Is it Possible I Have Adhesions as a Result of an Appendectomy?

Question:

I had an appendectomy almost nine years ago and lately have been having pain in the surrounding area. Is it possible I have adhesions as a result of that surgery? If so, what can I do to stop the pain?

Answer:

"Adhesions" is simply a medical term that means scarring. Adhesions within the abdomen occur to a lesser or greater extent after any abdominal operation, including appendectomy. The bigger the operation, the more adhesions tend to form.

In the vast majority of cases, adhesions never cause any trouble. When they do cause trouble, it is most often by causing kinking and blockage of the small intestine. In this circumstance, the symptoms are usually sudden severe abdominal cramps, vomiting, and cessation of bowel movements.

A persistent low-level pain in one area of the abdomen would not be typical of something caused by adhesions. Adhesions with symptoms after abdominal operations are very common, and nonspecific pain like this is also very common. Therefore, it is difficult to conclude that there is a cause-and-effect. (Another example of this is: Driving a car and having a head cold are both very common, so it is difficult to argue that car driving causes colds.) Many physicians believe that adhesions are hardly ever a cause of chronic low-level abdominal pain.

In any event, there is no medicine to treat adhesions. Surgeons can re-operate on the abdomen to release adhesions, but this should be avoided whenever possible. The reason is that adhesions are likely to return even worse than before if more surgery is done. So the usual practice is to operate for adhesions only when forced to do so — usually when an intestinal blockage is present that does not improve with nonsurgical therapy.

The pain in the area of the appendectomy scar could be irritation of a nerve under the skin as a result of the incision for surgery. There is also the small possibility that it is due to some important disorder in the abdomen unrelated to the appendix surgery. So, if it is persistent or worsening, you should contact your doctor.

It's quite likely that nothing specific will be found to explain this type of discomfort. If no specific disorder is found, then treatment will be directed toward decreasing your pain. Work with your doctor to find a strategy that helps you achieve some comfort. This may not happen with the first or even the second recommendation. Be patient; relieving persistent pain can be challenging.