Major Medical Facilities

From: Anne Hayashi (
Wed Jun 2 18:36:23 1999

It was interesting to read your postings about your visit to the Mayo Clinic and other major medical facilities. I also visited the Mayo Clinic and had the standard battery of tests with the results that "their impression was that it may represent either a nerve entrapment syndrome in the scar or myofascial pain syndrome." I later had a laparoscopy and what was found was "massive adhesions between the bladder, sigmoid and anterior abdominal wall with massive adhesions between the omentum and the previous incisions in the abdomen."

I think another facet of the problem is that the Mayo Clinic and probably most M.D.s believe that adhesions do not cause pain. There is a study out by Fayez and Clark conducted on patients with chronic abdominal pain associated with adhesions. I will quote a part of the study, "At laparoscopy, it was noted that pain symptoms corresponded with the location of the adhesions. Chronic lower abdominal pain was associated with bowel and/or omentum attachment to the lower portion of the abdominal wall...Upper abdominal pain was associated with bowel and omentum attachment to peritoneum covering previous incisions such as those used for bowel or gallbladder surgery. The organs adjacent to areas where previous surgery was performed were invariably involved with adhesions."

So, I am guessing that since the Mayo Clinic seems to believe that adhesions only cause problems when there is bowel obstruction, it is impossible to get a diagnosis that pinpoints adhesions as the pain culprit, even though studies are coming out that note a high correlation between pain and the location of certain adhesions. Also, even if it is adhesions, it is difficult to know how to help the patient get rid of them,since they also know that surgery can cause more adhesions for the patient. A differential diagnosis has to be made, thus the battery of tests, but there also has to be an admission that ADHESIONS CAN AND DO CAUSE A LOT OF PAIN PROBLEMS above and beyond bowel obstruction. You can't work on a problem until you believe there is one. There will also be very little research money until there is general acceptance that there is an urgent need to solve the adhesion problem.

O.K. I am off my pulpit. My gratitude and thanks again to Dr. Wiseman for all of his efforts and for this forum. I hope that all of us acting together can make a difference.

Anne Hayashi

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