International Adhesions Society





A Patient's Guide to Adhesions & Related Pain (part 6)

Treatment of Adhesions

Despite doubts as to the relationship between ADHESIONS and pain, several studies show that lysis (cutting, adhesiolysis) (photo) of ADHESIONS provides some relief.

In a study in Germany (Frey et al., 1994) 58 (40 female, 18 male) patients with chronic abdominal pain underwent laparoscopy.  Other than adhesions, there were no abnormal findings.  The ADHESIONS were then cut (adhesiolysis) and the patients’ pain was assessed up to 30 months later.  There was a complete remission of pain in 45% of the patients, with 35% of patients reporting a substantial improvement.  Pain persisted in 205 of the patients.  Similar figures were reported by a Swiss group (Mueller et al., 1995).  American surgeons such as Steege and Stout (1991) and Daniell (1989) have also reported improvement in pain after adhesiolysis.  In a Dutch study (Peters et al., 1992), only patients with chronic pelvic pain and severe adhesions benefited from adhesiolysis.

If there is an underlying cause of adhesions, such as endometriosis or infection, then clearly this must be treated.  A full discussion of endometriosis is well beyond the scope of this paper, and I thoroughly recommend visiting the Endometriosis Society web site for more information.

The problem with adhesiolysis is that ADHESIONS almost always reform, and so the procedure is sometimes self-defeating.  This is one of the main reasons why surgeons are reluctant to perform adhesiolysis, particularly in severe cases.  In addition, the presence of adhesions makes surgery more hazardous, because of the risk of injury to the bowel, bladder, blood vessels and ureters.  As we have seen, some patients may have periods of relief from and/or bowel obstruction for several months, only to have the problem recur, as in this email I received:

"Subj: adhesions
 Date: 98-04-04

I have come back from the [Famous Hospital], the GI specialist said that they were 10 - 12 years from knowing how to treat this problem. I still run into alot of MD's who say adhesions don't cause pain, but since I have had 7 surgeries and each time adhesions are "taken down" I get about 1 years worth of pain relief. I have even showed them research studies that show a decrease in pain s/s after surgery and they still are skeptical. Anyway, they are sending me to a Dr. XXXX who supposedly specializes in this kind of pain. I hope to have an appointment at the end of April. I'll let you know how it turns out. Keep me informed of any developments that might be helpful with my case. Thanks"

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