Question: I thought adhesions only grew the first 7 days after surgery; and that they start out pliable and then tighten up and shrink, which is the onset of the pain. Is this true?
Answer: This is true! Adhesion tissue does NOT continue to form unless there is a reason for it to be occuring after seven (7) days. In that case, then these adhesions would be in response to something new -- thus they're called denovo adhesions. The formation of re-formed AND denovo adhesion tissue on a single wound is completed within 7 days -- and it is finished.
Since the formation of adhesion tissue is meant to offer "healing" to wounds -- or any infection or inflammation in or on our bodies -- the response MUST be accomplished as quickly as possible. Adhesion tissue contains -- among other cells -- a sticky substance, called fibrin, that is effective in the clotting of blood so we would not bleed to death.
The cellls of adhesion tissue will bond, so to speak; and cover the wound to protect it from outside pathogens ( germs ). In nursing school we were told: "If blood can get out of a wound, pathogens can get in!!" The peritoneum is a tissue inside of the abdominal/pelvic cavity; and it surrounds all of our internal organs. The peritoneum is there to keep ALL harmful pathogens out of the abdominal/pelvic cavity! Not even microscopic foreign particles are meant to be in the abdominal/pelvic cavity!!! Dried, unoxygenated blood is also a foreign body to our own body! Regardless if it is our own blood, it is no longer usefull to us and should not be there. The purpose of the peritoneal tissue is to maintain a sterile environment for all of the organs within the peritoneum .
In the event there is an infectious situation inside the peritoneum -- such as appendicitis ( inflammation of the appendix due to infection ) -- the body will immediately surround and encase the appendix in adhesions. Since there is a "threat" of the infection spreading out and contaminating other organs within the peritoneum, this infection could cause peritonitis! In most cases, peritonitis is potentially life-threatening!
The body MUST create adhesion tissue on any potentially "threatening" abnormal pathology within the abdominal/pelvic cavity; and it had better do it as quickly as possible.
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Question: Do adhesions multiply or continue to grow??
Answer: No, adhesions do NOT multiply or continue to grow!! Adhesions do NOT spread or extend out from themselves! That is NOT how an adhesion forms or functions; because adhesions fulfill a very necessary function in our body . The body creates an adhesion at the site of a wound or problem.
In the case of post surgical adhesions, there are many small blood clots, powder from the surgeon's gloves, gauze and even the drying out of tissue -- either on the surfaces of our internal organs from CO2 being pumped into the abdominal/pelvic cavity or from the exposure of our internal organs to the outside air during a laparotomy. Any of these will send a signal to our body that there are abnormal pathogens ( germs ) that need to be taken care of -- or invading tissue, shall we say.
So our body sends out the adhesion army to combat the foreign tissue, which is a"threat" to its sterile environment!! Because there is so much carelessness during surgeries -- with laparotomies exposing our internal organs to everything but the kitchen sink while our internal organs are exposed to the operating room environment -- what is our body supposed to do??
The reason some post surgical patients suffer pain -- as a result of adhesion formation -- is due to the attachment sites of the adhesions. It is not that our body produces any more adhesion tissue than anyone else. We are no different than anyone else who has surgery. Everyone develops adhesions as a result of surgery; because the development of adhesions is a normal protective function of the human body; but not everyone experiences pain because of the adhesions. The experience of pain is dependent upon the attachment sites of the adhesions.
Adhesions are a problem for those of us who suffer from them; but adhesions are the body's defense system as well. If there weren't so much intrusion into our abdominal/pelvic cavity -- and especially if all surgeons were meticulous in their clean-up before closing their patients up following a surgery -- we, who suffer from Adhesions-related disease ( ARD ), would not be suffering as we do!
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Question: I thought once they reached the 7 day growth, they were done growing??
Answer: You are correct!
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Question: How then do they obstruct a bowel or continue to "weave" themselves among other organs??
Answer: Adhesions do NOT "continue to weave themselves among the other organs!!" They only get tougher. While that process can take time, it starts right away!! Depending on the insult to the internal organs, the longer adhesions remain tethered from one organ to another -- and how the adhesions are attached in the abdominal/pelvic cavity -- the adhesions will toughen, tighten and create pulling of the attached organs or cause constriction around an organ, whichever way the adhesions are formed.
If the adhesions surround the intestine, the adhesions will squeeze that organ thus causing constriction and probable bowel problems. As the adhesions a pulling one organ from another, this will cause pain and dysfunction to the attached organs. Keep in mind that this is occuring INSIDE the abdominal/pelvic cavity; but on the OUTSIDE of the tissues of your internal organs.
Adhesions will NOT be seen by a proctoscope or an endoscopic diagnostic test. A narrowing of the bowel may be visualized; but the adhesions will NOT and CANNOT be seen by looking at the internal organ via a scope placed inside the organs. There is only one way that adhesions can be diagnosed; and that is a surgical procedure. Currently, a diagnostic laparoscopy is the only known way to diagnose adhesions!!
It bears repeating: Adhesions that attach and tether down organs that are meant to move freely, will toughen over time; and decrease the affected organ's ability to function as it is meant to function. At the same time the person will experience more pulling or constricting on the affected organs -- and thus an increase in symptoms.
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Question: Adhesion tissue does NOT weave itself anywhere?
Answer: Due to the many microscopic blood clots left in the abdomen from the surgical wounds -- including the splattering of blood in the abdominal/pelvic cavity during surgery -- adhesions are formed all over inside the body cavity; thus giving the appearance of " weaving." It's like pathogens ( germs ) have been thrown all over within the body cavity.
For example: Imagine taking a handful of micro-sized sand particles and spilling them into your abdomen. Then your body sends out the adhesion tissue army! The body's fibrins and cells must surround each and every micro particle of that sand ( pathogens or germs ) in your abdominal/pelvic cavity!! Think of that process; and you will understand why adhesions appear to be everywhere within the abdominal/pelvic cavity. Well, they probably are everywhere!!
BUT...if the only surgical procedure a person has had is an appendectomy, it is not unusual to find the formation of adhesions located pretty much in the lower right quadrant. These adhesions are NOT found to be "weaved" throughout the entire abdomen. After numerous invasive surgeries though, adhesions will be found throughout the abdominal/ pelvic cavity!!