seal on our website.

This seal means,

  • that the IAS has submitted a formal application for membership and after a detailed review process, has been accepted.
  • that maintains constant compliance with the HONcode requirements.
  • that the IAS is committed to observing the HONcode principles.

Learn more about the HONcode Foundation or read the HONcode of Conduct Principles.

Adhesions recognized at the NIH

Follow this link to read what the NIH and National Digestive Diseases Information Clearinghouse (NDDIC) have to say about Adhesions!

Adhesion Related Disorder (ARD) - Recognized by United States Congress.

The Committee on Appropriations for the House of Representatives has recognized the significance of ARD and has encouraged the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) division of NIH to investigate this disease and to support research into its causes and treatments.

Specifically their report regarding FY2006 (p78) states:

“Adhesion related disorder.--This little known condition commonly leads to abnormal attachments between the organs inside the abdomen. The adhesions generally are composed of scar tissue resulting from previous operations. Very little is known about why adhesions form more aggressively in some people. Diagnosis of the disease is typically difficult, and surgical correction is often unsuccessful. The Committee encourages NIDDK to investigate this disease, supporting research to find treatments and understand causation and to communicate these findings to broaden knowledge of the disease in the medical community.”

The report, dated September 7th 2004 may be viewed here.

Although the report does not earmark any funds for this research, it represents an important milestone in our campaign of awareness and research into ARD, a term first used by the IAS. It represents the tireless efforts of many IAS volunteers who have written to their legislators, newspapers and TV stations about ARD and its devastating consequences.

As part of the budgetary process, all government agencies that may be affected by recommendations made by the Committee on Appropriations are required to respond regarding the action that they will be taking. Accordingly, in their Congressional Justification 2006, stated

“Future plans for NIDDK research on IBD and other adhesion-related disorders will include the continued pursuit of new drug therapies, the development of surrogate markers of disease, the maximization of research investment in animal models of disease, and the establishment of a repository that will collect and make available to investigators various types of human samples including blood, biopsied tissue, genetic material, and datasets.”


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