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From: KathFindlay
To: Multiple recipients of list ADHESIONS
Sent: Sunday, July 01, 2001 8:40 PM
Subject: Sigmoid Adhesions Could Cause Irritable Bowel Symptoms Article 1, 1Jul 01.doc
Irritable Bowel Symptoms
Sigmoid Adhesions Could Cause Article 1, 1Jul 01 Obstetrics and Gynaecology Communications
By Elda Hauschildt
Treatment failure in women with irritable bowel syndrome (IBS) could be the result of sigmoid adhesions that have developed around the colon, deflecting the colon from its normal position.
Dr. B.W. Bost, a researcher at St. Elizabeth Hospital in Beaumont, Texas, points out that in many women, the sigmoid colon is attached to the pelvic sidewall through filamentous and fibrous adhesions.
Such tissue attachments are considered normal. But "they often deflect the course of the colon as it enters the pelvis," Dr. Bost says.
To evaluate the possible relationship between deflecting sigmoid adhesions, chronic pelvic pain and gastrointestinal symptoms, Dr. Bost evaluated 146 women with chronic pelvic pain.
Laparoscopy was used to grade each sigmoid attachment by the degree of deflection. Three degrees were included: mild, moderate and severe.
Attachments were cut as needed to return patients' colons to a position of minimal deflection.
Dr. Bost found that 38 percent of the patients evaluated had deflecting sigmoid adhesions. Often, the adhesions were found in association with endometriosis.
"However, deflecting sigmoid adhesions were the only abnormality found in 23 percent of cases," Dr. Bost notes. Several of these women had been referred because of treatment failure for IBS.
Of sigmoid adhesions-only patients, 80 percent reported significant reductions in their symptoms at six-, 12- and 18-month follow-up.
"Deflecting sigmoid adhesions were common in this group of women with chronic pelvic pain and frequently were associated with gastrointestinal symptoms," Dr. Bost concluded.
"Further investigation of this entity is warranted."
In Friendship Katherine Findlay United Kingdom Adhesion Society mailto:kath.findlay@adhesions.org.uk http://www.adhesions.org.uk