International Adhesions Society





Chat About Adhesions

The following chat transcript courtesy of now


Prior Chat Transcripts


Prevention of Post-Surgical Adhesions
David Wiseman, PhD
Wednesday, March 24, 1999


Drwiseman "Hi, are you here for the adhesions chat?"

Jeffsbaby "My name is Becky (jeffsbaby) am I finally at the right place?"

Drwiseman "Do you want to talk about adhesions? Then you are in the right place."

Jeffsbaby "Yes sir, I do."

Drwiseman "Well what would you like to know?"

Jeffsbaby "I am post op TAH/Bso/ appendectomy 5 months....and"

Jeffsbaby "This constant chronic pain in my abdomen...have had cat scan with contrast x2 and shows nothing"

Drwiseman "What did your doctor say?"

Jeffsbaby "I have a drs appt. tomorrow with my surgeon, and he wants to do a laparoscopic to dx. possible adhesions...I am in constant pain, exacerbated by sex as well..."

Jeffsbaby "Have never had abdom. surgery prior to this, and never had adhesions...I am frightened about the possibility of adhesions for I know they come back after they are removed...??"

Jeffsbaby "Can adhesions be diagnosed any other way then a lap?"

Jeffsbaby "What questions should I ask my surgeon?"

Drwiseman "The possibility of recurrence is reduced (but not eliminated) if an adhesion barrier is used. you should speak to your doctor about that."

Drwiseman "You should ask him/her what s/he will do if they find adhesions - will they cut them, leave them etc. you should also ask about endometriosis."

Jeffsbaby "I read my path. report from my hyster. and no endometriosis was mentioned....but if they are left how do you manage pain?"

Drwiseman "You need to work with a pelvic pain specialist. There are a variety of methods, but I have no way of saying which one you should try first. I would ask your doctor tomorrow if s/he can map your pain during the laparoscopy. It seems important to determine if you have adhesions, whether they are the cause of the pain. Sometimes they are not."

Jeffsbaby "Map pain?"

Jeffsbaby "Do they not show right up, easily visible via lap? clear cut diagnosis?"

Drwiseman "Basically the laparoscopy is done under local anesthetic and the surgeon is able to determine, with your cooperation, the exact source of the pain. Sometimes this is an adhesion and sometimes it is not. Adhesions show up - you can see them straight away."

Jeffsbaby "Well that's good, easily diagnosed. Do they form this 5 months, pain for about 3 weeks solid?"

Drwiseman "Adhesions certainly do form that quickly. They do not always give rise to pain or other problems, and they do not always do so straight away."

Jeffsbaby "Wonder what else could be the source if the CAT w/ contrast was clean? (broad question I know)"

Drwiseman "That will be for your doctor to figure out."

Drwiseman "You should ask your doctor to list the most likely causes in your case."

Jeffsbaby "My pain is like a twist feeling, a cramp-like feeling, a knot feeling? Sound like adhesions to you?"

Drwiseman "Knot twist: it certainly matches other people's descriptions of adhesion related pain, but again it matches other kinds of pain too."

Jeffsbaby "Do you have to have a lap to dx. adhesions?"

Drwiseman "We have no way of diagnosing adhesions indirectly e.g. by x ray, cat scan etc. The only way is to to a laparotomy or laparoscopy."

Jeffsbaby "What is an adhesion barrier...and how are they removed ...cauterized, cut, what? In how many percentages does a person have to have repeat surgery for adhesions? I don't mean to be taking up all your time, anyone else please jump right in!"

Peggyk "I had one laparoscopy in Oct. which revealed severe adhesions. Dr removed what he saw but I still have all the pain."

Peggyk "He is prescribing another lap in April."

Peggyk "Is there any other way?"

Caprine_latte "Sorry, every time I hit the backspace button I am booted - this is the mailing list Karen"

Peggyk "What causes the adhesions"

Peggyk "Is it poor surgical technique?"

Drwiseman "Good questions: an adhesion barrier is a device - a kind of band aid used inside the body, that is placed over the organ where surgery was done to protect it from forming adhesions. The barrier is left in place because it dissolves by itself after a few days. About 3% of patients overall may need repeat surgeries for adhesions - although this is a very difficult number to explain."

Drwiseman "Hi everyone else: welcome to Karen our mailing list guru!"

Jeffsbaby "So the barrier should have been used during my hyster. to PREVENT the adhesions?!"

Caprine_latte "brb - trying to help someone log in with out being booted. Excuse the typos - I cannot fix them."

Drwiseman "I feel that adhesion barriers should be used on most occasions in order to reduce adhesions."

Jeffsbaby "No adhesion barrier was noted in my operative report."

Guest22 "Can adhesions actually "crowd out" organs?"

Drwiseman "Peggy: sorry did not get to your question: what causes adhesions? Poor technique: it seems that technique is very important. However even the best surgeons still get adhesions."

Jeffsbaby "I am taking motrin 800mg. for the pain, are narcotic-type meds suggested or normal for adhesion pain, I feel I need more pain relief?"

Peggyk "Poor technique can cause but no way to really prove it?"

Drwiseman "Peggy: currently the only way to treat adhesions is to cut them and to use an adhesion barrier. This will cut down the chance of recurrence, but will not eliminate it. You need to speak with your doctor about that."

Guest22 "Y, can adhesions actually "crowd out" organs?"

Drwiseman "Peggy: poor technique can cause - but no way to prove it - that's right."

Caprine_latte "I take a lot of narcotic pain meds...they don't make me drowsy, I don't take more than prescribed, I'm not a druggie, and they help but, they don't come close to taking pain away although I can live a semi-decent life now."

Peggyk "I did speak to my dr. about this and he told me that adhesion barriers can't be used on large areas"

Jeffsbaby "This is horrible.....after all I went through with my TAH/BSO/appendectomy and all the complications post surgery then to get adhesions...."

Drwiseman "Can adhesions crowd out? In a certain sense they can."

Guest22 "I have had several laps to remove adhesions from my intestines to the wall of my stomach."

Jeffsbaby "And you still have the pain?"

Drwiseman "Peggy: adhesion barriers on large areas: there is no basic objection to using them over large areas other than we have no data to support (or to refute) this idea. Most of the studies that have been done have been over relatively small areas."

Jeffsbaby "My pain NEVER leaves....worsens and lessens but never leaves this the case with you all too?"

Guest22 "But now they tell me that the problem is that the adhesions have built up behind my intestines and they are crowding my organs out, is this possible?"

Guest22 "The pain is absolutely terrible!"

Drwiseman "Guest 22 : yes that is possible"

Jeffsbaby "What do you take guest...I'm gonna ask my dr. tomorrow for something stronger than this motrin...I can't take much more...have only been married less than 2 years and sex is so painful..."

Caprine_latte "My pain changes over the course of a day...and over the course of gets to a point of me not being capable of function...I have other changes with the pain too.,"

Guest22 "I take several different things..."

Caprine_latte "If it were not for pain med ...there would be no sex."

Jeffsbaby "So Drwiseman what is the solution to the sounds like a never ending circle of debilitation?"

Jeffsbaby "Just give me an idea of what helps you (meds) so I may ask my dr. tomorrow..."

Guest22 "Fentanyl for long term relief, short-term demoral, 750mgs Robozin, and 10mgs of Bentyl"

Peggyk "Dr. Wiseman, I had a post operative infection. Would this be a main factor for adhesions?"

Jeffsbaby "Thanks guest....I wrote them down."

Jeffsbaby "Has anyone else here developed adhesions from hysterectomy?"

Jeffsbaby "or appendectomy?"

Guest22 "Is it true that if you've tried adhesion barriers and had no positive results the only thing left is to keep taking pain medication and only do laps when absolutely necessary until something new comes out on the market?"

Drwiseman "What is the answer to adhesions? I'm afraid there isn't one yet. The best solution right now is for doctors to use careful technique and then to use an adhesion barrier if possible."

Guest22 "My adhesions are from a hyst."

Guest25 "Drwiseman, it's Jonesy, hi. Any idea yet more definitely when the Intergel will be available?"

Drwiseman "Post-op infection: that is certainly a factor as infection can increase the possibility of adhesions."

Peggyk "Right now I am taking hyphen 7.5/500 2 every 4 hrs. along with naproxin 500 1 every 8 hrs. and this seems to be working for me."

Jeffsbaby "Oh my gosh guest...I'm so scared, mine haven't been dx. yet, go to dr. tomorrow."

Caprine_latte "I've tried toradol (helps headaches), some kind of epilepsy drug, amytriptiline, naprasyn, vicodin, tylenol 3, and many other meds over the course of several years...I currently take 7.5 Lortab (and worry about tylenol risk)...aspirin (plain), when intolerable - morphine."

Drwiseman "Jonesy: INTERGEL: the company has submitted their data to the FDA. If everything goes smoothly then they may have approval by the end of the year."

Guest22 "I've tried all of those you listed, about the only thing that works for me is the "hard" stuff"

Guest25 "So, the time I heard about June or July is probably not going to happen ?"

Guest22 "I haven't been able to keep anything solid down for over a month."

Drwiseman "June/July is unlikely to happen."

Guest22 "Since my hyster. I've lost over 100 lbs"

Jeffsbaby "Dr Wiseman, do you routinely give narcotics for this pain and do you do repeat surgeries for adhesions."

Guest25 "Dr., anything we can do, to help them hurry along?"

Jeffsbaby "What exactly about 'technique' can cause the adhesions?"

Peggyk "I was really happy to find all the information about adhesions on the internet I thought that I was going crazy with having this pain until I read about all the other people that suffer with adhesions like I do."

Caprine_latte "I cannot have any more surgery unless it is a life threatening emergency...I've had fecal purulent peritonitis twice now, do have a question though..."

Drwiseman "Jeffsbaby: please note that I am not an MD and do not treat patients. Narcotics are given by many doctors."

Jeffsbaby "I'm sorry ....."

Drwiseman "Can we hurry things along (with INTERGEL) : I don't thinks so, the answer is in the hands of FDA."

Guest25 "Thanx, Dr......."

Drwiseman "If you want to help research into adhesions directly you should email me ( and we can talk about it further."

Drwiseman "Karen: what do want to ask?"

Caprine_latte "I've begun to have "bowel" changes...I'm losing weight...pain (different)...wondering if it could be the's happened over a long period of time but now is causing a problem...I feel like swearing off eating."

Guest22 "I was told that about the only thing for those of us that have tried everything out there so far is to get on a research list at a research hospital; however, if your body reacts as crazy as mine does to a lot of things then there is no way they would put you on a research list."

Guest25 "Research list, as in guinea pigs??"

Jeffsbaby "Me either guest 22"

Drwiseman "Karen: if you are losing weight, there could be a number of causes of that. You should get a check up."

Guest22 "yes"

Caprine_latte "Well, they have to test it somewhere and if you hurt like's an option that begins to look appealing."

Lauri "-Hi, My Name is Lauri, I keep getting these banner ads , and then it cuts me off. Help???"

Guest25 "I understand."

Lauri "I have had five abdominal surgies, last one TAH/BSO."

Jeffsbaby "I got along just horrible with my hyster...from start to finish, and am a reasonably healthy emotionally stable woman."

Jeffsbaby "oh my Lauri..."

Lauri "I think I have adhesions constant pain."

Guest25 "Drwiseman, is that info. on Lifecore's page, about Intergel?"

Jeffsbaby "do you have the adhesions...."

Vhc "Hi everyone! I've had a TAH/BSO and one year later another lap was done to remove adhesions that were twisting my colon...three months later I'm doing long will that last?"

Drwiseman "Guest25: I'm not sure where that info is. You should check out LCBM's page and press releases."

Caprine_latte "Doc thinks it is adhesions but no way other than surgery to tell...I have severe dense adhesions...that is a known...but it's like putting together a mystery...symptoms are not bad enough for me to warrant surgery (doc would like it though)...could adhesions play havoc on a colostomy (I don't have any intestinal diseases)?"

Jeffsbaby "that's what I' m dealing with too Lauri, haven't been dx. yet...TAH/BSO/appendectomy now, constant pain in abdomen."

Drwiseman "Jeffsbaby: no I don't have adhesions."

Guest22 "What is this you're saying about technique? I have done quite a bit of research and this is the first time I've heard about technique causing them."

Vhc " what cases do you think additional surgery is warranted?"

Lauri "What are the pain symptoms of adhesion pain?"

Jeffsbaby "No, not you Dr. Wiseman...tee hee....Lauri...sorry.. tee hee (this chat thing gets confusing sometimes)"

Lauri "I do not know yet, one dr. wants to do a pelvic cat scan, but I heard that is not a way to dx. adhesions."

Jeffsbaby "Dr. Wiseman said technique can be responsible for adhesions....guest 22"

Drwiseman "Technique: it is quite well accepted (at least by Gyn doctors) that careful surgical technique can reduce adhesions. There are certainly some doctors who have a very gentle and meticulous technique and who seem to get fewer adhesions than others. Among general surgeons, this is not as well understood."

Vhc "Lauri....I've had several cat scans and they did not show my adhesions"

Drwiseman "Please understand though that even the doctors with the best and most gentle technique can still have adhesions in their patients."

Guest25 "Drwiseman, thank you for the info concerning the Intergel."

Jeffsbaby "Me too, had 2 cat scans with contrast, pelvic ultrasound...showed no adhesions...have to have a lap for that ...Lauri."

Drwiseman "Cat scans do not show adhesions"

Lauri "Again I ask I have constant pain in the lower pelvic area, is adhesion pain that way, I always have had endo too"

Guest22 "I understand now, they say mine isn't due to technique but from blunt abdominal trauma less than a week after my hyster."

Drwiseman "Sorry Lauri: adhesion pain can present in a variety of ways. There is no "one" type of adhesion pain"

Lauri "I thought my hysterectomy was going to be my answer to end my pelvic pain."

Drwiseman "I'm sorry it wasn't."

Peggyk "Me too Lauri"

Jeffsbaby "Amen to that Lauri too...I wish I had never had it (hysterectomy)."

Lauri "Is a diagnostic lap the only way to dx. adhesions?"

Vhc "I'll third that Lauri....when I found out I should have more lap surgery this last Dec. talk about frustration!"

Peggyk "I have more constant pain now than before the hyster"

Caprine_latte "I've read that some people who have never had surgery have formed adhesions...they don't seem to know why...also, doc said that a ct or mri could only show say, a twisted bowel (possible) or something wrong with the loops of bowel which he infers could be the result of the adhesions...but they can't see them unless it's with their eyes."

Guest25 "Bye, all, God bless, and Good Luck."

Jeffsbaby "Me too Peggy...oh this is getting depressing..."

Lauri "Me Too, although it has helped my back pain and period pain, now my mind crazy!!!"

Vhc "Doctor.....have any studies proven that exercise helps with adhesion pain?"

Jeffsbaby "hey guest?"

Peggyk "At least we're not alone in this."

Jeffsbaby "Are you familiar with the hystersister mailing list?"

Drwiseman "Lauri: a diagnostic lap is the only way to diagnose adhesions. Whether they cause adhesions is another matter."

Jeffsbaby "Can laps themselves cause adhesions too?"

Guest25 "which guest?"

Jeffsbaby "Well either one of you, the one that was leaving, I was gonna tell her about it...the list..."

Drwiseman "Exercise: I know of no studies that show this. I have heard from some people that certain kinds of exercise (aerobics, jazzercise, etc.) can help, but nothing scientific."

Vhc "Jeffsbaby....I belong to the hystersister list"

Lauri "What is the hystersister list?"

Jeffsbaby "Oh who are you...I do too...if you wanna tell me that is...vhc?"

Guest22 "Question, those of you that are having problems with adhesions, what is your age...I'm only 28 and can't seem to find anyone my age that is going through this."

Jeffsbaby "I think I may know who you are."

Caprine_latte "I know there are exercises that cause excruciating the trampoline."

Peggyk "I can't even go for a walk without the pain intensifying."

Vhc "Doctor...I have been exercising five days a week for two months and my pains/twinges have eased substantially.....coincidence?"

Guest25 "Jeffsbaby, what list?"

Drwiseman "Any operation has the potential to cause adhesions. with a simple diagnostic laparoscopy, the risk is fairly minimal because no surgical procedure (other than the laparoscopy) is being done."

Guest25 "Peggyk, I know what you mean!"

Peggyk "It really stinks."

Vhc " name is Verna....I'm one of the originals...and you are ?"

Drwiseman "Vhc: it may be coincidence, we can never know."

Guest25 "Yeah, I know......"

Vhc "Doctor...what is your opinion of Seprafilm and other such efforts?"

Caprine_latte "I'm 36 and have been dealing with this for quite a while...all ages are affected though."

Jeffsbaby "Lauri...the hystersister list is an email group for support of women who have had hyster....go to and look for it,, and or email"

Drwiseman "Seprafilm: has made some important strides in adhesions. However it cannot be used by laparoscopy and is difficult to handle. There are other things on the horizon that have benefited from the experience of Seprafilm."

Lauri "Thanks, I can't believe there are so many women still in pain."

Peggyk "When is this chat on again?"

Drwiseman "OK folks: I'm going to have to go. One more last question?"

Guest22 "I have had Seprafilm put inside of me, it slows the adhesions down but they still come back"

Peggyk "Thank You Dr. Wiseman hope to talk to all again."

Jeffsbaby "Guest 25, did you see my response to Lauri about the hystersister list?"

Vhc "What in your opinion is the most promising new technique?"

Jeffsbaby "Thank you Dr. Wiseman, you have given me great info. for my drs appointment, thank you for your invaluable time!"

Lauri "Thank You!"

Drwiseman "vhc: there are some drugs and devices in development that I think will do very well. One is ADCON P, but it will not be around for some time. Another is INTERGEL and another is Sepragel. We will still need something stronger than all of these, but it is too detailed for me to give you a simple answer right now."

Lauri "How do some of you convince your Dr. that your in pain again after a hysterectomy?"

Drwiseman "I'm logging off now. Thank you all for a lively discussion."


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