Adhesive disease of the intestine: causes, symptoms, diagnosis, treatment
Adhesive disease of the intestine is the presence of adhesions( strips of fibrous tissue), Which are formed between the loops of the thick and small intestine and the inner mucosa of the abdominal wall( parietal peritoneum) or other organs of the abdominal cavity: stoveThroat, gall bladder, uterus, ovaries, bladder.
Normally, the abdominal organs and its walls are covered with a slippery peritoneum, which prevents them from sticking together. Spikes are formed after organ tissue damage. Symptoms of adhesive intestinal disease depend on the location and amount of adhesions. Treatment is carried out in a severe clinical picture of the disease. Eliminate spikes only by surgical means.
Reasons for
The most frequent cause of adhesions in the intestine is surgical interventions on the abdominal organs. Almost all patients( about 93%) after operations on the abdomen develop spikes.
The risk of their formation is higher with interventions performed in the lower abdomen and pelvis, including intestinal and female genital surgery. Spikes can grow in size and thicken with time, causing problems many years after the operation.
Causes of formation of adhesions during surgical interventions:
- Incisions of tissues, especially involving internal organs.
- Hand touching the internal organs.
- Drying of internal organs and tissues.
- Contact of internal organs with foreign materials, for example, with gauze, surgical gloves and sutures.
- Blood or blood clots that are not completely washed during surgery.
Less frequently, adhesions in the abdomen are caused by an inflammatory process, the development of which is not associated with surgical interventions.
For these reasons belong:
- Appendicitis.
- Carrying out radiation therapy for the treatment of oncological diseases.
- Gynecological infections.
- Infectious diseases of the abdominal cavity.
Seldom adhesive disease of the intestine develops for no apparent reason.
Mechanism for the development of a commissural disease
Under normal conditions, the loops of the small and large intestine can move freely inside the abdominal cavity, sliding relative to each other and to other surrounding organs. This sliding is provided by the peritoneum and a thin film of the lubricating fluid that covers it.
In case of tissue damage inside the abdomen, an inflammatory process develops, in the place of which a fibrous connective tissue is formed. It forms spikes. In the presence of adhesions, the intestine can no longer move freely through the abdominal cavity, since its loops are connected with each other, with the abdominal wall or with other abdominal organs.
In the places of formation of adhesions, the intestine can be twisted around its axis, because of which its blood supply or normal passage through it is disturbed. Especially often this happens with the small intestine. Most cases of twisting are temporary, but sometimes it can not spontaneously recover.
Symptoms of an adhesive disease of the intestine may appear soon after the inflammatory process subsides. However, most often they develop after a few months or even years.
Symptoms of
Doctors associate symptoms and signs of adhesive intestinal disease not with the spikes themselves, but with the problems that they cause. People display various complaints that are based on where the spikes were formed and the functioning of which organs they violated. In most cases, adhesions in the abdominal cavity do not cause any symptoms, and they are simply not detected.
Pain in the abdomen with adhesive disease develops as a result of nerve tension in the organs of the abdominal cavity or within the adhesions themselves.
Clinical picture of the adhesive process in the abdomen:
- Adherence to the liver can cause pain with deep breathing.
- Intestinal adhesions can cause pain associated with intestinal obstruction, which arises from the overlapping of the passage of food through the digestive tract.
- Spikes developing between the intestine and the vagina or uterus can cause pain during intercourse.
Intestinal obstruction caused by a commissural disease may require urgent surgical treatment. Adhesion of the intestine can cause a wave-like spastic pain in the abdomen, which can last several seconds or minutes and worsen after eating, which increases the activity of the digestive tract.
After the onset of pain, the patient may experience vomiting that facilitates his condition. The patient gradually develops bloating, he can hear a sonorous rumbling in the intestines, which is accompanied by flatulence and a stiff stool. Later, there is an increase in temperature.
Adhesive intestinal obstruction can pass independently.
However, the patient needs to see a doctor if the obstruction progresses and the following symptoms develop:
- Strong bowel tension.
- Severe and persistent pain.
- The disappearance of the sounds of intestinal peristalsis.
- Disappearance of gases and defecation.
- Increased abdomen in size.
- Strong rise in body temperature.
Further progression of adhesive intestinal obstruction can lead to rupture of its wall and contamination of the abdominal cavity with contents.
Diagnosis
Adhesions in the abdominal cavity can not be detected with ultrasound or radiographic methods. Most of them are detected during surgical interventions. However, radiography of the abdominal cavity, irrigoscopy and computed tomography can help diagnose intestinal obstruction.
Treatment
Indigestion without causing complaints does not require any treatment. There are no conservative methods for eliminating adhesions.
Treatment of an adhesive disease of the intestine depends on the location and the degree of formation of adhesions and the causes of their appearance. Often the patient's condition improves without surgery. Before the development of intestinal obstruction, doctors prescribe symptomatic therapy.
Surgical treatment of
Two methods of surgical interventions are most often used to eliminate adhesions in the abdomen:
- Laparoscopic operation , during which the surgeon inserts the camera into the abdominal cavity through a small incision in the abdominal wall. After the detection of adhesions, they are disconnected using scissors or cauterizing with electric current.
- Open operation , during which the surgeon makes a large incision of the abdominal wall. In this case, the adhesions are disassembled under direct vision control with a scalpel or an electrocoagulator.
In most cases, attempts to avoid repeated surgical intervention, as its conduct is characterized by the risk of additional adhesions.
Complete intestinal obstruction due to adhesions usually requires urgent surgery to eliminate intussusception. Most cases of partial intestinal obstruction can be alleviated without surgery.
Folk methods of treatment
There are many different folk remedies used for adhesive adhesion of the intestine. However, their efficacy and safety have not been studied in studies, so before using these methods it is necessary to consult a physician.
Castor oil
Relieves pain and inflammation, and with prolonged use can reduce scar tissue and adhesions. It is necessary to moisten several layers of cotton or woolen cloth with castor oil, place it on the stomach above the supposed places of adhesions. Cover this fabric with cellophane tape and secure it in place, wrapping something around the waist. Then attach a hot water bottle to it. Thanks to this heat, castor oil will penetrate through the skin. Hold this bandage for 2 hours, then remove. You need compresses every other day.
Healing plants
For the treatment of adhesions in the stomach, comfrey and calendula are recommended, which can be used separately or in combination with each other.
Comfrey and marigold tea :
- ½ teaspoon of comfrey leaves:
- ½ teaspoon of marigold flowers:
- 2 cups of water.
Boil water and pour the herbs. Infuse for 15 minutes and drain. Add honey if needed. Drink daily.
Comfrey and Calendula Oil:
- 1 cup dry leaves of comfrey:
- 1 cup of dried marigold flowers;
- castor oil;
- extra virgin olive oil.
Put the herbs in the jar. Using equal parts of olive and castor oils, pour them with herbs. At the bottom of the multivark, put a piece of cloth and put a jar of herbs and oil on it. Add water to the cup of the multivarker so that it does not reach the top of the jar a little. Set on the maintenance of heat and keep the jar in it for 5 days. Every day you need to add a little water to the multivark. After 5 days, drain the oil.
Twice a day gently rub this oil into the stomach. Do this regularly, for several weeks or months.
It should be recalled that before applying any traditional medicine you need to consult a doctor.
Contraindications to folk methods of treatment
Folk methods should not be practiced if the patient has allergic reactions to the drugs used. Local treatments for adhesions( compresses with castor oil, rubbing) do not need to be used for skin diseases, especially at the site of application. With the development of intestinal obstruction all means of traditional medicine are strictly contraindicated, since it is possible to save a person's life only with the help of an urgent operation.
The
Diet Scientists have not been able to detect food connections with the development or prevention of an adhesive disease of the intestine. However, patients with partial intestinal obstruction caused by spikes may benefit from a slag-free diet.
Such a diet with adhesive disease of the intestine restricts the use of foods that contain a lot of fiber and other substances poorly digestible in the digestive tract. Although such a diet does not completely correspond to the long-term needs of the patient's body, it can reduce stool volume and reduce abdominal pain with partial intestinal obstruction.
In the case of adhesive disease of the intestine, whole-grain foods, brown rice, dried beans, vegetables and fruits, juices with pulp are excluded from the diet. A person can eat yogurt, jelly, puddings, ice cream and creamy soups, but they should not contain seeds and pulp.
The physician may also allow you to eat cleaned white rice and baked goods from refined flour, cereals and crackers, tender poultry meat, fish, low-fat soups and broths. A slag-free diet can also limit the milk products in case of an adhesive disease of the intestine.
Prevention of
The formation of adhesions in the abdominal cavity is difficult to prevent, however, it is possible to minimize the risk of their occurrence.
Laparoscopic surgical procedures reduce the risk of adhesions, as they are made through several small incisions, and not through a large one. If the operation is not minimally invasive, and a large incision of the abdominal wall is necessary, at the end of the operation, a special film or solution can be used that reduces the risk of adhesion.
Other steps that can be taken during surgery to minimize the likelihood of adhesions :
- Use of gloves without latex and talc.
- Cautious contact with tissues and organs.
- Reducing the duration of a surgical procedure.
- Use of wet tampons and napkins.
- Use of physiological solution for moisturizing tissues and organs.
Presence of adhesions after surgical interventions on the abdomen is a common phenomenon. In most cases, they do not cause any symptoms and do not pose a danger to humans. However, sometimes an adhesion can cause a bright clinical picture of intestinal obstruction, for the elimination of which surgical intervention is necessary.
Author: Taras Nevelichuk, doctor,
specially for Moizhivot.ru
