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Forum Name: Gastroenterology Topics

Question: Adhesion Formation


 CrohnieToo - Wed Apr 19, 2006 3:23 am

I have had Crohn's disease since 1975. In the 1970s I had a pubic "smiley" incision for a tubal ligation, bladder and uterine suspension and a couple of years later a full open abdomen incision for a resection of 18" of the mid ileum.

I'm aware that all surgery creates some scar tissue or adhesions. What I am curious about is how long these adhesions can keep forming?

I've gone all these years w/no problems from any adhesions from these two surgeries (only surgeries I've had) but my last Small Bowel Follow Thru "the distal ileum appears to extend to the left side and then turn and cross over to the right to reach the cecum". I saw the films as well and it does appear that the small intestine clumps to the left. They did not have this appearance in 2003. Could it be adhesions causing this at this late date so many years after surgery?
 Theresa Jones, RN - Tue Jun 20, 2006 7:02 am

User avatar Hi CrohnieToo,
Adhesion formation may result from surgical procedures or may also result from other causes, ie., endometriosis. Have you discussed the diagnostic changes with your physician to identify the causative factor?
Sincerely,
Theresa Jones, RN
 CrohnieToo - Tue Jun 20, 2006 8:21 am

Thank you, Nurse Jones.

I won't see my gastro until October for my annual well-visit. I saw her for my annual colonoscopy in March, the results of which suggested the SBFT.

I hate to make an appointment w/my family doctor just to ask a question such as this. Its just one of those "curiosity" things.

I had a 20 year remission after the resection and have had only mild or no symptoms since the disease became active again in 1998. I've recently (last two years) had a 30 lb weight fluctuation (115 to 90, then 98-117 lbs, lowest to highest), but no other symptoms, so have at least been in symptomatic remission but obviously not total remission. The SBFT didn't reveal any disease activity at the anastomosis in the mid-ileum only at the ileocecal valve area. I've read elsewhere since posting that Crohn's disease activity itself can cause some adhesions so I'm assuming that maybe the SBFT missed disease activity at the anastomosis since the ICV is on the right and the bulk of the small intestine is now "clumped" to the left. I had just assumed that the scar tissue caused by disease activity meant thickening of the interior wall of the intestine, it never occured to me that it might cause the outerwalls to adhere to one another.

Next time I see my family doctor or my gastro I'll ask about it if I remember. We have so little time during an office call its usually just "the squeaky wheel that gets the grease" and somehow the items of curiosity don't always to get brought up. I sure do miss the old Ask the Specialist forum that the Crohn's & Colitis Foundation of America used to sponsor. We could always satisfy our curiosity there. Dr May was such a great and patient gastro!!! CCFA did us a great disservice when they discontinued that forum. This forum is GREATLY appreciated. Thank you for taking the time to monitor it and answer questions such as this.

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