Ugh, ADHESIONS, the bane of all those who practice the art of surgery. They drive the physician crazy and the patient nuts. So what are we talking about here. After any injury or violation of the body, the way it repairs itself is through healing and scarring. We see it all the time when you get a cut on the skin. Sometimes it heals great, but when the injury is bad, it can really scar. The same thing can happen inside after surgery. The body tries to seal things and control things through the scarring process. Unfortunately, when it comes to the intestines, scarring can be a problem. Remember, healthy intestines are very free flowing so they can accommodate your food. When they get scarred down, there are kinks and turns that may make food difficult to pass. We call that a SMALL BOWEL OBSTRUCTION (SBO).
Most of the time, small, partial small bowel obstructions can pass just with time. You might have pain and feel nauseated, but eventually the food works its way through. In severe prolonged attacks, the food may really be stuck and you can’t even pass gas or have a bowel movement. This may require hospitalization, bowel rest, intravenous fluids, possibly a tube through the nose to suck out digestive juices, and even surgery to free the blockage.
But the problem is not just in the intestinse (though that’s how most people feel it). For me, when I do surgery and there are a lot of adhesions, it makes the operation more complicated and dangerous because I need to free the adhesions before doing whatever needs to be done. In experienced hands, freeing up those adhesions (we call it “lysis of adhesions) can be done safely, but it does carry risks. Whenever I do surgery, I try to think about future operations, so I may put down some treatments to reduce adhesions or use some techniques to prevent them. But there’s no guarantee.
Dr. Eric Liu
Neuroendocrine Surgeon, The Neuroendocrine Institute at Rocky Mountain Cancer Centers
Co-Founder and Chief Medical Advisory of The Healing NET Foundation