Following abdominal or pelvic surgery, bands of scar tissue known as adhesions may develop. These bands can cause tissues or organs that would normally remain separate and move freely against one another to become attached.

Adhesions are common after abdominal surgery and, in most cases, do not cause symptoms or require treatment.

However, some people may experience:

  • Persistent or intermittent abdominal pain.
  • Discomfort or a sensation of tightness in the abdomen.
  • Episodes of partial or complete bowel obstruction.

In some cases, adhesions can cause the bowel to bend, become compressed or twist, making it difficult for intestinal contents to pass normally. This may lead to a bowel obstruction, which requires urgent medical assessment.

Symptoms of Bowel Obstruction

Symptoms may include:

  • Severe abdominal pain or cramping.
  • Nausea and vomiting.
  • Abdominal distension or swelling.
  • A sensation of a swollen or hard abdomen.
  • Inability to pass wind.
  • Constipation or absence of bowel movements.
  • Abnormal bowel sounds or changes in bowel activity.

When to Seek Medical Attention

You should contact a doctor or attend an emergency department if you experience:

  • Severe or worsening abdominal pain.
  • Persistent vomiting.
  • Significant abdominal swelling.
  • Inability to pass wind or open your bowels.
  • Fever associated with abdominal pain.

Your healthcare team may request investigations such as blood tests, X-rays or a CT scan to determine whether a bowel obstruction is present.

Treatment

When the obstruction is partial, treatment may include:

  • Temporary bowel rest.
  • Intravenous fluids.
  • Symptom control and medical observation.
  • Temporary dietary modifications according to the recommendations of your healthcare team.

If there is a complete obstruction, impaired blood supply to the bowel or other complications, urgent surgery may be required.

Surgery to remove adhesions (adhesiolysis) is generally reserved for cases where adhesions cause bowel obstruction or significant symptoms affecting quality of life, as any additional abdominal surgery can itself increase the risk of forming new adhesions.

Most people with abdominal adhesions never develop complications and do not require any specific treatment.