Knowledge | Endometriosis Adhesions: Symptoms, Diagnosis, and Treatment



Knowledge | Endometriosis Adhesions: Symptoms, Diagnosis, and Treatment


Adhesions are thick bands of scar tissue that may form after surgery or infection. They can cause organs to stick to one another or to the inside of the abdominal cavity, leading to varying discomfort or pain. In people with endometriosis, adhesions may be associated with cyclical shedding of lesions and inflammation.


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Symptoms of Endometriosis Adhesions

Pain is the main symptom, but unlike pain from endometriosis itself, it often feels like pulling or tugging inside the abdomen. Adhesions around the bowel may also cause digestive problems such as:


Abdominal pain and bloating


Reduced passage of gas


Constipation


Nausea and vomiting


A complete bowel obstruction caused by adhesions can be life-threatening. Severe abdominal pain or inability to urinate, have a bowel movement, or pass gas requires immediate medical care.


Adhesions affecting the bladder may cause:


Frequent or urgent urination


A feeling of incomplete bladder emptying


Pain in the bladder area


Endometriosis adhesions may also affect fertility. Each month, an egg travels from the ovary through the fallopian tube toward the uterus, and adhesions may prevent sperm from reaching the egg, making conception difficult.


Pain during sex may indicate adhesions affecting the pelvic area.


Diagnosing Endometriosis Adhesions

Adhesions are difficult to detect directly through a routine physical examination or imaging such as ultrasound, CT, or MRI, making diagnosis challenging.


Laparoscopy is currently the most reliable method. Under general anesthesia, the doctor makes a small abdominal incision and inserts a small camera to look directly for adhesions. If found, they may be removed during the procedure.


Treatment of Endometriosis Adhesions

1. Medication: Hormonal therapy may relieve pain

Oral contraceptives or hormone therapy, such as progestins or gonadotropin-releasing hormone antagonists, may suppress endometrial tissue growth, slow formation of new adhesions, and relieve pain, but cannot remove existing scar tissue.


2. Physical therapy: Soft tissue mobilization

Soft tissue mobilization uses gentle pressure on the abdomen to mobilize adhesions, helping relieve pain and improve movement.


3. Surgery: Laparoscopic adhesiolysis

If pain severely affects quality of life or fertility problems occur, surgery is the only way to remove adhesions effectively. Adhesions can be divided laparoscopically, but surgery itself may create new adhesions, so risks should be carefully assessed beforehand.


4. Preventing new adhesions

If surgery is needed, the doctor may use an adhesion barrier gel or film to reduce the risk of new adhesions.


How can discomfort from endometriosis adhesions be relieved?

Diet: A high-fiber diet may improve digestive symptoms and reduce constipation and bloating.


Heat or massage: These may relax abdominal muscles and relieve pulling sensations.


Regular exercise: Yoga, Pilates, or gentle stretching may improve flexibility and reduce discomfort.


Consult a doctor: Choose an appropriate treatment, such as hormonal or physical therapy, based on individual needs.


When Should You Seek Medical Care?

Seek immediate medical care for:


Severe abdominal pain, especially persistent or worsening pain


Complete inability to urinate, have a bowel movement, or pass gas


Persistent nausea, vomiting, or loss of appetite


Unexplained weight loss


Endometriosis adhesions can affect quality of life, but appropriate treatment and management may relieve symptoms and reduce their effect on daily activities. If adhesions are suspected, consult a doctor promptly for an individualized treatment plan.


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