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Suggest Treatment For Post Surgical Intestinal Adhesions
Posted on
Fri, 10 Apr 2015
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Fri, 10 Apr 2015
Answered on
Thu, 30 Apr 2015
Last reviewed on
Question : I have listed past medical/surgical history. Following the abdominal surgeries in 2011 I have had continued GI issues (nause, constipation, diarrhea, abdominal cramping and pain), 50+ pound weight gain, noticable hair loss, feeling hot and diaphoretic nearly constantly, sever pain in the abdomen often lower left but generally all over the abdomen. I've had a pelvic US to rule out ovarian cysts which was negative, CT scans checking for obstruction which have always been normal, put on antidepressants by family Dr, started seeing a psychiatrist for anxiety r/t health problems, and do talk therapy with a therapist. My family doctor has pretty much written me off as being depressed and gives the impression that "nothing is wrong with you." I had C Diff x 2 following my last abd surgery in 2/2012. Are there tests, medications, etc I should be pushing for to get to the bottom of this? Thank you, Sue Patton, RN
Brief Answer:
You might have post surgical intestinal adhesions!
Detailed Answer:
Hi XXXXXXX
Thank you so much for sharing yo plight with us. I have reviewed your information fully and I do understand that it must have been a very difficult trend of events for you to handle. Though difficult, understanding what the problem is and making reasonable and helpful recommendations is the way forward. I do promise to do my all in addressing these with you.
1. The digestive symptoms(pain, constipation, nausea, cramping) are suggestive of post surgical adhesions. Because of the many surgical interventions you have had and the complications(abdominal abscess), the intestines are somewhat tied together by small adhesion bands in such a way that movement is no longer free, independent and without pain. This is the main reason why you have these symptoms. The usually treatment is to attempt a procedure called surgical adhesiolysis which consists in identifying bands that hold neighboring intestines together and cutting them apart. However, there is no guarantee to this as some patients never completely get over this condition. Also, at times separating the intestinal loops apart becomes impossible. This procedure is best done using minimally invasive surgical techniques(not opening up the whole abdomen). CT scans often do not see adhesions from surgery because the problem is motility and not with the structure of the intestines.
2. The weight gain, depression and hair falling off may be suggestive of a thyroid problem. I will like to know if the doctors have evaluated the thyroid and what were the numbers? Was everything okay? Beside this, do you have other symptoms like irregular menses, dry skin, feeling fatigued, low pulse, etc? If you do, then I will strongly advice that you get thoroughly evaluated for a possible hypothyroid condition.
3. For now, I will recommend that you take drugs to help address the various symptoms that you have reported. I will will suggest you continue with a healthy diet rich in fruits, vegetables and fibers and try to exercise on most days of the week for at least 30minutes. A good drug for smooth muscle spasms and abdominal pain is bisacodyl. I will like that you give this a try and report the evolution of your symptoms to me.
In all, your past surgical interventions and complications are at the root cause of this. I would like your doctor to role out any possible thyroid disease. Discuss with your doctors about the possibility of having an exploratory laparoscopy to see if there are bands that can be separated to enable the intestines to move freely and independently. Also, healthy diet and Bisacodyl would offer some relief with the abdominal pains and cramps.
I hope this helps. I wish you well. Thanks for using our services and feel free to ask for more information and clarifications if need be.
You might have post surgical intestinal adhesions!
Detailed Answer:
Hi XXXXXXX
Thank you so much for sharing yo plight with us. I have reviewed your information fully and I do understand that it must have been a very difficult trend of events for you to handle. Though difficult, understanding what the problem is and making reasonable and helpful recommendations is the way forward. I do promise to do my all in addressing these with you.
1. The digestive symptoms(pain, constipation, nausea, cramping) are suggestive of post surgical adhesions. Because of the many surgical interventions you have had and the complications(abdominal abscess), the intestines are somewhat tied together by small adhesion bands in such a way that movement is no longer free, independent and without pain. This is the main reason why you have these symptoms. The usually treatment is to attempt a procedure called surgical adhesiolysis which consists in identifying bands that hold neighboring intestines together and cutting them apart. However, there is no guarantee to this as some patients never completely get over this condition. Also, at times separating the intestinal loops apart becomes impossible. This procedure is best done using minimally invasive surgical techniques(not opening up the whole abdomen). CT scans often do not see adhesions from surgery because the problem is motility and not with the structure of the intestines.
2. The weight gain, depression and hair falling off may be suggestive of a thyroid problem. I will like to know if the doctors have evaluated the thyroid and what were the numbers? Was everything okay? Beside this, do you have other symptoms like irregular menses, dry skin, feeling fatigued, low pulse, etc? If you do, then I will strongly advice that you get thoroughly evaluated for a possible hypothyroid condition.
3. For now, I will recommend that you take drugs to help address the various symptoms that you have reported. I will will suggest you continue with a healthy diet rich in fruits, vegetables and fibers and try to exercise on most days of the week for at least 30minutes. A good drug for smooth muscle spasms and abdominal pain is bisacodyl. I will like that you give this a try and report the evolution of your symptoms to me.
In all, your past surgical interventions and complications are at the root cause of this. I would like your doctor to role out any possible thyroid disease. Discuss with your doctors about the possibility of having an exploratory laparoscopy to see if there are bands that can be separated to enable the intestines to move freely and independently. Also, healthy diet and Bisacodyl would offer some relief with the abdominal pains and cramps.
I hope this helps. I wish you well. Thanks for using our services and feel free to ask for more information and clarifications if need be.
Above answer was peer-reviewed by :
Dr. Prasad
Hi Dr. Ditah,
I made an appointment with an internist for next Friday at which time I will talk about all of these things. I know I have terrible adhesions because my surgeon that did my lap chole told me below the umbilicus is a mess of adhesions. I fear undergoing lysis of adhesions may result in another perforation so I'm saving this as a last resort. I am a post-surgical RN and know that the adhesiolysis is not always successful and adhesions often return. If it comes down to that I would certainly seek out a qualified gastro surgeon.
I mentioned the thyroid-like symptoms to my family practice doctor and they drew a TSH level (attached) but no FT4, T4, or T3. I definitely feel fatigued on most days and would say my skin is dry. My HR is not low, generally 60-70 bpm resting.
I truly appreciate your time and sincerity in addressing these issues.
Thanks!
Sue Patton
I made an appointment with an internist for next Friday at which time I will talk about all of these things. I know I have terrible adhesions because my surgeon that did my lap chole told me below the umbilicus is a mess of adhesions. I fear undergoing lysis of adhesions may result in another perforation so I'm saving this as a last resort. I am a post-surgical RN and know that the adhesiolysis is not always successful and adhesions often return. If it comes down to that I would certainly seek out a qualified gastro surgeon.
I mentioned the thyroid-like symptoms to my family practice doctor and they drew a TSH level (attached) but no FT4, T4, or T3. I definitely feel fatigued on most days and would say my skin is dry. My HR is not low, generally 60-70 bpm resting.
I truly appreciate your time and sincerity in addressing these issues.
Thanks!
Sue Patton
Brief Answer:
I will suggest they do a complete thyroid panel. Keep me updated!
Detailed Answer:
Hi,
Thank you so much for this followup information.
I am happy you have a background that helps with understanding what the various challenges are. As I mentioned, we would approach this is a very logical way and save all the aggressive measures for the end. I will appreciate an update from the encounter with your internist. Also, I would suggest you get a full thyroid panel investigations as TSH alone, though in the normal range, would not suffice at this time because of your symptoms.
I know it is difficult. I understand the challenges. However, I call on you to be positive, optimistic and believe in a better tomorrow despite the odds. It is difficult as a physician to watch my cherished clients go through so much pain. Though I cannot take on their pain, I have just one promise to them: I will always be by your side providing the best care possible and you would never walk alone.
With these words, anyway, anytime, feel free to contact me and I would gladly respond to your worries.
I will suggest they do a complete thyroid panel. Keep me updated!
Detailed Answer:
Hi,
Thank you so much for this followup information.
I am happy you have a background that helps with understanding what the various challenges are. As I mentioned, we would approach this is a very logical way and save all the aggressive measures for the end. I will appreciate an update from the encounter with your internist. Also, I would suggest you get a full thyroid panel investigations as TSH alone, though in the normal range, would not suffice at this time because of your symptoms.
I know it is difficult. I understand the challenges. However, I call on you to be positive, optimistic and believe in a better tomorrow despite the odds. It is difficult as a physician to watch my cherished clients go through so much pain. Though I cannot take on their pain, I have just one promise to them: I will always be by your side providing the best care possible and you would never walk alone.
With these words, anyway, anytime, feel free to contact me and I would gladly respond to your worries.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
You are just what the world needs! A compassionate, caring physician who goes the extra mile for his patients! I will definitely update you following my appointment. I appreciate your time.
Thank you!
Thank you!
Brief Answer:
Thanks for your kind words!
Detailed Answer:
Hi XXXXXXX
Thank you so much for your kind words. I am greatly humbled hearing this from you.
Until we next communicate, accept best wishes from me.
Thanks for your kind words!
Detailed Answer:
Hi XXXXXXX
Thank you so much for your kind words. I am greatly humbled hearing this from you.
Until we next communicate, accept best wishes from me.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
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