Bev's answers are based on: "If adhesions are only formed until the 7th day after surgery, what makes ARD so progressive? The pain cycle itself ? Or the adhesions becoming more fibrous and tight?"
When most adhesions first form, they are soft and pliable tissue.
Over time, adhesions become tougher; and that is when adhesions start to create the pulling on the organs to which they're attached.
If the adhesion attachments are tethering organs that are meant to move, then there will be pulling on them -- thus causing agitation at the attachment sites -- thus causing inflammation -- thus causing pain.
As time goes by, the adhesion tissue continues to toughen...causing tightening and the tethering and constricting of the bowels and other organs -- such as the urinary bladder, ovaries, uterus, tubes, etc. -- and thus increasing the pain and other symptoms.
When some adhesions form, they are very thick and vascular; and these adhesions create pain and tethering immediately. These adhesions can be detected within 2 days of re-formation.
The inner bowel adhesions (between the intestines) might not cause pain; because they are not pulling. The attached intestines move in unison. They are attached -- but in a ball-like form. These adhesions can create bowel constriction, narrowing and thus pain.