Post-Surgery Bowel Adhesions and Their Symptoms - Surgery

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Why do adhesions or bowel obstructions occur after surgery?


Dear Dr.
Ke,
Thank you very much for taking the time to respond.
My father was discharged from the hospital on Monday and is now recovering at home.
However, he still requires nutritional IV infusions and is unable to eat solid food.
Recently, my father's stoma has started to produce some drainage, although there hasn't been any solid output.
Today, he mentioned that he has been passing gas from the stoma, and there has been quite a bit of it.

He hadn't been able to pass gas for over three weeks, and his abdomen was quite distended.
In the past couple of days since his discharge, he has reported that he is now able to pass gas and that there is also some drainage from the stoma.
Initially, his attending physician suspected that he might have intestinal adhesions.
Now that my father can pass gas and his abdominal pain has decreased, along with some reduction in abdominal distension, does this still indicate the presence of adhesions? Does this mean that my father is significantly improving? Will there be a possibility of further complications in the future?
Thank you for your guidance.

Yifang, 20~29 year old female. Ask Date: 2007/08/30

Dr. Ke Fangxu reply Surgery


Hello: In response to your question, congratulations on your father's recovery and discharge from the hospital.
Based on the process, it seems more like intestinal adhesion.
Unfortunately, intestinal adhesions can recur, and generally, there are no effective preventive measures.
It is usually recommended for patients to eat small, frequent meals and to consume easily digestible foods.
Last year, National Taiwan University published a study on a three-in-one therapy (gascon + MgO + digestive enzyme) that claims to reduce the likelihood of recurrence of intestinal adhesions.
However, opinions in the academic community are divided.
Nevertheless, these three medications have minimal side effects, and based on my experience with patients, they seem to work well.
It might be worth trying, and I hope your father will not experience any further intestinal adhesions.

Reply Date: 2007/08/30

More Info


Post-surgery bowel adhesions are a common concern following abdominal surgeries, including those for colorectal cancer. Adhesions are bands of scar tissue that can form between abdominal tissues and organs, often as a result of surgical trauma. They can lead to various symptoms, including bowel obstruction, abdominal pain, and changes in bowel habits. Understanding the implications of these adhesions and their symptoms is crucial for patients and their families.

In your father's case, it seems that he is experiencing some improvement after surgery, particularly with the ability to pass gas and the reduction of abdominal pain and bloating. This is a positive sign, as it indicates that his digestive system may be starting to function more normally. The fact that he is able to pass gas suggests that there is some degree of bowel movement occurring, which is essential for recovery.

Initially, the presence of abdominal distension and difficulty in passing gas can be indicative of bowel obstruction, which is a potential complication of adhesions. However, as your father begins to pass gas and experiences less pain, it may suggest that any initial obstruction is resolving. This improvement is encouraging, but it is essential to remain vigilant for any recurring symptoms.

It's important to note that while the ability to pass gas and the reduction of bloating are positive developments, the risk of adhesions can persist even after initial recovery. Adhesions can sometimes lead to intermittent bowel obstructions, which may present with symptoms such as abdominal pain, nausea, vomiting, and changes in bowel habits. Therefore, ongoing monitoring of your father's condition is crucial.

In terms of management, there are several strategies that can help minimize the risk of complications related to adhesions:
1. Dietary Adjustments: Once your father is cleared to eat, a gradual introduction of a low-fiber diet may be beneficial initially, as it can help reduce the workload on the intestines. Gradually increasing fiber intake can help normalize bowel function.

2. Hydration: Ensuring adequate fluid intake is essential for maintaining bowel health and preventing constipation, which can exacerbate discomfort.

3. Physical Activity: Encouraging gentle movement, as tolerated, can help stimulate bowel function and reduce the risk of adhesions forming.

4. Follow-Up Care: Regular follow-up appointments with the healthcare provider are essential for monitoring recovery and addressing any concerns that may arise.

5. Awareness of Symptoms: Educating your father and family members about the signs of bowel obstruction, such as severe abdominal pain, vomiting, or inability to pass gas or stool, is crucial. If these symptoms occur, seeking medical attention promptly is important.

In conclusion, while your father's ability to pass gas and the reduction of abdominal pain are positive indicators of recovery, it is essential to remain cautious about the potential for adhesions and their associated complications. Continuous monitoring and proactive management can help ensure a smoother recovery process. If any concerning symptoms arise, do not hesitate to reach out to his healthcare provider for further evaluation and guidance.

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