Irritable Bowel Syndrome and Abdominal Adhesions

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Irritable Bowel Syndrome and Abdominal Adhesions

Question:

I was diagnosed with irritable bowel syndrome as a teenager. Seven years ago, I had abdominal laparoscopic surgery for abdominal pain. They found adhesions. I have no history of major surgery or pelvic inflammatory disease. Now, my symptoms have returned. Are irritable bowel syndrome and abdominal adhesions related?

Answer:

Although abdominal adhesions and irritable bowel syndrome can both cause abdominal pain, there is no cause and effect relationship between the two.

Irritable bowel syndrome is a common disorder. Symptoms are believed to be due to overly sensitive nerves of the gut. This results in spasms and a heightened perception of pain. Along with pain, abnormal bowel movements are common. Diarrhea, constipation or alternating patterns of the two can be the source of considerable misery. Symptoms often worsen during stressful times of life.

Adhesions do not cause bowel irregularities. Pain is the predominant symptom. It is unusual for adhesions to form in someone who has never had surgery, but there are some situations in which this can happen. One would be a prior bout of pelvic inflammatory disease that involved the uterus and fallopian tubes. If you have never had pelvic inflammatory disease this doesn't apply to you. Another gynecological condition, endometriosis, can also cause adhesions.

It's possible, but very unlikely, that you have an unrecognized bowel perforation from an appendicitis or diverticulitis that healed and left scarring.

Another unusual possibility to consider is recurring bouts of spontaneous peritonitis from a rare genetic disorder called familial Mediterranean fever. If you have a history of brief attacks of fever with severe abdominal pain (lasting one to three days), but feel well in between, it would be worth getting checked out for familial Mediterranean fever.

Stephen Goldfinger, M.D., is a professor of medicine at Harvard Medical School. He is a graduate of Columbia College of Physicians and Surgeons, and his clinical base is at the Massachusetts General Hospital.

Last updated:	July 20, 2009