It seems that most surgeons would rather leave the adhesions alone unless they cause complete bowel obstruction. What else would convince a surgeon to operate. Mine does not seem to concerned about my reoccurant belly pain.
It is an interesting comment made that a visit to a surgeon about adhesion removal is a good idea. I get a lot of pelvic abdominal pain as had surgery on small intestine and sigmoid colon removed. Comments have been made that adhesions could be causing problems. But no-one wants to look in there and remove them.
What should be done? Is it better to leave them?? Some of my doctors think that while removing them they create more??? Any comments would be appreciated. Apparently pulling them apart causes more bleeding and perforations which need stitching back together... Thank you...
There has been a comprehensive evaluation performed, including CT scans, UGI series and colonoscopy. In addition to endometriosis, you may want to consider irritable bowel syndrome (especially with the presence of diarrhea), fibromyalgia, and interstitial cystitis.
You may want to consider laparoscopic pain mapping. This refers to laparoscopy performed under local anesthesia in which the tissues are probed and pulled with surgical instruments while the patient is asked about the severity and nature of any pain she perceives.
Empirical sequential treatment with nonsteroidal antiinflammatory medications, oral contraceptives used in monthly cycles, oral contraceptives used in long cycles, GnRH agonist analogues (eg, nafarelin, leuprolide, goserelin), and antibiotics are often successful in the treatment of pelvic pain of gynecologic origin, especially endometriosis.
If the GYN referral is not revealing, I would consider being treated for irritable bowel syndrome. As surgeon has commented below, a surgery referral to evaluate for possible obstruction is also a possibility.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Barbieri. Chronic pelvic pain. UptoDate, 2003.
Another laparoscopy would be the most direct way to find endometriosis, whereever it might be. You also could have a chronic partial small bowel obstruction due to adhesions from prior surgery. It might be that a consultation with a general surgeon would be a good idea.