IBS/adhesions/surgical outcomes

From: Tina Shelby (tshelby@usit.net)
Sat Oct 16 16:49:45 1999

Hi all -

I just wanted to comment about the adhesion/IBS relationship - I think some of us may have been diagnosed with IBS first because IBS is what we call a diagnosis of exclusion - which basically means that no disease process (like IBD, diverticulitis etc) was found on GI work-up. Since no "visible" pathology is found then IBS will usually be the diagnosis. It would astound you how many people have a GI work-up and come out with a diagnosis of IBS. When comparing the symptoms of IBS with the symptoms of adhesions - they are very close in nature - diarrhea/constipation/nausea/vomiting/pain with BM's etc. One "red flag" symptom that is not supposed to be assoicated with IBS is night attacks of pain. True IBS episodes only happen when the sufferer is awake. Other symptoms such as fever and an elevated white count are also not considered to be IBS symptomology.

GI specialists are not the best choice for treatment of adhesions. Having assisted with 100's of colonoscopy procedures, I know first hand that if a patient has a difficult colonoscopy because of adhesions the GI specialist will note it on the op report and then write that the colonscopy was normal. Most either do not or choose not to recognize adhesions as a possible explaination for the patient's pain.

According to one study (Menzies&Ellis) - in a study of 210 patients who had > 1 abdominal surgery history - 93% had intra-abdominal adhesions. However
only 2-3% of those patients experienced pain from the adhesions. A study done at UCLA (Rapkin) indicated a direct relationship between complaints of pelvic pain and the density of adhesions. The adhesions were rated according to density ranging from filmy, moderate, and dense. Those with the dense adhesions had more complaints of pelvic pain than those who did not. Other studies that used a rating scale to define the severity of the adhesions also found a relationship beween the complaints of pain and the severity of the adhesions.

In our best interest - there is enough well-documented research that indicates adhesions do cause abd/pelvic pain. So in the past - when I encountered a GI specialist or surgeon who said adhesions did not cause pain - I was able to show them - in their own medical research journals - that they were not correct. Some appreciated the info - others did not. If your health care provider will not acknowledge that adhesions can cause pain - consider finding one who does.

I'm sorry for the length of this post - but I would like to add one more comment. DON'T believe a surgeon/specialist if they tell you they have never had a "case like yours" because some are experts at "playing dumb", and tell you they have never seen such an outcome or of heard anyone complain of such symptoms (leaving you to believe it is just you and no one else in the whole world has had these kinds of problems.) It is for this reason that re-state what Helen Dyna has so often said - knowledge is power - the more you know about what you are dealing with - the less likely someone will be able to convince you that you are strange or that the problem is mental instead of physical. Some health care providers can be hard to convince that a person is having problems when tests and lab results are normal or there is no test to provide an objective measure. Most of us have come to realize that the ONLY true test for adhesions is actually visualization inside the abd cavity by surgery. Sometimes a small bowel series or that torturous entercolysis test will show places where adhesions might be but for most - these tests are usually normal.

I hope this helps -


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