A |
dhesions are internal scars (synechiae)
that connect organs and tissues that are not normally
connected.
They may form as a result of any kind of trauma – surgery,
wounding, infection, radiation or other disease.
Although almost everyone undergoing surgery will
form adhesions,
not everyone will develop problems, and in those
that problems do occur, they may not happen for many
years.
Approximately one third of patients undergoing abdominal
or pelvic surgery will be readmitted twice in the
ten years following surgery, for a problem directly
caused
by adhesions or a problem that will be complicated
by adhesions.
Adhesions can cause a variety of problems including
infertility, bowel obstruction, pain, as well as
prolonged subsequent surgeries with increased blood
loss.
“Adhesions Related Disorder” (ARD),
typified by the patient who presents with a constellation
of recurrent bowel obstruction, chronic abdominal
or pelvic pain, chronic diarrhea or constipation,
a variety of psychosocial issues, and who has undergone
a number of procedures in an attempt to diagnose
and/or correct a sometimes unidentifiable underlying
problem.
Somewhere in the late 1990’s, shortly after
its inception, the International Adhesions Society
coined the term “Adhesion Related Disorder” (ARD)
as a result of its research it had started into the
nature of the problems of adhesions, from the
perspective of the patient. Having adhesions is about much more
than bowel obstruction, pelvic or abdominal pain.
It is about disturbed bowel function, malnourishment,
painful defecation, painful urination, painful intercourse,
and a misery made worse by the loneliness, hopelessness,
frustration, desperation and thoughts of suicide
for thousands of patients that strain family and
work relationships to the limit and beyond.
Adhesions are an almost inevitable outcome of surgery.
It has been said that adhesions are the single most
common and costly problem related to surgery, and
yet most people have not even heard the term. This
lack of awareness means that, excluding infertility,
many doctors are unable or unwilling to tackle the
problems of adhesions, many insurance companies are
unwilling to pay for treatment and many patients
are left in misery. The good news is due to the efforts
of the IAS and its members, that awareness about
adhesions and ARD has improved greatly. But we still
have much work to do.
Read Dr. David Wiseman's "A
Patient's Guide to Adhesions and Related Pain",
which describes adhesions, their treatment and
their
relationship to pain and bowel obstruction. In addition,
stories from patients are featured to illustrate how
adhesions (or suspected adhesions) affect their daily
lives and how they cope with a sometimes-insurmountable
problem.
A key lesson and source of comfort for patients
with this problem is that they are not alone and
the importance
of mutual support among patients cannot be underestimated.
There are no easy answers as yet. In drawing attention
to the human side of this problem, we hope to (begin
to) educate patients and doctors about the range
of treatments available, be they of a medical, surgical
or psychological nature.
Another key breakthrough,
again from our own research, was the realization
that the ARD patient is a member of a much larger
group
of patients who, in varying degrees, combinations
and sequences experience a range of symptoms and
conditions
including endometriosis, interstitial cystitis (IC),
irritable bowel syndrome (IBS), bowel obstruction
and chronic abdominal and/or pelvic pain.
Although ‘‘adhesions’’ may
start out as a single, stand-alone entity, an adhesions
patient may develop a number of related conditions
(ARD) which renders those patients practically indistinguishable
from patients with multiple symptoms originating from
other abdominal or pelvic conditions. Read
more about this research and why it was important
to coin the term “Complex AbdominoPelvic and
Pain Syndrome” (CAPPS),
defined as:
“ a syndrome of nonmalignant 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.”
Please review our large
collection of links to find more information
about adhesions and related disorders.
|