Abdominal 


Adhesions
 

National Digestive Diseases Information Clearinghouse 

U.S. Department 

of Health and 

Human Services 

NATIONAL 

INSTITUTES 

OF HEALTH 

What are abdominal 

adhesions? 

Abdominal adhesions are bands of tissue that 

form between abdominal tissues and organs. 

Normally, internal tissues and organs have 

slippery surfaces, which allow them to shift 

easily as the body moves. Adhesions cause 

tissues and organs to stick together. 

Although most adhesions cause no symptoms 

or problems, others cause chronic abdominal 

or pelvic pain. Adhesions are also a major 

cause of intestinal obstruction and female 

infertility. 

What causes abdominal 

adhesions? 

Abdominal surgery is the most frequent 

cause of abdominal adhesions. Almost 

everyone who undergoes abdominal surgery 

develops adhesions; however, the risk is 

greater after operations on the lower abdomen and pelvis, including bowel and gynecological surgeries. Adhesions can become 

larger and tighter as time passes, causing 

problems years after surgery. 

Surgery-induced causes of abdominal adhesions include 

• 	 tissue incisions, especially those involving internal organs 

• 	 the handling of internal organs 

• 	 the drying out of internal organs and 

tissues 

• 	 contact of internal tissues with foreign 

materials, such as gauze, surgical gloves, 

and stitches 

Liver 

Small 

intestine 

Large 

intestine 

Stomach 

Rectum 

Appendix Anus 

Pancreas 

Esophagus 

The intestines are part of the digestive system. 

Abdominal adhesions can cause an intestinal 

obstruction. 

• 	 blood or blood clots that were not 

rinsed out during surgery 

A less common cause of abdominal adhesions is inflammation from sources not 

related to surgery, including 

• 	 appendicitis—in particular, appendix 

rupture 

• 	radiation treatment for cancer 

• 	 gynecological infections 

• 	 abdominal infections 

Rarely, abdominal adhesions form without 

apparent cause. 
How can abdominal 

adhesions cause intestinal 

obstruction? 

Abdominal adhesions can kink, twist, or pull 

the intestines out of place, causing an intestinal obstruction. An intestinal obstruction 

partially or completely restricts the movement of food or stool through the intestines. 

A complete intestinal obstruction is life 

threatening and requires immediate medical 

attention and often surgery. 

How can abdominal 

adhesions cause female 

infertility? 

Abdominal adhesions cause female infertility 

by preventing fertilized eggs from reaching 

the uterus, where fetal development takes 

place. Adhesions can kink, twist, or pull out 

of place the fallopian tubes, which carry eggs 

from the ovaries—where eggs are stored and 

released—to the uterus. 

What are the symptoms of 

abdominal adhesions? 

Although most abdominal adhesions go 

unnoticed, the most common symptom 

is chronic abdominal or pelvic pain. The 

pain often mimics that of other conditions, 

including appendicitis, endometriosis, and 

diverticulitis. 

What are the symptoms of 

an intestinal obstruction? 

Symptoms of an intestinal obstruction 

include 

• severe abdominal pain or cramping 

• vomiting 

• bloating 

• loud bowel sounds 

• swelling of the abdomen 

• inability to pass gas 

• constipation 

A person with these symptoms should seek 

medical attention immediately. 

How are abdominal 

adhesions and intestinal 

obstructions diagnosed? 

No tests are available to diagnose adhesions, 

and adhesions cannot be seen through imaging techniques such as x rays or ultrasound. 

Most adhesions are found during exploratory 

surgery. An intestinal obstruction, however, can be seen through abdominal x rays, 

barium contrast studies—also called a lower 

GI series—and computerized tomography. 

How are abdominal 

adhesions and intestinal 

obstructions treated? 

Treatment for abdominal adhesions is usually 

not necessary, as most do not cause problems. Surgery is currently the only way to 

break adhesions that cause pain, intestinal 

obstruction, or fertility problems. More surgery, however, carries the risk of additional 

adhesions and is avoided when possible. 

A complete intestinal obstruction usually requires immediate surgery. A partial 

obstruction can sometimes be relieved with 

a liquid or low-residue diet. A low-residue 

diet is high in dairy products, low in fi ber, 

and more easily broken down into smaller 

particles by the digestive system. 

2 Abdominal Adhesions 
Can abdominal adhesions be 

prevented? 

Abdominal adhesions are difficult to prevent; 

however, surgical technique can minimize 

adhesions. 

Laparoscopic surgery avoids opening up the 

abdomen with a large incision. Instead, the 

abdomen is inflated with gas while special 

surgical tools and a video camera are 

threaded through a few, small abdominal 

incisions. Inflating the abdomen gives the 

surgeon room to operate. 

If a large abdominal incision is required, 

a special filmlike material (Seprafi lm) can 

be inserted between organs or between the 

organs and the abdominal incision at the 

end of surgery. The filmlike material, which 

looks similar to wax paper, is absorbed by the 

body in about a week. 

Other steps during surgery to reduce adhesion formation include using starch- and 

latex-free gloves, handling tissues and organs 

gently, shortening surgery time, and not 

allowing tissues to dry out. 

Points to Remember 

• 	 Abdominal adhesions are bands of 

tissue that form between abdominal 

tissues and organs, causing tissues and 

organs to stick together. 

• 	 Although most adhesions cause no 

symptoms or problems, others cause 

chronic abdominal or pelvic pain, bowel 

obstruction, or female infertility. 

• 	 Abdominal surgery is the most frequent 

cause of abdominal adhesions. 

• 	 Abdominal adhesions can kink, twist, or 

pull the intestines out of place, causing 

an intestinal obstruction. 

• 	 A complete intestinal obstruction is life 

threatening and requires immediate 

medical attention and often surgery. 

• 	 Abdominal adhesions cause female 

infertility by preventing fertilized eggs 

from reaching the uterus, where fetal 

development takes place. 

• 	 No tests are available to diagnose adhesions, and adhesions cannot be seen 

through imaging techniques such as 

x rays or ultrasound. 

• 	 An intestinal obstruction can be seen 

through abdominal x rays, barium 

contrast studies—also called a lower GI 

series—and computerized tomography. 

• 	 Surgery is currently the only way to 

break adhesions that cause pain, intestinal obstruction, or fertility problems. 

Hope through Research 

The National Institute of Diabetes and 

Digestive and Kidney Diseases conducts 

and supports basic and clinical research into 

many digestive disorders. 

Participants in clinical trials can play a more 

active role in their own health care, gain 

access to new research treatments before 

they are widely available, and help others 

by contributing to medical research. For 

information about current studies, visit 

www.ClinicalTrials.gov. 

3 	 Abdominal Adhesions 
For More Information

American College of Gastroenterology

P.O. Box 342260 

Bethesda, MD 20827–2260 

Phone: 301–263–9000 

Fax: 301–263–9025 

Email: info@acg.gi.org 

Internet: www.acg.gi.org

International Foundation for Functional 

Gastrointestinal Disorders

P.O. Box 170864 

Milwaukee, WI 53217–8076 

Phone: 1–888–964–2001 or 414–964–1799 

Fax: 414–964–7176 

Email: iffgd@iffgd.org 

Internet: www.iffgd.org

You may also find additional information about this 

topic by visiting MedlinePlus at www.medlineplus.gov.

This publication may contain information about medications. When prepared, this publication included 

the most current information available. For updates 

or for questions about any medications, contact 

the U.S. Food and Drug Administration toll-free at 

1–888–INFO–FDA (463–6332) or visit www.fda.gov. 

Consult your doctor for more information.

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specific commercial product or company. Trade, 

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document are used only because they are considered 

necessary in the context of the information provided. 

If a product is not mentioned, the omission does not 

mean or imply that the product is unsatisfactory.

National Digestive Diseases 

Information Clearinghouse

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Phone: 1–800–891–5389

TTY: 1–866–569–1162

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Email: nddic@info.niddk.nih.gov

Internet: www.digestive.niddk.nih.gov

The National Digestive Diseases Information 

Clearinghouse (NDDIC) is a service of the 

National Institute of Diabetes and Digestive 

and Kidney Diseases (NIDDK). The NIDDK 

is part of the National Institutes of Health of 

the U.S. Department of Health and Human 

Services. Established in 1980, the Clearinghouse 

provides information about digestive diseases 

to people with digestive disorders and to their 

families, health care professionals, and the 

public. The NDDIC answers inquiries, develops 

and distributes publications, and works closely 

with professional and patient organizations and 

Government agencies to coordinate resources 

about digestive diseases.

Publications produced by the Clearinghouse are 

carefully reviewed by both NIDDK scientists 

and outside experts. This publication was 

reviewed by James M. Becker, M.D., F.A.C.S., 

Boston University Medical Center, and Arthur 

F. Stucchi, Ph.D., and Karen L. Reed, Ph.D., 

Boston University School of Medicine. 

This publication is not copyrighted. The Clearinghouse 

encourages users of this fact sheet to duplicate and 

distribute as many copies as desired.

This fact sheet is also available at 

www.digestive.niddk.nih.gov.

U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES

National Institutes of Health

NIH Publication No. 09–5037

January 2009