Adhesion process after. Causes of intestinal adhesions, their symptoms and treatment methods. Causes of adhesions in the pelvis

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Thin films of connective tissue between internal organs are adhesions. After surgery, they occur most often. Consider the features of their appearance and treatment.

The internal organs of a person are covered on the outside with a thin membrane that separates them from each other. A small amount of fluid and the smoothness of the tissues ensures the displacement of organs during movements.

Normally, after the operation, the internal organ is scarred, and the period of its healing is called the adhesive process. That is, connective tissue adhesions (similar to a plastic film or fibrous strips) are physiology that goes away on its own and does not disrupt the functioning of the body.

With the development of the pathological process, the strands stick together, disrupting the normal movement and functioning of organs. After surgery, they are most often diagnosed on such organs:

Appendix and intestinal lesions - lead to obstruction of the organ and require additional surgical treatment.
Formations in the small pelvis - can significantly disrupt women's health and the possibility of conceiving a child.
Inclusions in the ovaries or tubes - occur due to inflammation of the appendages or infectious lesions, can lead to infertility.
Without timely diagnosis and treatment, it threatens with serious complications and severe pain.

What are the dangers of adhesions after surgery?

Very often, patients wonder why adhesions after surgery are dangerous. So, if strands appeared in the abdominal cavity, for example, in the small intestine, then this negatively affects the functioning of the digestive system. Such neoplasms complicate any surgical interventions in the abdominal cavity, significantly increasing the risk of organ perforation and bleeding.

Connective tissue inclusions in the peritoneum are dangerous because they can cause intestinal obstruction and intestinal obstruction. Neoplasms bend and stretch individual parts of the intestines or organs, disrupting their work. In this case, a life-threatening condition is complete intestinal obstruction.

The proliferation of connective tissue on the respiratory organs causes respiratory and cardiovascular failure. Due to a violation of the local blood supply, tissue necrosis and the development of peritonitis are possible. A lot of dangerous formations on the pelvic organs. So, adhesions of the ovary, uterus or intestines can cause obstruction of the fallopian tubes and infertility.

ICD-10 code

K66.0 Peritoneal adhesions

Epidemiology

According to medical statistics, the epidemiology of adhesions in 98% of cases is associated with surgical intervention. Women suffer from adhesive disease more often (after appendectomy and operations on the uterus and appendages) than men (abdominal injuries).

After surgery on the abdominal organs, 80-85% of patients develop adhesions on the small and large intestines.
Repeated laparotomy leads to the formation of adhesions in 93-96% of patients.
After appendicitis, intestinal adhesions appear one year later in 23% of those operated on and three years later in 57%.
After gynecological pathologies, in 70% of cases, cords occur on the uterus and ovaries.

The formation of collagen fibers begins on the third day of the pathological process, and connective tissue adhesions appear from 7 to 21 days. During this time, loose strands are transformed into dense scar tissue, blood vessels and even nerve endings appear in them.

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Causes of adhesions after surgery

There are a number of factors that affect the growth of the connective tissue of internal organs. The reasons for the formation of adhesions after surgery largely depend on the professionalism of the surgeon. Most often, the pathological condition occurs when:

Inflammatory and infectious complications.
Bleeding in the abdomen.
Injuries of the abdomen and pelvic organs.
Prolonged tissue ischemia.
Foreign objects in the wound.
Violations of the technique of the operation.

The adhesive process can be provoked by the patient himself, due to failure to follow the doctor's recommendations for recovery after surgery. Bands are formed after appendicitis, ectopic pregnancy or abortion, with intestinal obstruction, endometriosis and stomach ulcers.

Based on this, we can conclude that postoperative inclusions are formed for a variety of reasons. Without timely diagnosis and treatment, they impede the functioning of internal organs, which leads to various complications.

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Risk factors

The proliferation of connective tissues of internal organs, in most cases, is associated with surgical intervention, but there are other risk factors. A pathological condition is possible with:

Strands in the abdominal cavity can form with bruises and injuries of the abdomen. Hemorrhages in the retroperitoneal space and hematomas in the mesentery lead to lymphostasis and impaired blood outflow. In turn, this leads to a violation of exudation into the abdominal cavity. As a result, the internal organs are left without natural lubrication, they begin to rub against each other and become soldered.
Abdominal obesity - excess adipose tissue in the area of a huge omentum, that is, the folds behind the visceral sheet of the peritoneum and the closing loop of the intestine, can provoke connective tissue adhesions. The loose tissue of the omentum is especially sensitive to the formation of strands due to the pressure of fatty deposits in the abdomen.
Adhesions can occur during inflammatory processes. For example, in chronic cholecystitis, adhesions appear not only on the gallbladder, but also on the liver, stomach, duodenum, and omentum. Most often, this is observed after influenza, dysentery or Botkin's disease.
Another risk factor is congenital malformations of the abdominal organs. As a rule, adhesions are diagnosed in the ileum and caecum.
Some chemicals promote the formation of strands. For example, alcohol, Ravinol and iodine lead to aseptic inflammation of the abdominal cavity. Most often, these fluids enter the peritoneum during surgery.

In addition to the above factors, there is a huge risk of adhesions after laparotomy. Any operation on the abdominal organs is associated with mechanical trauma to the peritoneum. At the same time, the rougher the surgeon will work, the higher the risk of pathological accretion. The disorder occurs due to a violation of the fibrinolytic system of the body.

Pathogenesis

The mechanism of development of strands of internal organs is associated with cellular and humoral processes. The pathogenesis of adhesions after surgery is based on a violation of the local balance between the synthesis of fibrin and fibinolysis, that is, its splitting. Surgical interventions lead to damage to the mesothelial layer of tissues and blood vessels. This results in an inflammatory response and activation of inflammatory mediators and the formation of blood clots.

The permeability of blood vessels gradually increases, and damaged tissues secrete serous-hemorrhagic exudate (contains leukocytes, platelets, interleukins, macrophages, fibrinogen, hyaluronic acid, proteoglycans). Under normal conditions, fibrin undergoes lysis, but due to the operation, fibrinolytic activity decreases, and excess fibrinogen is transformed into a kind of gel that covers the affected tissues. Gradually, fibroblasts grow and fasten together, transforming into internal scars, that is, adhesions.

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Symptoms of adhesions after surgery

The duration of the formation of connective tissue adhesions directly depends on the affected organ. Symptoms of adhesions after surgery are most often manifested by painful sensations in the area of the surgical scar.

The most common symptoms of postoperative disorder are:

Nausea and vomiting.
Defecation disorder.
No chair.
Regular constipation.
Pain on palpation of the surgical suture.
Increase in body temperature.
Difficulty breathing and shortness of breath.
Redness and swelling of the outer scar.

Initially, pain symptoms are absent, but as the scar thickens, they become pulling. Discomfort increases with physical exertion and any movement. For example, after surgery on the liver, lungs or pericardium, pain occurs with a deep breath. If adhesions form on the pelvic organs, then pain during intercourse is possible. The clinical picture depends on the localization of the strands and the general condition of the body.

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First signs

Very often, after surgery, patients are faced with such a problem as connective tissue adhesions between adjacent organs or surfaces. The first signs of the adhesive process are manifested by cramping pains in the area of the scar. Discomfort is aching in nature and increases with physical exertion.

The pathological condition is accompanied by bouts of nausea and vomiting. There may be bloating and frequent constipation. Paroxysmal pains weaken and resume. Because of this, the patient becomes irritable, changes in body weight due to lack of appetite are possible. As the disease progresses, disorders of the cardiovascular and respiratory systems appear.

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Pain with adhesions after surgery

Symptoms such as pain with adhesions after surgery occur in many patients. Discomfort is paroxysmal and cutting in nature. At the same time, taking antispasmodics and painkillers does not give positive dynamics.

Depending on the pain, there are such forms of adhesions:

Acute form - adhesions cause pain of varying intensity, which leads to a sharp deterioration in well-being. The temperature rises, shortness of breath appears, the pulse quickens. Attempts to palpate the postoperative scar cause severe pain. Against this background, intestinal obstruction, renal failure may develop.
Chronic form - if the cords are formed in the pelvis, then the symptoms of the disease are similar to premenstrual syndrome. There may be disturbances in the work of the intestines and bladder. Pain occurs during sexual intercourse and when the position of the body changes.
The intermittent form is characterized by severe disturbances in the functioning of the organs of the gastrointestinal tract. Chronic constipation is replaced by indigestion. Pain occurs less frequently, but quite intense.

In addition to pain, frequent bouts of nausea and vomiting, appetite disturbances, loss of working capacity, migraine and dizziness appear.

Intestinal adhesions after surgery

Formations from the connective tissue between the loops of the intestines and the abdominal organs are intestinal adhesions. After surgery, they appear most often. Surgical intervention leads to adhesion of the serous membranes of the organs to each other and to their functional disorders. In this case, the strands consist of the same tissue as the outer wall of the intestine.

Consider the main causes of the appearance of connective tissue adhesions of the intestine:

Surgical intervention - according to medical statistics, if a primary laparotomy intervention was performed on the intestine, then inclusions form in 14% of patients. If this is a 3-4 operation, then soldering occurs in 96% of cases. Pathology is aggravated by infectious and inflammatory processes.
Abdominal injuries (open, closed) - very often mechanical damage leads to internal bleeding. Hematomas are formed on the intestines, lymphatic outflow and metabolic processes in the tissues of the organ are disturbed. Inflammation develops, which provokes the adhesive process.

In addition to the above reasons, the disorder may occur due to inflammation of the appendages in women, with congenital anomalies in the development of the organ, foreign bodies in the peritoneum, or taking certain medications.

There are additional risk factors for adhesions after bowel surgery:

Organ tissue ischemia.
Imposition of non-absorbable sutures.
Postoperative infections.
intraoperative trauma.
Blood in the peritoneum after surgery.
Hereditary predisposition to the formation of strands.
Connective tissue hyperactivity.
Decreased local immunity.

Symptoms of a pathological condition are divided into several stages. The first thing the patient encounters is intestinal obstruction. There are paroxysmal pains in the abdomen, which are complemented by nausea and profuse vomiting. Possible asymmetrical bloating. Palpation of the abdominal cavity causes severe pain. Early adhesive obstruction, as a rule, is formed against the background of an inflammatory process. If you leave this condition without medical care, it will lead to intoxication complications and paresis of the organ.

Diagnosis of postoperative intestinal pathologies is based on the characteristic symptoms, visual examination of the patient and the collection of anamnesis. To clarify the diagnosis, plain radiography of the abdominal cavity, electrogastroenterography, ultrasound and MRI, and laparoscopy are used. During research, it is necessary to differentiate strands from other types of acute intestinal obstruction or tumor formations. Surgical treatment, with a course of physiotherapy to prevent the growth of connective tissue.

Adhesions after abdominal surgery

Almost every patient faces such a pathology as adhesions after abdominal surgery. The proliferation of connective tissue can lead to adhesive disease, which is accompanied by serious dysfunction of the internal organs.

The adhesive process with a large incision of the abdominal wall, that is, after laparotomy, can occur for the following reasons:

inflammatory reactions.
Infectious complications of the operation.
Anti-clotting.
Increased protein content in the blood.
Individual characteristics of the organism.

If, during traumatization of the peritoneum, only one of its sheets is damaged, and the one with which the internal organs are in contact, intact adhesions, as a rule, are not formed. If soldering still appears, then this does not lead to dysfunction of the organs, since the strands are superficial and easily delaminate.

If two adjacent sheets were injured, then this triggers a series of pathological reactions. Violation of the integrity of blood capillaries is associated with certain blood proteins, and adhesion of organs with coagulation factors and the action of globulins.

Connective tissue adhesions are small, but can lead to deformation of the organ structure. Clinical signs of the disease depend on the location and size of adhesions. Most often, patients face such problems: abdominal pain, deterioration in general well-being, constipation, nausea and vomiting. Pain occurs due to disruption of the functioning of the intestine, and, as a rule, they have a paroxysmal character. To diagnose the disease, anamnesis is collected and the patient is examined. Surgical treatment.

Adhesions after hysterectomy

Seals from the connective tissue that occur during surgical interventions and inflammatory processes are adhesions. After surgery to remove the uterus, they occur in 90% of women. Strands are a rather dangerous complication, as they can lead to functional disorders in the functioning of internal organs and even to severe intestinal obstruction.

Hysterectomy, that is, removal of the uterus, is characterized by the formation of connective tissue scarring at the site of incisions and scars. If the physiological process proceeds with complications (infection, inflammation), then the fibrous cords continue to grow and grow into other internal organs.

The main reasons for the growth of connective tissue after removal of the uterus depend on such factors:

The duration of the operation.
The scope of the surgical intervention.
Volume of blood loss.
Endometriosis.
Genetic predisposition to adhesive disease.
Internal bleeding and infection of wounds in the postoperative period.
Immune system disorders.

In addition to the above factors, the development of pathology largely depends on the actions of the surgeon. In some cases, the disorder occurs due to foreign objects in the abdominal cavity, for example, if fibers from a tampon or gauze get into the wound, particles of talc from the surgeon's gloves.

Signs of the development of the pathological process are manifested by the following symptoms:

Drawing and aching pains in the lower abdomen. The discomfort is intermittent.
Urination and defecation disorders.
Dyspeptic disorders.
A sharp rise in temperature.
Pain during intercourse.

If more than a month has passed since the hysterectomy, and the above symptoms do not go away, you should immediately seek medical help. To diagnose the disorder in the postoperative period, the patient is prescribed the following examinations:

Complex of laboratory researches.
Ultrasound examination of the abdominal cavity and pelvic organs.
X-ray of the intestine with contrast.
Laparoscopic diagnostics.

Connective tissue adhesions are treated surgically. Dissection and removal of neoplasms is carried out using laser therapy, aquadissection, electrosurgery. In the postoperative period, medical prophylaxis is indicated. The patient is prescribed broad-spectrum antibiotics and anticoagulants. Physiotherapy is also prescribed with electrophoresis of enzymes that destroy fibrin.

If you leave adhesions in the uterus without treatment, this will lead to the fact that the fallopian tube will turn into a connective tissue sac. The body will lose the ability to promote fertilized eggs. In this case, even surgical treatment is not able to restore the functions of the fallopian tubes, which is one of the causes of infertility.

Adhesions after appendicitis surgery

One of the most common surgical interventions is the removal of the appendix. Despite the simplicity of the procedure, the patient has a long recovery period. Adhesions after appendicitis surgery are formed quite often and are one of the complications.

The proliferation of connective tissue is associated with irritation of internal organs due to mechanical action on them. Dense strands gradually form on the membranes that cover the intestines. They grow among the internal organs, occupying a certain space. The pathological process is accompanied by damage to the blood vessels and leads to deformation of the intestine due to the fusion of its loops with each other.

The appearance of strands after treatment of appendicitis is associated with such factors:

Removal of the appendix by an open method, and not by laparoscopy.
A protracted inflammatory process after surgery (the tissues of the peritoneum and intestines are affected by pathogens and their toxins).
Genetic predisposition to increased activity of certain enzymes that accelerate the scarring process.
The development of pathology due to a medical error (for example, a napkin left in the abdominal cavity).
Coagulation (when blood vessels are cauterized, strands may form) or internal bleeding.

The painful condition is manifested by pulling pains in the area of the postoperative scar and deeper in the abdomen. Against this background, there are symptoms from the gastrointestinal tract: bloating, nausea and vomiting. There is also a decrease in blood pressure and disruption of the heart, general weakness. For the diagnosis of connective tissue adhesions, an ultrasound examination of the abdominal cavity, anamnesis, a set of laboratory tests, radiography and diagnostic laparoscopy are indicated.

Treatment depends on the results of the diagnosis. The patient is prescribed conservative therapy, which consists of taking medications, following a therapeutic diet and physiotherapy. In especially severe cases, surgical treatment is prescribed. The operation is carried out using a laser or an electric knife. The doctor dissects adhesive formations, freeing the organs.

Leaving appendicitis bands without medical attention can lead to serious complications. First of all, it is intestinal obstruction due to squeezing of the loops of the organ. With damage to the appendages, uterus or patency of the fallopian tubes, infertility may develop. The most dangerous complication is tissue necrosis. Adhesions put pressure on tissues and compress blood vessels, which leads to circulatory disorders. The bloodless area gradually dies off.

Adhesions in the nose after surgery

Synechia or adhesions in the nose after surgery are connective tissue cartilage or bone bridges between the mucous walls of the nasal sinuses. In addition to surgery, neoplasms can also appear for the following reasons:

Intrauterine development disorders and genetic pathologies.
Chemical or thermal burns of the mucosa.
Infectious diseases.
Regular nosebleeds.
Syphilis.
Scleroma.

In some patients, the bands do not cause discomfort, as they are soft and thin. But most often, patients face such problems:

Difficult nasal breathing.
Voice change.
Dryness in the throat in the morning.
Full or partial perception of smells.
Inflammation of the upper respiratory tract.
Inflammation in the paranasal sinuses.

Synechia in the nasal cavity are distinguished depending on their location and the tissue from which they are formed. If the growths formed in the vestibule of the nose, then they are anterior, the inclusions between the nasal concha and the septum are median, and the formations in the choanal region are posterior synechia. The last type of splicing is the most dangerous, as they can completely or partially block the air supply from the nose to the throat.

Connective tissue strands are also distinguished, which have a soft texture and are easily dissected. More dense and bone neoplasms are most often a sign of congenital pathology and require surgical treatment. To diagnose postoperative adhesions in the nose, you should contact an otolaryngologist. With the help of rhinoscopy, the doctor determines the presence of pathology. It is also necessary to pass a complex of laboratory tests that will reveal inflammatory processes and other disorders.

Treatment is carried out only surgically, since the neoplasms do not resolve on their own. For this, a classic operation can be prescribed, that is, removal with a scalpel, laser removal or radio wave exposure. Drug therapy is used only to stop the infectious or inflammatory process.

If the pathology is left untreated, it can lead to various ENT diseases (pharyngitis, otitis media, pneumonia, bronchitis). In addition, insufficient ventilation of the paranasal sinuses is an ideal environment for infection, which can affect the ears and affect the quality of hearing.

Adhesions in the pelvis after surgery

Connective tissue adhesions in the pelvic organs is a common pathology among women that leads to infertility. Adhesions in the pelvis after surgery occur due to tissue trauma and various inflammatory complications. At the same time, the longer and more traumatic the operation, the higher the risk of cord formation.

The clinical picture of the adhesive process has several forms:

Acute - the pain syndrome has an increasing character. There is nausea and vomiting, fever, increased heart rate. When trying to palpate the abdomen, sharp pains occur. It is also possible acute intestinal obstruction, general weakness and drowsiness, urination disorders.
Intermittent form - periodic pain, there are intestinal disorders (diarrhea, followed by constipation).
Chronic - the symptoms of this form are hidden. Aching pains in the lower abdomen, constipation. Most often, this type of disorder is diagnosed by chance, during an examination for suspected infertility or endometriosis.

Diagnosis is difficult. At the initial request for medical care, the doctor collects an anamnesis and complaints of the patient. Bimanual examination reveals the immobility of organs or their limited displacement. Ultrasound, MRI, laboratory tests and other examinations are also performed.

Treatment of cords after surgery in the small pelvis consists of medical and surgical methods. To remove adhesions and separate organs, the following methods are used: laser therapy, aquadissection, electrosurgery. Conservative therapy is based on the elimination of the inflammatory process. Patients are shown a therapeutic diet, physiotherapy and a set of other measures for normal recovery.

Adhesions after gallbladder surgery

The formation of strands during cholecystectomy occurs in every third patient. Adhesions after gallbladder surgery are associated with several factors, consider them:

Injuries and bruises of the peritoneum, which disrupt the outflow of blood from the tissues lining the surface of the abdominal cavity.
Aseptic inflammation caused by certain substances (alcohol, iodine or rivanol solution) entering the peritoneum during surgery.
Inflammatory infiltration in the area of surgical intervention.
Chronic cholecystitis causes cicatricial changes in the gallbladder, which significantly complicates the process of its removal and recovery after surgery.
Atypical anatomical structure of the organ, its vessels and bile ducts.

Risk factors for the appearance of adhesions include the patient's advanced age, overweight, and the presence of chronic diseases. A painful condition may be associated with blood or an inflammatory fluid that did not resolve after the operation, but thickened and was replaced by connective tissue.

Symptoms of strands after gallbladder surgery are manifested by a decrease in pressure, sharp sharp pains, constipation, general weakness and fever. If the pathology becomes chronic, then the following symptoms occur: intestinal spasms, bloating, vomiting mixed with feces, severe thirst, deterioration in general well-being.

Treatment depends entirely on the physical condition of the patient and the course of the adhesive process. As a drug therapy, anticoagulants, proteolytic enzymes, fibrinolytics are indicated. In severe cases, surgery is performed. Particular attention is paid to prevention, which consists of a special diet and physiotherapy.

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Adhesions after ovarian surgery

There are a number of reasons why adhesions form after ovarian surgery. The main factor is a long-term inflammatory process, infection or complications during the operation. Possible causes of the disorder include:

Erosion of the cervix or violations during its cauterization.
Numerous tears received during childbirth.
External endometriosis and blood entering the abdominal cavity.

The risk of postoperative adhesions directly depends on the individual characteristics of the patient's body and on compliance with medical recommendations after surgery. That is, abdominal trauma, various diseases of the pelvic organs, STDs, abortion, hypothermia, and even prolonged use of antibiotics can provoke the appearance of inclusions after ovarian surgery.

The pathological process goes through several stages in its development.

The cords are localized around the ovary, but do not disrupt the capture of the egg.
Tissues grow between the ovary and the fallopian tube, creating obstacles for the egg.
There is a torsion of the fallopian tube, but its patency is not impaired.

The disorder is characterized by menstrual irregularities, pulling pains in the lower abdomen and lower back, discomfort during intercourse, and the inability to become pregnant for a long period of time. Since the symptoms may coincide with signs of other gynecological or endocrine pathologies, you should consult a doctor and undergo a thorough diagnosis.

For the treatment of connective tissue adhesions, the method of laparoscopy, laser therapy, electrosurgery or the technique of aquadissection, that is, dissection of neoplasms with water, is used. The patient is prescribed a course of antibiotic therapy to suppress infection, anti-inflammatory and fibrinolytic agents, anticoagulants and vitamins.

Adhesions after spinal surgery

Scars and adhesions after spinal surgery occur in almost all patients. This leads to narrowing of the spinal canal. At the site of the lesion, both an infectious and an autoimmune process can develop with a violation of the movement of the cerebrospinal fluid. Fibrous cords fuse spinal roots with herniated discs, epidural tissue and spinal cord membranes. Neoplasms can be both light and heavy, dense.

The main causes of adhesions in the spine:

Traumatic hematomas.
infectious complications.
Epidural administration of certain medications.
Removal of herniated intervertebral discs.

The disease state begins with aseptic inflammation. In the area of surgical intervention, swelling occurs, which affects the spinal root and surrounding tissues. Gradually, the inflammatory process passes into the fibroblastic stage, forming dense adhesions.

Cicatricial adhesion fixes the nerve root in one position, exerting increased pressure on it. This provokes pronounced painful sensations of varying intensity. Chronic pain masquerades as various diseases of the spine. For example, cords in the lumbar region are similar in pain to lumbalgia. Discomfort can spread along the sciatic nerve to one or both legs. Without treatment, this condition leads to tissue malnutrition and atrophic processes.

Adhesions after lung surgery

A problem such as adhesions after lung surgery occurs in 30% of patients who have undergone surgery. Overgrown connective tissue strands are most often localized between the serous membranes of the pleural cavity. They can occupy all parts of the pleura (total) and single cavities due to fusion of the pleural sheets. Bands form anywhere where there is connective tissue.

The pathological condition has the following symptoms: shortness of breath, palpitations, respiratory failure, pain in the chest cavity, various respiratory disorders due to a violation of the natural ventilation of the lungs. Deterioration of general well-being, cough, sputum, elevated body temperature, oxygen starvation, intoxication.

The cords negatively affect the functioning of the respiratory organs, impede their work and limit mobility. In some cases, complete overgrowth of the cavities occurs, which causes acute respiratory failure and requires urgent medical attention.

To diagnose the disease, fluorography and x-rays of the lungs are performed. Treatment depends on the severity of the disease state. Surgical intervention is indicated if tissue inclusions have provoked pulmonary insufficiency and other life-threatening conditions. In other cases, drug therapy and a course of physiotherapy are carried out.

Adhesions after stomach surgery

The organs of the abdominal cavity are most susceptible to the appearance of postoperative bands. Neoplasms are localized between the intestinal loops, stomach and other organs, provoking a gradual fusion of the serous membranes.

Adhesions after stomach surgery can be aggravated by such factors:

Abdominal injuries (open, closed).
Increased synthesis of enzymes that provoke the growth of connective tissue.
Inflammatory and infectious diseases of the internal organs.
Radiation therapy in oncology.

According to medical statistics, in 15% of patients, adhesions develop precisely after surgery. The clinical picture of the pathology is accompanied by such symptoms: nagging pains, digestive disorders, intestinal obstruction, appetite disorders, sudden weight loss, problems with stool. Treatment can be both conservative and surgical, depending on the neglect of the pathology.

Complications and consequences

The adhesive process, like any pathology left untreated, can cause serious consequences and complications. Most often, patients face such problems:

Acute intestinal obstruction.
Respiratory failure.
Inflammatory and infectious pathologies.
Obstruction of the fallopian tubes.
Infertility.
Peritonitis.
tissue necrosis.
Curvature of the uterus.
Chronic pain.

Regardless of the severity of complications, the adhesive process requires surgical treatment and a set of preventive measures.

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Diagnosis of adhesions after surgery

If a postoperative adhesive process is suspected, the patient is prescribed a complex of various examinations. Diagnosis of adhesions after surgery consists of:

History taking and visual examination.
Analysis of patient complaints.
Complex of laboratory tests (blood, urine).
Instrumental diagnostics (ultrasound, MRI, CT, radiography, laparoscopy).

The results of a comprehensive medical examination make it possible to determine the presence of strands, their localization, thickness and even shape. Evaluate the work of internal organs and identify existing violations. Based on the results of the diagnosis, a treatment plan is drawn up.

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Analyzes

Laboratory diagnostics of the adhesive process is necessary to determine the degree of its impact on the body. Tests are usually ordered based on clinical symptoms. Most often, patients complain of pain of various localization and disturbances in the work of the intestines.

To diagnose a disease state, it is necessary to pass the following tests:

A complete blood count is a standard study that is prescribed to all patients, regardless of the suspected disease. Determines the general condition of the body and allows you to draw conclusions about the work of all its organs and systems. With adhesive disease in the blood, the following deviations may be present:

Leukocytosis - an increased level of leukocytes indicates an inflammatory process. At the same time, the more stab cells, the more intense the inflammation.
Anemia - a decrease in the number of red blood cells occurs when bleeding in the body. With postoperative bands, this is a rare deviation, which may be associated with increased physical activity and rupture of adhesions. This condition requires treatment, as a low level of red blood cells lowers the protective properties of the immune system.

Biochemical blood test - reflects the work of internal organs, especially the liver and kidneys. In a pathological condition, such violations are possible:

Elevated urea levels - occurs due to urinary retention. This is observed when the walls of the bladder or ureter are deformed by strands. Indicates the involvement of the urinary tract in the adhesive process.
Reduced hemoglobin - found in red blood cells, so it may indicate internal bleeding.
C-reactive protein - indicates the acute phase of inflammation.

A stool test may also be prescribed, which is performed if an intestinal obstruction caused by adhesions is suspected. With concomitant infertility, a blood test for hormones and an analysis of seminal fluid are shown, which will determine reproductive dysfunctions and whether connective tissue adhesions are associated with this.

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Instrumental diagnostics

Another method for identifying the adhesive process is instrumental diagnostics. If adhesions are suspected after surgery, the patient should undergo the following examinations:

Ultrasound - ultrasound examination of internal organs visually determines connective tissue adhesions.
CT - computed tomography allows not only to study the pathological process, but also the factors that provoked it. It belongs to the most effective diagnostic methods.
X-ray with a contrast agent - before the procedure on an empty stomach, you must drink a glass of barium salt. X-rays will show bowel irregularities and other complications that cause pain.
Laparoscopy - for this diagnostic method, a small puncture is made in the abdominal cavity and a fiber optic tube with a camera is inserted. The device fixes the adhesions and allows them to be cut out.

Based on the results of instrumental diagnostics, the doctor may prescribe the necessary treatment or additional examinations.

Differential Diagnosis

In its symptoms, the adhesive process is similar to many diseases. Differential diagnosis allows you to identify connective tissue adhesions and separate them from other pathologies. Since postoperative pain and the presence of scars do not always indicate strands. At that time, adhesions can simulate kidney damage, peptic ulcer, respiratory failure, pancreatitis, cholecystitis, lumbalgia.

Consider the differential diagnostic signs of abdominal adhesions and other diseases of internal organs:

Strangulated hernia - the presence of a hernial protrusion, pain and tension in the affected area.
Acute pancreatitis or cholecystitis - intense pain in the right hypochondrium or girdle. Increased body temperature, severe nausea and vomiting.
Ulcerative lesions of the stomach or duodenum - acute paroxysmal pain in the abdomen, which increase with the slightest movement. X-ray reveals free gas in the peritoneum.
Acute appendicitis - pain in the right iliac region, which is aggravated by movement. Elevated body temperature and elevated levels of white blood cells.
Torsion of an ovarian cyst - paroxysmal pain in the lower abdomen. When trying to palpate the abdomen, a volumetric neoplasm is determined.

The process of differentiation is carried out at the first suspicion of postoperative adhesions. For this, methods of laboratory and instrumental diagnostics are used.

Treatment of adhesions after surgery

The method of treating adhesions after surgery depends on the general condition of the patient. Since the main reason for the formation of strands is surgical intervention, the treatment should be as gentle as possible, preferably therapeutic. Surgical removal of neoplasms is carried out only in extreme cases, when there is a threat to the life of the patient.

In the early stages of the adhesive process, vitamin E, folic acid and aloe preparations are used. Such tools prevent the formation of new splices, and make existing ones more elastic.

In the acute course of the pathology, laparoscopy is indicated. With its help, the strands are dissected, which allows you to restore the normal functioning of the affected organs. Particular attention is paid to physiotherapy and therapeutic nutrition, which alleviate the patient's painful condition.

Medications

Treatment of postoperative connective tissue adhesions is carried out both surgically and more conservatively, that is, with medication. Drugs against adhesions are divided into:

Fibrinolytic agents - the composition of such drugs includes substances that dissolve fibrin, around tissue soldering. Fibrinolysin, Urokinase, Hyaluronidase, Chemotrypsin, Streptokinase, Trypsin, as well as tissue plasminogen activators.
Anticoagulants - prevent blood clotting. Preparations from the group of citrates and oxalates, heparin.
Antibacterial and anti-inflammatory drugs - prevent the development of infectious and inflammatory complications. Most often, patients are prescribed drugs from the tetracycline group, cephalosporins, sulfonamides, NSAIDs, antihistamines, or corticosteroids.

Consider the most effective drugs prescribed to patients with postoperative cords of any localization:

Streptokinase

Fibrinolytic agent that dissolves blood clots. Affects the enzyme system and dissolves fibrin in blood clots.

Indications for use: blockage of the pulmonary arteries and its branches, thrombosis, blockage of the vessels of the retina, acute myocardial infarction during the first 10-12 hours, formation of strands on the internal organs.
Method of application: the drug is administered intravenously, in rare cases intraarterially. The initial dosage is 250,000 IU (IE) dissolved in 50 ml of isotonic sodium chloride solution. With a pronounced adhesive process, the drug must be administered over a long period of time.
Side effects: headaches, nausea, chills, allergic reactions, non-specific reactions to protein.
Contraindications: increased bleeding, recent bleeding, stomach ulcers, microbial diseases, pregnancy, diabetes mellitus, severe kidney and liver diseases, active tuberculosis, hypertension.

Chemotrypsin

Local application of this drug breaks down necrotic tissues and fibrinous formations, helps to thin viscous secretions, exudate and blood clots. Contains the active ingredient - chymotrypsin.

Indications for use: thrombophlebitis, inflammatory-dystrophic form of periodontal disease, otitis media, tracheitis. It is used during physiotherapy for the treatment of adhesions.
Method of application: intramuscularly at 0.0025 g 1 time per day. For injection, the drug is dissolved in isotonic sodium chloride solution. The solution is injected deep into the buttocks. The course of treatment is 6-15 injections.
Side effects: burning at the site of application, allergic reactions, bleeding from healing sites.
Contraindications: individual intolerance to the active components, intravenous administration, bleeding wounds, malignant neoplasms.

Hyaluronidase (Lidase)

An enzyme agent used to eliminate joint contractures, soften cicatricial formations and treat hematomas. Contains hyaluronic acid.

Indications for use: cicatricial changes in the skin of various origins, hematomas, joint contractures, long-term non-healing ulcers, scleroderma, traumatic lesions of the nerve plexuses, rheumatoid arthritis.
Method of application: the drug is administered subcutaneously under scar tissue, intramuscularly, using electrophoresis, applications on the mucous membranes. In ophthalmic practice, the drug is used subconjunctivally and retrobulbarno. The course of therapy is individual for each patient and depends on the severity of the pathological process.
Side effects: skin allergic reactions.
Contraindications: malignant neoplasms.
Overdose: in rare cases, allergic skin reactions occur.

Urokinase

Fibrinolytic, dissolves blood clots by activating plasminogen.

Indications for use: thromboembolic occlusive vascular diseases, local thrombosis, coronary thrombosis, bleeding in the anterior chamber of the eye and vitreous body, local treatment of adhesions.
Method of application: the average dose is 1000-2000 IU / kg / hour, the duration of therapy is determined by the attending physician.
Side effects: state of shock, changes in liver tests, bouts of nausea and vomiting, loss of appetite, fever, headaches, deterioration in general well-being, skin allergic reactions.
Contraindications: hemorrhagic stroke, bleeding, recent biopsy, arterial hypertension, recent surgery, severe renal or hepatic failure, pregnancy.

fibrinolysin

Affects the blood system and fibrinolysis. Very often used in combination with Heparin. Its activity is based on the body's natural anticoagulant system and the ability to dissolve fibrin strands.

Indications for use: blockage of blood vessels by a blood clot of peripheral or pulmonary arteries, recent myocardial infarction, acute thrombophlebitis.
Method of application: intravenously (drip) with isotonic sodium chloride solution, topically.
Side effects: fever, pain at the site of application, allergic reactions, chills.
Contraindications: increased bleeding, peptic ulcer of the stomach and duodenum, tuberculosis, radiation sickness, low levels of fibrinogen in the blood.

If the adhesive process is accompanied by severe pain, then Paracetamol, No-shpu or Spazmalgon are used to eliminate them. With the local use of antiadhesion drugs, electrophoresis, applications and other physiotherapy are performed.

Ointments for adhesions after surgery

For resorption of connective tissue adhesions and scars, topical preparations, that is, ointments, are widely used. From adhesions after surgery, the following remedies are effective:

Vishnevsky ointment

Antiseptic, which includes castor oil, xeroform and tar. It is widely used in the treatment of inflammation caused by abscesses or boils. Restores tissue in burns, bedsores and frostbite, is used in gynecology. Helps soften postoperative scars and adhesions.

The ointment is evenly distributed over gauze and applied to the affected areas. Bandages are changed 2-3 times a day. A weak irritating effect on tissue receptors accelerates the regeneration process. Prolonged use of the product can cause allergic reactions and skin irritation. The main contraindication is kidney disease.

Ointment Cel-T

Homeopathic chondroprotective agent with a wide spectrum of action. It has protective, anti-inflammatory and analgesic properties. Contains active herbal ingredients that reduce swelling, have a therapeutic effect on cartilaginous bone and soft tissues. The drug is effective in the treatment of postoperative adhesions and scars.

The drug contains chondroitin sulfate (a structural element of cartilage tissue), sius-organ components that slow down degenerative changes in cartilage tissue, improve microcirculation and enhance plastic processes, and biocatalysts of redox reactions in the body.

Indications for use: various diseases of the musculoskeletal system (osteochondrosis, tendopathy, spondylarthrosis, deforming osteoarthrosis), injuries and surgical interventions, after which adhesions and contractures formed.
Method of application: a small amount of ointment should be applied to the affected area 2-5 times a day. The tool can be used during massage and various physiotherapy procedures.
Side effects: allergic reactions, skin itching, rash. Overdose symptoms have not been recorded. The ointment is contraindicated in case of individual intolerance to its components.

Heparin ointment

Reduces the inflammatory process, prevents blood clotting, dilates superficial vessels, anesthetizes.

Indications for use: thrombophlebitis of the extremities, phlebitis, thrombosis of hemorrhoidal veins, ulcers of the extremities, postoperative bands.
Method of application: the ointment is applied to the affected area of the skin 2-3 times a day. The tool can be used under a gauze bandage, during a massage.
Contraindications: ulcerative necrotic processes, reduced blood clotting, thrombopenia.

Hydrocartisone ointment

Inflammatory and allergic skin lesions of non-microbial etiology, allergic and contact dermatitis, eczema, neurodermatitis, resorption of postoperative scars and bands. The agent is applied to the skin with a thin layer 2-3 times a day. The ointment is contraindicated in infectious skin diseases, pyoderma, fungal infections, ulcerative lesions and wounds.

Adhesion gels after surgery

In addition to the ointment, a gel can be used to treat the adhesive process. This dosage form does not contain fats and oils, viscous and soft in composition and consistency. The gel consists of 70% thickeners and water, so its active ingredients quickly penetrate into the wound surface.

Consider the popular gels for adhesions after surgery:

Traumeel gel

A complex homotoxic agent with regenerating, analgesic, anti-inflammatory and anti-exudative properties. Quickly relieves swelling and stops bleeding. Increases vascular tone and reduces their permeability.

Indications for use: inflammatory processes of the musculoskeletal system, bruises, injuries, sprains, fractures, severe pain syndrome, prevention of postoperative complications, including adhesive disease, purulent-inflammatory diseases.
The gel is applied in a thin layer to the affected area of the skin 2-3 times a day, the product can be used under a bandage.
Side effects are manifested in the form of local allergic reactions, itching and redness. The main contraindication is intolerance to the components of the drug.

Interkot

Gel used in laparotomy and laparoscopic operations in gynecology and surgery to reduce the number of postoperative bands. The absorbable agent is a combination of polyethylene oxide and sodium carboxymethyl cellulose.

Indications for use: open and closed operations in the abdominal cavity and on the pelvic organs. The medicine is produced in a special syringe, which facilitates the process of its use. Easy to apply and dissolves connective tissue adhesions within four weeks.
Contraindications: infectious processes or complications.

Contractubex

Antiproliferative, anti-inflammatory, softening and smoothing scar tissue drug. Contains an active substance - onion extract, which reduces the release of anti-inflammatory mediators in the area of application and allergic reactions. Reduces the growth of fibroblast cells, has bactericidal properties. The gel also contains heparin and allantoin, which accelerate the healing process, improve tissue permeability, and slow down collagen synthesis.

Indications for use: postoperative and post-traumatic scars and bands, Dupuytren's contracture, keloids, traumatic contractures.
Method of application: a small amount of gel must be applied to the postoperative scar and rubbed until completely absorbed. The tool can be used under a bandage.
Side effects are manifested in the form of local allergic reactions. The gel is contraindicated in case of individual intolerance to its components.

Mesogel

Anti-adhesion agent based on carboxymethyl cellulose polymer. It is used for surgical interventions, after which there is a risk of developing an adhesive process. It does not have a general toxic, local irritant or allergenic effect. Effective in the presence of exudate or blood, does not encapsulate and is not a breeding ground for pathogens.

The mechanism of action of the gel is based on the separation of damaged surfaces until they are completely healed. The drug creates conditions for the normal sliding of organs, reduces the level of fibrin. Produced in sterile syringes with a volume of 5-100 ml and in polymer containers of 200 ml.

Indications for use: prevention of cord formation during operations on organs and tissues with increased formation of adhesions.
The method of application and dose depend on the packaging of the drug and the technique of the operation. The gel is applied to areas of tissue where strands may form. The agent is applied in a thin layer over the treated surface, thereby creating a reliable coating for the duration of tissue healing.
Contraindications: hypersensitivity to cellulose ethers, any disease at the stage of decompensation, terminal conditions, kidney and liver diseases, acute stage of purulent peritonitis.

After application, Mesogel gradually dissolves, and its concentration decreases through an increase in volume and splitting of its molecules into short fragments. If the agent is used in the abdominal cavity, then its molecules are absorbed into the capillary network of the peritoneum, penetrate into the lymphatic system through the serous membrane of the intestine. Most of the drug is excreted in the urine, and the rest breaks down into glucose, water and carbon dioxide.

Candles against adhesions after surgery

For the prevention and treatment of connective tissue adhesions after surgery (especially during gynecological or urological manipulations), suppositories against adhesions are recommended. After surgery, you can use the following drugs:

Ichthyol candles

They have antiseptic, anti-inflammatory and local anesthetic properties. They are used for neuralgia, inflammatory pathologies of the pelvic organs, after recent surgical interventions. Candles should be administered after a cleansing enema, the duration of therapy and the frequency of use are determined by the attending physician.

Longidaza

Suppositories for vaginal or rectal use. The drug is a macromolecular complex of the proteolytic enzyme hyaluronidase with a high molecular weight carrier. It has pronounced anti-edema, anti-inflammatory, immunomodulatory, antioxidant properties. Increases the permeability and trophism of tissues, dissolves hematomas, increases the elasticity of cicatricial changes. Reduces and completely eliminates adhesive formations and contractures, improves joint mobility.

Indications for use: diseases accompanied by proliferation of connective tissue. It is most often prescribed in urological and gynecological practice, in surgery, cosmetology, pulmonology and phthisiology, after surgical interventions in the abdominal cavity and long-term non-healing wounds.
Method of application: suppositories are administered rectally after cleansing the intestines, 1 suppository 1 time in 48 hours or vaginally, 1 pc. once every three days. The duration of therapy is determined by the attending physician. If necessary, a second course of treatment can be prescribed, but not earlier than 3 months after the end of the previous one.
Side effects: systemic or local allergic reactions.
Contraindications: intolerance to active ingredients, severe renal dysfunction, malignant neoplasms, patients under 12 years of age. With extreme caution is prescribed for patients with renal failure, recent bleeding, with an acute form of an infectious disease.

In addition to the suppositories described above, you can use tampons with various ointments, for example, with heparin or Vishnevsky ointment.

vitamins

To treat and prevent the formation of adhesions after surgery, patients are advised to use vitamins. In the fight against strands, tocopherol (vitamin E) and folic acid (vitamin B9) have proven themselves well.

Tocopherol

Vitamin E is an active antioxidant that protects various substances from oxidation, such as retinol or polyunsaturated fatty acids. The natural antioxidant is involved in protein biosynthesis, tissue respiration and important processes of cellular metabolism. Its deficiency leads to degenerative changes in nerve cells and damage to the tissues of internal organs, especially the liver parenchyma.

Indications for use: muscular dystrophies, diseases of the central nervous system, dermatosis, spasms of peripheral vessels, various disorders of motor activity, complex treatment of cardiovascular and ophthalmic diseases.
The method of application and dosage depend on the form of release of the drug, indications for use and the individual characteristics of the patient's body.
Side effects: high doses of the vitamin cause gastrointestinal disorders, decreased performance and creatinuria.
Contraindications: destructive changes in the heart muscle, myocardial infarction, high risk of thromboembolism.

Vitamin E deficiency may be associated with a decrease in red blood cells. Vitamin has several forms of release: vials, oil solution, capsules for oral administration, ampoules for intravenous or intramuscular administration.

Folic acid

Belongs to the group of vitamins B. It enters the body with food and is synthesized by the intestinal microflora. Participates in important metabolic processes in the body, is necessary for the exchange of choline. Stimulates the processes of blood formation. It has a tablet form of release.

After oral administration, it is completely absorbed in the duodenum and proximal parts of the small intestine. About 98% of the accepted dose gets into blood within 3-6 hours. Metabolized in the liver, 50% is excreted in the urine, the rest in the feces.

Indications for use: hyperchromic macrocytic and megaloblastic anemia, normalization of erythropoiesis, anemia and leukopenia, pellagra, pernicious anemia, postoperative conditions, improvement of the epidermis.
How to use: Tablets are recommended to be taken orally after meals. As a rule, 3-5 capsules per day. The course of treatment is 20-30 days.
Side effects: in rare cases, allergic reactions occur, which are stopped with antiallergic medicines.
The main contraindication is individual intolerance to folic acid. Cases of overdose have not been recorded.

To speed up recovery and minimize the risk of adhesions, vitamins should be taken daily. Particular attention should be paid to a balanced diet with micro and macro elements necessary for the body, minerals and, of course, vitamins.

Physiotherapy treatment

One of the effective methods for eliminating postoperative adhesions is physiotherapy. Most often, such therapy is prescribed for adhesions in the pelvic organs.

The main purpose of physiotherapy:

Activation of tissue metabolism - due to physiotherapy, blood circulation and metabolism in the affected tissues improves. This helps to prevent squeezing and twisting of organs.
Softening of the connective tissue - due to the influence of physical factors on the connective tissue, it becomes more elastic. This minimizes pain and the risk of developing intestinal obstruction or blockage of the fallopian tubes.

The most noticeable effect is possible in the first months of the disease, when the cords are not too hard and strong. Treatment prevents their strengthening and prevents the growth of new tissues. During the adhesive process, the following methods are used:

Ozokerite and paraffin applications.
Electrophoresis with absorbable and analgesic drugs.
Laser or magnetic therapy.
Electrical stimulation.
Ultrasound and massage.
Hirudotherapy.

Let us consider in more detail the most effective physiotherapy procedures:

Ozokerite and paraffin applications are aimed at warming up the pelvic organs. In their action, they are similar to laser therapy and ultrasound. Increase local immunity, stimulate blood circulation and lymph flow. Applications are contraindicated in inflammatory lesions of the small pelvis and skin diseases.
Ultrasound is a method of influencing organs and tissues using ultrasonic waves. Accelerates metabolic processes at the molecular level. Promotes the destruction of pathogens in chronic foci of infection. Destroys the microstructure of adhesions, increases their elasticity.
Laser therapy - warming up the affected tissues to stimulate blood circulation and prevent the formation of collagen protein (the basis of adhesive and scar tissues). This method is especially effective in the early stages of the pathological process.
Electrical stimulation is based on sending electrical impulses using a special apparatus to the affected tissues. Stimulates blood circulation and lymph flow, enhances regeneration processes, minimizes pain.
Electrophoresis - this procedure consists of hardware and drug exposure. With the help of an electric field, drugs containing the enzyme hyaluronidase (Lidase, Longidase and others) are introduced into the body. Electrophoresis is especially effective in the first months after surgery, as it prevents the formation of strands. With its help, you can restore the functioning of organs even with neglected connective tissue formations. The technique is absolutely painless, but has a number of contraindications: severe intoxication, blood diseases, oncology, cachexia, heart rhythm disturbances, intolerance to the medications used.
Treatment with leeches (hirudotherapy) - the effectiveness of this method is based on the enzyme hyaluronidase, which is part of the leeches. It softens adhesions and makes them permeable to drugs, reduces their size. As a result of such treatment, the mobility of organs is restored, and painful sensations are reduced. Leeches are placed on problem areas for 30-40 minutes. At the same time, there should be no wounds or other damage on the skin. As a rule, patients are prescribed 7-10 sessions. This method has no contraindications and side effects.

Physiotherapeutic treatment is also carried out with advanced adhesive processes, which led to deformation of the organs and the appearance of acute pathological symptoms. Such therapy can minimize pain and improve the patient's condition.

Alternative treatment

In addition to medical and surgical therapy for postoperative strands, alternative treatment is often used to eliminate them. Alternative therapy can prevent the growth of neoplasms. Consider popular folk recipes:

Take 50 g of flax seeds, wrap them in a piece of gauze and dip them in 500 ml of boiling water for 5-10 minutes. Cool and apply to the sore spot for 1-2 hours 2-3 times a day.
Pour 250 ml of boiling water over a tablespoon of dry St. John's wort and boil over low heat for 10-15 minutes. Strain the resulting broth, and take ¼ cup 3 times a day.
Take two parts of wild rose and nettle, mix with one part of lingonberries. Pour the resulting mixture with 250 ml of boiling water and let it brew for 2-3 hours. Take ½ cup twice a day.
Take in equal parts the grass of sweet clover, centaury and coltsfoot. Pour 250 ml of boiling water and let it brew for 1.5 hours. Take ¼ cup 3-5 times a day.
Black cumin oil, which can be purchased at a pharmacy, has healing properties. It contains phytosterols, tannins, carotenoids and fatty acids. It has an antibacterial, regenerating and anti-inflammatory effect. The oil can be used for wetting tampons, for douching, external or internal use.

Herbal treatment

Another option for folk treatment of adhesions is herbal treatment. Consider popular herbal recipes:

Grind three tablespoons of bergenia roots and pour 300 ml of water over them. The product should be infused for 3-4 hours, preferably in a thermos or a tightly sealed container. Strain and take 2-3 teaspoons one hour before meals. The course of treatment is three days, after which you need to take a break of 2-3 days and continue therapy again.
Take aloe (at least 3 years old), cut off a couple of leaves and put them in a cold place for 48 hours. Grind, add 5 tablespoons of honey and 50 ml of milk. Mix all the ingredients well and take 1 tablespoon 3 times a day.
A tablespoon of milk thistle seeds pour 200 ml of boiling water and boil for 10 minutes. After cooling, the broth should be filtered and taken 15 ml 3 times a day.
50 g of crushed Maryina root pour 1 liter of vodka and let it brew for 10 days in a dark place. The infusion should be taken 40 drops for a month 2-3 times a day before meals. After that, you need to take a break of 10 days and repeat the treatment again.

Herbal treatment should be carried out with extreme caution and only after medical permission. Particular attention should be paid to the proportions of medicinal components.

Homeopathy

For the treatment of strands of different localization, not only traditional medicine, but also alternative methods are used. Homeopathy is one of the latter. In the postoperative adhesive process, the following drugs are recommended:

Arsenicum album - painful growths after injuries.
Calcarea fluorica - strands after operations, deep wounds and various injuries.
Cundurango - accretion and ulceration in the oral cavity.
Dulcamara, Euphrasia, Plumbum, Rhus toxicodendron, Thuja - overgrowth of connective tissue in the nose.
Ranunculus bulbosus - bands after pleurisy.
Silicea - used for adhesions after operations, injuries and wounds. Stimulates the body to accelerate the resorption of fibrous formations and scar tissue.

Homeopathic medicines can be taken only as prescribed by a homeopathic doctor, who selects the medicine (dosage, course of treatment) individually for each patient.

Surgical treatment

If the adhesive process in a neglected or acute state causes pathological symptoms from the internal organs, then surgical treatment is indicated. The main goal of such therapy is the mechanical removal of inclusions that disrupt blood supply and interfere with the normal functioning of the gastrointestinal tract and other organs.

Surgical treatment can be carried out by such methods: laparoscopy and laparotomy. This takes into account the fact that abdominal surgery can cause new connective tissue adhesions. Therefore, when choosing a method, preference is given to less traumatic.

Refers to low-traumatic operations. Through an incision in the abdomen, the doctor inserts a fiber optic tube with a miniature camera and light. Through additional incisions, surgical instruments are inserted, with the help of which adhesions are dissected and blood vessels are cauterized. Cutting can be done with an electric knife, laser, or hydraulic pressure. After such an operation, recovery is quick and with minimal complications. But still there is no guarantee that a relapse will not happen again.

Laparotomy

It is prescribed for a large number of adhesions. The operation is performed through an incision (10-15 cm) in the anterior wall of the peritoneum to obtain extensive access to the internal organs. The method is traumatic, recovery is long with a mandatory course of anti-adhesion physiotherapy.

Many factors are taken into account when choosing the tactics of surgical treatment. First of all, it is the age of the patient. Elderly patients undergo laparoscopy only. Another factor is the presence of comorbidities and general health. If the patient has serious diseases of the cardiovascular or respiratory system, then this is a contraindication to surgery.

Particular attention should be paid to the postoperative period. It is necessary to provide the intestines with functional rest until the wounds are completely healed. To do this, you should refuse food in the first days after the operation and take only liquid. On the second or third day, you can gradually take liquid diet food (broths, grated cereals, vegetable purees). As the condition improves, that is, after about 7-10 days, you can gradually restore the diet.

After the operation, it is strictly contraindicated to drink alcohol, strong coffee and tea, confectionery, spicy, salty, fatty or fried. Compliance with the diet allows you to quickly recover after treatment and prevent the appearance of new strands.

Removal of adhesions after abdominal operations

In many patients, after surgical interventions or prolonged inflammatory processes, scars appear, that is, strands. Such adhesions disrupt the functioning of internal organs and cause acute pain. This is the main indication for the removal of adhesions. After abdominal operations, the laparoscopic method is most often used.

If the pathological process is running, then a laparotomy is performed. This method has the following indications:

Growth of connective tissue throughout the abdominal cavity.
The appearance of purulent formations in the intestine.
Severe intestinal obstruction.
Acute inflammatory process in the abdominal cavity.

With laparotomy, access to the internal organs is carried out through an incision in the abdominal wall, that is, as in a full-fledged abdominal operation. During laparoscopy, several small incisions are made through which equipment is inserted. Both in the first and in the second case, the operation lasts about 1-2 hours. The patient is waiting for a long recovery period and a set of preventive measures.

Anti-Adhesion Exercises After Surgery

One of the methods of preventing strands is therapeutic exercises. Exercises against adhesions after surgery are aimed at activating the local blood supply to the affected tissues and internal muscle fibers, increasing their elasticity.

Consider an approximate set of anti-adhesion exercises:

Sit on the floor and stretch your legs straight. Bend them at the knees and pull them to the chest, slowly straightening to the starting position.
Lie on the floor, put your hands behind your head, legs bent at the knees and stand on the floor. Raise your shoulder blades slowly.
Lying on the floor, bend your knees, press your shoulder blades to the floor, stretch your arms along the body. Gradually lift your pelvis, lowering your knees to your chest, and return to the starting position.
Lie on the floor, put your hands under the buttocks, legs straight, raised. Make crossing movements with your legs (scissors). Another option for such an exercise is a bicycle, while the movements should be with a large amplitude, directed towards the peritoneum and chest.

Nutrition is important both preventive and restorative. Consider the main dietary recommendations:

You can not starve or overeat, as this aggravates the pathological condition and can cause complications.
It is necessary to observe the regimen of meals at certain hours. Food should be fractional, you need to eat in small portions 4-6 times a day.
Heavy and fatty foods, foods high in fiber and causing flatulence (legumes, cabbage, radish, turnips, radishes, grapes, corn) should be excluded from the diet. The ban includes carbonated and alcoholic drinks, hot spices and sauces, whole milk.
The menu should include food rich in calcium, that is, cottage cheese, cheese, dairy products. They promote intestinal peristalsis. In this case, food should be at room temperature, as too cold or hot can cause cramps.
Patients should consume lean broths, steamed, boiled or baked lean meats and fish. You can eat greens, vegetables and fruits. In this case, marinades and smoked meats should be abandoned.

To prevent the development of the adhesive process, it is necessary to treat constipation in time, avoid food poisoning and inflammatory processes. You should lead an active lifestyle, but avoid heavy physical exertion. The above recommendations minimize the risk of developing pathology.

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It is important to know!

Surgical interventions of moderate trauma can cause significant pain after surgery. At the same time, traditional opioids (morphine, promedol, etc.) are not suitable for patients after such operations, since their use, especially in the early period after general anesthesia, is dangerous for the development of central respiratory depression and requires monitoring of the patient in the intensive care unit.

Postoperative adhesions are dense connective tissue formations in the abdominal or pelvic cavity that connect internal organs. They are formed at the site of damage, inflammation and represent a kind of protective reaction of the body - an attempt to limit the focus of the disease. Adhesions disrupt the normal functioning of the abdominal organs and lead to serious complications.

Why do adhesions form?

Connective tissue strands (adhesions) in the abdominal or pelvic cavity are formed as a consequence of surgical interventions or as a response to inflammatory processes in this area. The body builds up additional tissue, releases sticky fibrin, and sticks adjacent surfaces together in an attempt to support a diseased organ or stop inflammation from spreading. Adhesions may take the form of scars, threads or films connecting neighboring organs and intestinal loops.

Reasons for the formation of adhesive strands:

tissue damage as a result of surgical interventions (laparoscopy, laparotomy);
inflammation of the appendix and surgery to remove it (appendectomy), diverticulitis;
abortions, uterine curettage, caesarean section;
prolonged use of intrauterine contraceptives;
hemorrhage in the body cavity;
endometriosis;
inflammatory diseases of the abdominal and pelvic cavities, including venereal.

Postoperative adhesive disease is caused by tissue damage, their hypoxia, ischemia or drying, as well as the ingress of foreign objects into the body cavity, some chemicals (talc particles, gauze fibers).

Why are spikes dangerous?

Normally, the organs of the abdominal cavity and the cavity of the small pelvis are mobile. Intestinal loops can shift during digestion, but their movements do not prevent the transport of an ovulated egg into the fallopian tube, and the uterus that grows during pregnancy does not have a critical effect on the bladder.

The resulting scars, limiting inflammation, interfere with the normal mobility of organs and the performance of their functions. Spikes can provoke acute intestinal obstruction or the development of female infertility. In some cases, the formation of adhesions does not cause discomfort and discomfort to a person, however, most often, adhesive disease is accompanied by a pronounced pain syndrome.

Symptoms of pathology

The manifestation of the disease depends on the degree of its development. There may be individual adhesive bands fixed at two points, or a large number of adhesions over the entire surface of the peritoneal membrane.

acute form

Pathology often manifests itself in an acute form, with sudden onset of pronounced symptoms, such as:

acute worsening pain in the abdomen;
intestinal obstruction;
vomit;
active intestinal peristalsis;
febrile temperature;
tachycardia.

As the bowel obstruction increases, the symptoms increase:

there is bloating of the intestine;
peristalsis stops;
diuresis decreases;
arterial hypotension occurs;
there is a violation of the exchange of fluid and microelements;
the general condition worsens, weakness, weakening of reflexes appear;
severe toxicity occurs.

Intermittent form

Symptoms are less pronounced, appear periodically:

pain of varying intensity;
indigestion, constipation, diarrhea.

Chronic form

Adhesions in a chronic form are hidden, can manifest themselves as rare pulling pains in the lower abdomen, digestive disorders, unreasonable weight loss. Often, adhesions are the hidden cause of female infertility.

Diagnosis of adhesive disease

It is possible to assume the presence of adhesions if the patient in the past underwent surgical interventions on the organs of the abdominal cavity or small pelvis, infectious and inflammatory diseases of the genitourinary system, endometriosis.

These risk factors contribute to the formation of adhesions, but are not a 100% guarantee of their presence. To confirm the diagnosis, it is necessary to conduct a series of studies.

Certain diagnostic data gives an examination in the gynecological chair.
X-ray examination of the uterus with the introduction of a contrast agent determines the obstruction of the fallopian tubes, which is often caused by adhesions. However, if the patency of the oviducts is established, adhesions cannot be excluded.
Ultrasound results cannot determine the presence of adhesions in the abdominal cavity.
Magnetic resonance imaging provides high accuracy of results.

The main method of diagnosing adhesive disease remains laparoscopy. With the help of special instruments inserted into the patient's abdominal cavity during laparoscopy, the doctor can assess the degree of development of the pathology and, if necessary, immediately perform medical manipulations.

Treatment of postoperative adhesions

If adhesions are just beginning to form at the site of the inflammatory process, there is a possibility of their spontaneous resorption, subject to prompt and adequate treatment. Over time, thin films of adhesions harden, thicken and become more like scars and scars.

Operation

The main method of treatment of acute and developed chronic forms of the disease is the surgical removal of adhesions. The patient is given general anesthesia and the surgeon uses special instruments to locate, dissect and remove the adhesions.

To access the abdominal cavity, laparotomy (incision of the abdominal wall) and laparoscopic methods (access through punctures) can be used.
Excision of adhesions is carried out using a laser, an electric knife or water, which is supplied under strong pressure (aquadissection).

The operation provides a one-time removal of pathological formations, but does not guarantee protection against relapses. The more the body tolerates surgical interventions, the more likely the development of the adhesive process. Therefore, special methods are often used to prevent pathologies after a medical operation: the introduction of barrier fluids (mineral oil, dextran), wrapping organs with a self-absorbable film.

Enzymes

Enzyme therapy can have a good effect, including injections of degrading enzymes (lipase, ribonuclease, lidase, streptase) and rubbing anti-inflammatory ointments into the abdomen.

One of the most powerful enzyme agents is human saliva. The substances contained in it are able to dissolve the tissue of adhesions. Saliva is especially active in the morning, while a person has not yet eaten or drunk. It is recommended to apply it liberally on scars.

Massotherapy

When manually examining the abdomen, adhesions are found as compacted areas. Sometimes pressure on them causes a pulling pain. Massage is designed to create tension in the affected area, activate the tissues of the abdominal cavity, increase blood circulation, and separate the organs connected by adhesions.

You need to massage gently, with your fingertips, along the natural arrangement of the internal organs. You can not massage immediately after the operation, while the sutures have not yet healed.

Prevention of postoperative adhesions

The main means of preventing the formation of adhesions after surgery is, oddly enough, physical activity. The patient should get out of bed and walk the next day after the operation. Any, even slow, movement contributes to the natural massage of the internal organs, which prevents the formation of scars and adhesive films.

As soon as possible (taking into account the patient's condition), it is necessary to start therapeutic exercises for the abdomen: moderate bends, turns of the body.

The combination of physical activity and special massage can prevent postoperative adhesive disease.

In modern life, a person has to deal with various diseases that many did not even know about before. Perhaps someone will say that it is better not to have an idea about many ailments. But if you are aware of all the events taking place with the body, then the treatment started in a timely manner will have a positive effect. In this article we will talk about such a phenomenon as spikes. What is it, what are the symptoms and how to deal with such an ailment?

adhesive process

To begin with, it is worth saying what kind of disease it is. And define the word soldering (what it is). This disease is characterized by the formation in the human body of the thinnest fibers or films. They stick together closely spaced organs. Thus, the work of a separate human system is disrupted.

It is worth noting that the adhesive process most often affects the fairer sex. They have such a disease occurs in the pelvis. Despite this, the disease can appear in the digestive, circulatory, cardiac and other body systems.

Diagnostics

It is almost impossible to see spikes. They are so thin and transparent that it is simply beyond the power of human vision. However, the presence of an ailment can be suspected by an incorrect one. Often the parts glued together are displaced.

The adhesive process can be diagnosed by manual examination or during ultrasound diagnostics. Films located in the small pelvis, the gynecologist may suspect during the examination on the chair. The diagnosis is confirmed after the ultrasound procedure.

A disease such as adhesions has a variety of causes. Let's consider them in as much detail as possible.

Inflammatory process

Perhaps the most common cause of the disease is inflammation. During a disease of an organ, it increases in volume and begins to secrete fluid. It is this mucus that eventually turns into the thinnest threads, and subsequently becomes a dense film that connects the organ with the peritoneum or other department of a particular body system.

As mentioned above, women are most often affected by this disease. In them, the cause of the adhesive process in the pelvic area can be metritis (inflammation of the uterus), salpingitis (inflammation of the fallopian tube), adnexitis. It is worth noting that the films are formed precisely in the organ where the inflammatory process was. However, with a severely neglected disease, the fluid can also enter neighboring organs.

Surgical operations

Almost always, after such manipulations, a person is faced with such a phenomenon as adhesions. What it is, you already know. Why are these films formed after such types of treatment?

Any operation is accompanied by blood loss. It can be moderate or profuse. After the end of the manipulation, the doctor always carries out the toilet of the abdominal cavity without fail, cleaning it from the remnants of blood and mucus. But during the healing period of wounds and sutures, leakage of ichor, drops of blood or mucus may occur. This is what causes the formation of adhesions. It is worth noting that the pathology develops in the organ on which the operation was performed.

For example, when removing the appendix or surgery on the intestines, adhesions form there. During surgical manipulations on the heart, thin films may appear between the chambers. During an operation on the female genital organs, the adhesive process affects this particular system. The larger the surgical incision and the longer the operation, the greater the likelihood of the onset of the disease.

internal bleeding

Adhesions may form inside the abdominal cavity during bleeding. What it is? Let's consider this process.

Often, when an organ is ruptured or damaged, blood or a fluid similar to it is released. It is she who contributes to the formation of threads, which subsequently become films. It is worth noting that each must be treated surgically, but this does not guarantee that the disease will not affect the body.

Female causes of the formation of the adhesive process

Adhesions on the ovaries, in or on the uterus can form due to various hormonal diseases. These include endometriosis, endometritis, fibroids and other diseases.

Also, with infections that were obtained through sexual contact and were not cured, an adhesive process occurs. A similar outcome can be obtained due to improper use of intrauterine contraceptives or frequent abortions.

Symptoms of the disease

Depending on where the adhesions appear, the symptoms can be different. Most often, the disease manifests itself as follows:

shortness of breath and difficulty breathing (with the formation of films on the area of the respiratory system);
indigestion and pain in the abdominal cavity (with adhesions on the stomach, liver or gallbladder);
stool disorders and pain during bowel movements (with adhesions on the intestines).

Adhesive disease of the small pelvis is characterized by the appearance of the following symptoms:

intermenstrual bleeding;
cycle disorders;
the appearance of pulling, aching or sharp pains in the lower abdomen;
the inability to become pregnant or the attachment of the fetal egg in an unusual place for him;
fever, nausea or vomiting.

Disease correction

Treatment of adhesions of the small pelvis or other organs can be carried out by various methods. This necessarily takes into account the age of the patient, the intensity of symptoms and the cause of the formation of adhesive disease.

There is a conservative, surgical and folk method of how to treat adhesions. Let's take a look at the details of the correction.

conservative way

Adhesions on the ovaries, in the fallopian tubes, or those located in other organs of the person, can be cured with medications. It is worth noting that this method of correction is most often chosen when the symptoms of the disease are not too pronounced and do not bring discomfort to the patient.

Also, a similar technique is chosen when it is necessary to prevent the formation of the thinnest threads and films between organs. Such therapy is prescribed in conjunction with the treatment of inflammation, as well as after surgical operations.

Most often, the patient is prescribed injections of the drug "Lidaza" or "Longidaza". In the treatment of adhesive disease of the small pelvis in women, the drug "Longidaza" is more effectively used in the form of rectal suppositories.

In addition, the doctor may recommend physiotherapy. During manipulation, a special beam is directed to the area of adhesion formation, which stops the growth of new tissue and prevents the formation of the adhesion process. Such prophylactic treatment is always prescribed after the correction of inflammatory diseases.

Surgical method of treatment

Adhesions, the symptoms and treatment of which are described in this article, can cause quite a lot of discomfort. And in this case, often resort to surgical intervention. Most often, this method is chosen when conservative therapy has not brought results.

It should be noted that the removal of adhesions can be carried out in two ways: laparotomy and laparoscopic way. Both of these methods are surgical procedures. Laparotomy is a fairly old and popular option. However, if there is an opportunity and the medical institution has the necessary equipment and specialists, then the advantage is given to laparoscopy.

Sometimes minor films that are removed by laparotomy are formed in a larger amount after the manipulation. That is why before the operation it is worth considering the complexity of the disease and the possible consequences.

The most gentle surgical way to remove adhesions is laparoscopy. During the procedure, the patient is under general anesthesia. That is why you do not need to be afraid of pain and you should completely trust the doctor. The doctor makes several punctures in the abdominal cavity. A video camera is inserted into one of them, which transmits an image of the internal cavity to a large screen.

In addition, the doctor makes several more incisions through which the manipulators are inserted. The number of these punctures depends on which organ the operation is performed on. Their number can be from two to four. Using these manipulators, the surgeon carefully separates the glued organs and removes the adhesion.

After the manipulation, the holes in the peritoneum are stitched together, and the patient comes to his senses.

Folk methods of treatment

Many people prefer traditional methods of treatment. It is worth noting that such a correction should not cancel the appointment of a doctor. Many experts recommend combining the folk method and the method of treatment with medications.

- St. John's wort. Treatment with such a decoction is quite common. To prepare the medicine, you will need a dried and crushed plant.

Pour one spoonful of boiling water in the amount of one glass. After that, boil the medicine for a quarter of an hour. Next, you need to cool the liquid and drink it one glass a day. The portion should be divided into four doses.

- Badan for the treatment of diseases in women. The use of this tool is not so common, but it is quite effective. You need to take 50 grams of a plant (root) and pour this loose mixture with hot water in an amount of 350 milliliters. This solution should be left for 8 hours in a dark place.

After that, the medicine is considered ready for use. It is necessary to store a container with a decoction in the refrigerator. Dilute a couple of tablespoons of medicine in one liter of boiled water daily. This means you need to douche before going to bed.

Self-rupture of adhesions

It is worth saying that the small pelvis can go away on its own after pregnancy. While waiting for the baby, the reproductive organ stretches and grows. This allows the thin threads to separate on their own.

This process is often painful. If necessary, the doctor may prescribe the expectant mother to take analgesics and sedatives. In some cases, hospital treatment may be required.

In any case, the treatment of the adhesive process should always be under the supervision of a specialist. Sometimes a gynecologist prescribes additional ones to a woman in order to determine the state of her organs.

Prevention of adhesions

Everyone knows that the best treatment for a disease is its prevention. In order to avoid the appearance of the adhesive process, you must carefully monitor your health.

Women are advised to visit the local gynecologist regularly and once a year to be tested for possible infections. If an inflammatory process is detected, it is necessary to start its treatment as soon as possible. This will help to avoid the release of fluid and prevent adhesions. The image of life also plays an important role. Give up bad habits and go in for sports.

Also, the fair sex needs to monitor the state of the hormonal background. For this, it is not necessary to take a blood test. Carefully monitor the regularity of the menstrual cycle and your well-being. Avoid unprotected casual sex. This will help you avoid various infections that cause adhesions.

If you had to undergo any operation, it is also necessary to prevent the formation of adhesions. Talk to your doctor and ask him to prescribe the necessary medications. Full compliance with all appointments will help you avoid the appearance of adhesive disease and its consequences.

Conclusion

Now you know everything about adhesive disease. If you are at risk, then get tested and start treatment if necessary, before symptoms appear and various health problems begin.

Consult with your doctor and choose the right treatment method. Watch your well-being and always try to be healthy!

The organs of the abdominal cavity are most often subject to adhesions. In most cases, the formation of adhesions is associated with previous operations. Let us consider in more detail what intestinal adhesions are, for what reasons they are formed and by what methods they are treated.

Intestinal adhesions are formations of connective tissue (strands) between the abdominal organs and intestinal loops, leading to fusion or gluing of the serous membranes of the organs to each other. The adhesive process is facilitated by the natural feature of the peritoneum to adhesion (adhesion).

As you know, the peritoneum is a thin film that envelops the internal organs. If for some reason an inflammatory focus is formed in the abdominal cavity, the film of the peritoneum, as it were, sticks to the inflamed area and prevents the pathological process from spreading to other organs.

But this useful protective function has another side. Sometimes the adhesion process can go too intensively, which leads to dysfunction and deformation of the organs enclosed in such a peritoneal membrane. Blood vessels can be pinched, often there is a narrowing of the intestine due to the compression of its walls by adhesions.

Why do intestinal adhesions form?

Doctors identify several main reasons leading to the formation of adhesions:

Doctors recognize that surgical operations are the most common cause of adhesion formation. According to statistics, they are formed in 15% of patients, and the more severe and voluminous the surgical intervention, the greater the risk of formation of adhesions between the internal organs.

Since the formation of adhesions is a rather long process, its symptoms do not appear immediately. Sometimes the pathological process does not manifest itself in any way and is discovered by chance during the examination. This becomes the reason that patients seek medical help already with a complicated adhesive process. So, what are its main symptoms:

Periodically arising pulling pains, which are localized in the area of the postoperative scar. Pain may increase after physical exertion, especially associated with sharp turns of the body and lifting weights.
Dysfunction in the work of the gastrointestinal tract, expressed in bloating, a tendency to constipation, a feeling of fullness in the navel.
Violation of the act of defecation, which manifests itself in persistent constipation. This is due to a slowdown in the patency of the intestinal contents through the areas pinched by adhesions.
Nausea and vomiting may occur after eating.
In the chronic course of the process, the patient may experience weight loss.

In some cases, serious complications can occur that pose a threat to the life of the patient and require immediate surgical intervention.

Diagnostics

Typical complaints of pain and intestinal disorders help to suspect an adhesive process in a patient. The doctor should conduct a thorough examination and question the patient about the nature of the pain, clarify whether there have been surgical interventions or abdominal injuries in the past. After a digital examination of the rectum, the patient is assigned laboratory tests and instrumental examinations.

Treatment of intestinal adhesions

Treatment of the adhesive process is carried out by conservative methods, folk remedies and with the help of a surgical operation.

Treatment with conservative methods

In about half of the cases, when diagnosing an adhesive process, it is possible to do without surgical intervention, using conservative methods of treatment in conjunction with traditional medicine and a special diet. If adhesions do not manifest themselves in any way and there is no pain syndrome, special treatment is not required. Enough observation and preventive examinations of the doctor.

With minor pain and minor functional disorders, the patient is prescribed antispasmodics and analgesics. The doctor may prescribe injections of enzymes, vitreous body, aloe preparations, splenin, which contribute to the partial resorption of adhesions. For chronic constipation, it is necessary to take laxatives prescribed by your doctor.

Diet and proper nutrition for intestinal adhesions

If you suspect an adhesive process, you must follow a special diet. In no case is it recommended to starve or overeat, this can lead to an aggravation of the problem and the development of complications. It is highly desirable to observe the regimen and eat at certain hours.

Food should be fractional, in small portions, you need to eat 4-5 times a day. Heavy and fatty foods, foods rich in fiber and provoking flatulence and bloating are excluded from the diet. These include:

legumes,
cabbage,
grape,
radish,
corn,
radish,
turnip.

It is not recommended to consume whole milk, any carbonated drinks, spicy seasonings, sauces. The menu should include foods containing calcium, eat more cheese and cottage cheese. Fermented milk products, especially kefir, are very useful. They help move the contents through the intestines.

It is better to drink kefir at night, it must be fresh, since three-day kefir, on the contrary, has a fixing effect. Food should not be hot or cold, it should be taken warm. This will help relieve intestinal spasm.

Patients with adhesive disease can eat:

low fat broths
steam or boiled fish,
soft-boiled eggs or in the form of an omelet,
boiled chicken meat,
butter in a small amount.

The patient needs to give up marinades, smoked meats, hot spices, canned food. Compliance with such a diet helps prevent exacerbations of the disease and serves as a kind of prevention of the adhesive process.

Surgical treatment: removal of adhesions through surgery

If the doctor suspects that the patient has a violation of the blood supply to the intestine due to the adhesive process, the operation should be carried out immediately. Surgical intervention will be aimed at removing obstructions and restoring the normal passage of intestinal contents. The essence of the operations is reduced to the dissection of adhesions, for which two types of operations are used: through the incision of the peritoneum and a minimally invasive laparoscopic operation.

The main problem of the surgical treatment of the adhesive process is the fact that any abdominal operation can again cause the formation of adhesions. Therefore, they try to carry out operations with minimal trauma: adhesions are separated with an electric knife or a laser. Another way is hydraulic compression of adhesions and the introduction of a special liquid under pressure into the connective tissue.

To date, two types of surgical intervention are used to remove adhesions:

Laparoscopy. A low-traumatic, sparing operation, during which a fiber-optic tube with a miniature camera and lighting is inserted through a puncture in the abdominal cavity. Through two additional incisions, manipulators with a surgical instrument are carried out, allowing, under the supervision of a camera, to dissect adhesions and cauterize blood vessels. After such a procedure, the patient quickly recovers and can return to normal life in a week.
Laparotomy. This method is used in the presence of a large number of adhesions. The operation is performed through an incision in the anterior abdominal wall, about 15 cm long, which allows you to get extensive access to the internal organs.

When choosing the tactics of surgical treatment, the doctor must take into account many factors. The first is the age of the patient. Elderly people are trying to carry out a sparing laparoscopic operation. Accompanying pathologies play an important role. For example, if a patient has problems with the heart or blood vessels, this may be a contraindication to surgery.

The choice of tactics is decisive for the number of adhesions. If a patient has single adhesions, a laparoscopic operation is indicated; if there are a large number of adhesions, surgery with a median incision of the peritoneum will be required.

Postoperative period

In the postoperative period, an important point is to provide the intestines with functional rest until the wounds are completely healed. This is ensured by refusing food on the first day after the operation. The patient is allowed to take only liquid.

On the second or third day, you can take liquid food little by little, in small portions: dietary broths, liquid pureed cereals and liquid vegetable purees. In addition to water, you can drink herbal decoctions, diluted juices. As the patient's condition improves, you can gradually switch to the next nutritional option.

A week after the operation to remove adhesions, foods of a denser consistency begin to be added to the diet. The nutrition of the patient should be complete and contain all the necessary nutrients, vitamins and minerals necessary for the speedy recovery of health. But the diet still remains sparing, the food is pre-crushed, wiped, the food is steamed or boiled.

At this time, protein-rich foods are useful - eggs, boiled lean meat or fish, vegetable puree from carrots, beets, grated apples. It is recommended to use fermented milk products (kefir, yogurt). To avoid irritation of the intestinal mucosa, food must be thermally processed. You can drink plenty of fluids:

So that fresh juices do not irritate the intestines, they are diluted with water. Under no circumstances should you drink unboiled chlorinated tap water.

After an operation of this kind, the intake of alcohol, strong coffee, and chocolate is categorically excluded. The diet should not contain flour, confectionery, smoked meats, salty, spicy, spicy, fatty and fried foods. Compliance with such a diet will allow the patient to quickly recover and soon return to a full life.

Treatment of intestinal adhesions folk remedies

Alternative methods for the treatment of adhesions can be used only after consultation with the attending physician and in cases where the disease is mild. Most often, traditional healers advise taking herbal decoctions:

Folk recipes should be treated with caution. In case of deterioration of health or the appearance of adverse symptoms, you should seek medical help as soon as possible.

Prevention of intestinal adhesions

In order to prevent the development of adhesions in the intestines, it is necessary to avoid food poisoning and any inflammatory processes in the abdominal organs. After surgical operations, it is necessary to follow the recommendations of the doctor, and already on the second day, try to turn from side to side.

This will help prevent adhesions. It is useful to perform deep exhalations and inhalations, tilts and turns of the body, if these exercises do not worsen the patient's condition and do not interfere with the healing of postoperative wounds.

It is equally important to choose the right diet and follow a diet, eating often and in small portions. It is necessary to monitor the proper functioning of the gastrointestinal tract,. Keeping an active lifestyle is helpful in preventing adhesions, but strenuous exercise should be avoided. By adhering to these recommendations, you will protect yourself from the occurrence of adhesions and will live a healthy and fulfilling life.

Content

Hysterectomy or removal of the uterus is a common operation in modern gynecology. The operation to remove or amputate the uterus is often performed in women after forty years. This is due to the fact that in patients of reproductive age, the removal of the uterus is performed only for serious indications.

Hysterectomy, which involves amputation or removal of the uterus, is performed in the following clinical cases:

uterine rupture during delivery;
intensive growth of benign tumors in women after menopause;
malignant tumors, both of the uterus and appendages, as well as suspicion of an oncological process;
prolapse of the uterus in the presence of concomitant pathologies.

Sometimes removal of the uterus is performed with extensive injuries in the pelvis and purulent peritonitis, which are characterized by a severe course. The issue of amputation of the uterine body is decided on an individual basis and depends primarily on the severity of the pathologies, the presence of other diseases, the age and reproductive plans of the patient.

Hysterectomy can be performed in several ways.

The most common is supravaginal removal or amputation.
Extirpation of the uterine body with appendages involves the amputation of both the cervix and both ovaries.
Total hysterectomy means the removal of the uterus along with the appendages, cervix, ovaries, local lymph nodes and affected tissues of the vagina. This type of removal is recommended for malignant uterine tumors.

Despite the prevalence of operations to remove the uterus, hysterectomy is recommended for serious indications. This is due to the fact that amputation of the uterus has operational and postoperative complications, as well as long-term consequences that significantly worsen the quality of life of a woman.

Gynecologists note the following operational and postoperative complications.

Inflammation and suppuration of the postoperative suture. In this case, edema, redness, suppuration of the wound develops with possible symptoms of divergence of postoperative sutures.
Suture infection after surgery. Symptoms of an infection include high fever and pain. In order to prevent infection, the postoperative suture needs regular treatment.
Violation of urination. In the early postoperative period, pain often occurs when emptying the bladder.

Bleeding. This complication can occur both in the operational and postoperative period.
Damage to neighboring organs. Amputation of the uterine body may damage the walls of the bladder and other organs.
Pulmonary thromboembolism. This dangerous complication can cause blockage of the pulmonary artery by pieces of torn tissue.
Paresis of the intestine. Occurs against the background of damage to the nerve fibers of the small pelvis during surgery.
Peritonitis. This pathology means inflammation that has spread in the abdominal region. If this postoperative complication is not eliminated in time, there is a risk of developing sepsis. In this case, the woman has symptoms such as severe pain, loss of consciousness, earthy skin tone, intense sweating, high fever. Treatment consists of antibiotics and removal of the uterine stump.

Later effects include the following manifestations.

Loss of reproductive function. Removal of the uterus entails the impossibility of bearing a pregnancy.
Psycho-emotional disorders. Hormonal fluctuations cause an unstable emotional background, depression, irritability.
Decreased libido. A woman may notice a lack of sexual desire. Sexual life is characterized by pain and psychological discomfort.
The onset of symptoms of early menopause. After amputation of the uterine body, symptoms such as sweating, hot flashes, and bone fragility appear.
The development of the adhesive process. After any surgical intervention, the appearance of adhesions is considered inevitable.
Cosmetic defect. Since amputation of the uterus occurs most often through abdominal surgery, a noticeable scar remains.

After removal of the uterus by hysterectomy, postoperative adhesions occur, which can lead to unpleasant symptoms, such as pain, defecation and urination disorders, displacement of the pelvic organs, and prolapse of the vaginal walls.

Causes after surgery

Adhesions after amputation of the uterus are one of the most unpleasant consequences of the postoperative period. According to statistics, adhesions after surgery occur in more than 90% of women. The adhesive process, despite its seeming harmlessness, is a serious postoperative complication. The danger of developing an adhesive process is that it can lead to serious illness and cause unpleasant symptoms.

If adhesions are extensive, they are defined by the term "adhesive disease". Gynecologists say that it is necessary to differentiate the physiological and pathological adhesive process.

With hysterectomy, accompanied by amputation of the uterine body, scars from the connective tissue always appear. Such scars are physiological adhesions. However, if fibrous bands continue to grow and disrupt the functioning of neighboring organs, this pathology is called adhesive disease.

Fibrous strands are distinguished by a light shade and strength. In their structure, such adhesions resemble fibrous formations that connect organs.

The etiology and pathogenesis of adhesive disease are not well understood. Usually, the appearance of adhesions is characteristic of large-scale operations involving the amputation of several organs.

There can be several reasons for education. The formation of adhesions can be associated with the following factors:

the duration of the operation;
volume of intervention and blood loss;
the presence of surgical and postoperative bleeding, which contributes to the appearance of adhesive disease;
accession of infection in the period after surgery;
genetic predisposition, manifested in the absence of an enzyme that dissolves the imposition of fibrin;
asthenic physique.

The actions of the gynecologist during the operation are essential in the formation of adhesions. It is important whether the incision was made correctly and the postoperative suture was applied.

In gynecological practice, it is sometimes found that surgeons leave foreign objects in the peritoneal region during surgery(gauze pads, tampons). This may contribute to the development of symptoms of adhesive disease after amputation of the uterus.

Symptoms upon occurrence

Adhesions after hysterectomy surgery are known to have symptoms. However, these symptoms of adhesive disease after hysterectomy are not always pronounced. Despite the fact that the severity of symptoms is individual, suspect adhesions after surgery to remove the uterus by the following symptoms.

Pain. A woman notices pains of a aching and pulling nature, which are stopped by taking painkillers. It is noteworthy that pain sensations can be both constant and periodic, and also reach considerable intensity.
Disorders regarding urination and defecation. With adhesions, disorders of the excretory function are noted.
Symptoms of disorders of the gastrointestinal tract. Quite often, adhesions after removal of the uterine body are manifested by flatulence, excessive intestinal motility.
Rise in body temperature. Adhesions after removal of the uterus can cause both high and subfebrile temperature.
Sore postoperative scar. An important symptom indicating the presence of adhesive pathology is pain in the process of probing the scar, as well as its swelling, redness.

Symptoms of adhesions are also pain during sexual intercourse. In some cases, there may be bloody discharge from the genital tract. Despite the presence of symptoms, an examination is necessary to confirm the diagnosis.

Diagnostic methods for detection

Diagnosis of adhesive disease after amputation of the uterine body is difficult. This is due to the fact that in most cases, it is possible to make an accurate diagnosis only in the process of laparoscopy or abdominal surgery.

It is possible to suspect the presence of adhesions after a hysterectomy after analyzing the patient's symptoms and history. It is possible to confirm adhesive pathology using basic diagnostic methods.

Laboratory research. This is an additional method of examination, which involves a blood test, it helps to identify inflammation, assess the activity of fibrinolysis.
Ultrasound of the abdominal cavity and small pelvis. This method of examination allows us to assume, and in some situations, to identify the presence of adhesions after hysterectomy by determining the incorrect position of the organs that are “pulled up” by adhesions.
X-ray of the intestine. The study is carried out with the help of a contrast agent. This method is auxiliary, as it helps to assess both intestinal patency and narrowing of the lumen.
Laparoscopy. This method is optimal for the diagnosis and treatment of adhesions after surgery to remove the uterus. The operating process involves the dissection and removal of adhesive formations.

Diagnosis of adhesions after amputation of the uterus is individual and depends on the symptoms and history.

Surgical tactics in the treatment

Adhesive disease is treated mainly with surgical techniques. This is due to the fact that conservative methods are ineffective and are used for prevention purposes, for example, in the postoperative period. Drug treatment is also used to eliminate unpleasant symptoms.

To eliminate adhesions after removal of the uterus, doctors use two types of operations:

laparoscopy;
laparotomy.

Laparoscopic surgery involves making several small incisions in the abdominal wall. These punctures are necessary for the use of special equipment in the operating period.

Laparoscopy has several advantages:

dissection of adhesions is performed under the direct control of the optical system;
tissue trauma is minimal;
cutting adhesions with special instruments, followed by hemostasis;
the absence of symptoms such as severe pain and postoperative complications;
the recovery phase takes several days;
rapid disappearance of symptoms of adhesions;
the possibility of motor activity the next day after the operation.

Gynecologists note that laparotomy in the treatment of adhesions that have arisen after amputation of the uterine body is rarely used. Laparotomy is mainly used in the following situations.

Inability to perform laparoscopic surgery.
Symptoms of extensive adhesive disease in the peritoneum.

Operational stages in laparotomy involve the use of lower median access. Then the surgeons expand its top to fifteen to twenty centimeters. This tactic is necessary for a thorough examination of all organs and removal of adhesions.

Laparotomy is considered a traumatic operation. This is due to the fact that such an operation has a significant risk of operative and postoperative complications. Often, after laparotomy surgery, relapses occur, and the recovery period lasts about a month.

Gynecologists advise in the postoperative period to follow the recommendations of the attending doctor, to prevent the occurrence of adhesions. If you have reproductive plans, it is advisable to start planning pregnancy after the end of the recovery period.

Prevention education

The risk of surgical and postoperative complications largely depends on the actions of the surgeon. In this connection, the choice of a doctor should be approached responsibly. The postoperative recovery period also depends on the course of the hysterectomy.

As a material for suturing the incision, it is necessary to use only absorbable thread. Hysterectomy is considered a rather extensive and serious operation, and the threads are a foreign object - an antigen for the body. Over time, the threads become overgrown with connective tissue. Subsequently, the formation of adhesions begins. Accordingly, the nature of adhesions also depends on the correct execution of the seam.

In the postoperative period after amputation of the uterine body, drug therapy is mandatory. The patient was advised to take broad-spectrum antibiotics. These drugs are the prevention of infection and inflammation. It is also advisable to use anticoagulants.

To eliminate symptoms after surgery, as well as to prevent adhesions, physiotherapy is performed. In particular, electrophoresis destroys the formation of adhesions and reduces the severity of symptoms in the early postoperative stage.

After the removal of the uterus by hysterectomy, the patient undergoes regular examinations, including ultrasound of the small pelvis and gynecological examination.

Early motor activation of the patient after removal of the uterine body is essential. For example, in the process of walking, intestinal motility may improve, and the risk of adhesions will be reduced.

Surgical treatment implies adherence to the correct diet. A woman should avoid spicy, salty and fried foods, as well as alcohol and carbonated drinks. Improper diet impairs digestion, which contributes to the weakening of intestinal motility.

Operational tactics involves fractional nutrition. Eat preferably in small portions six to eight times a day. Such a diet will not contribute to intestinal overload, and the possibility of adhesion formation will be significantly reduced.

After discharge from the hospital, a woman must follow the doctor's instructions, in particular, take prescribed medications, and conduct physiotherapy. In some cases, you can use folk remedies to prevent adhesions after surgery to remove the uterus.