Is lysis of adhesions in colon the only option for pain during colonoscopy?

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Posted on Thu, 11 Jun 2015 in General Health
Question: Hello Dr. Ditah...we spoke a while back regarding my chronic abdominal pain, IBS issues, etc following a D&C that perforated my uterus and bowel. If you recall, I had a temporary colostomy, was in the hospital 2+ weeks with multiple complications, had my colostomy reversal two months later, again multiple complications and a 2+ week hospitalization again. I also contracted C Diff and was treated twice before being successful. Since we spoke I have seen an Internist. He drew multiple labs to check for absorption of vitamins & minerals in the bowel as well as a thyroid panel, iron levels, etc. Nothing significant turned up on those labs, yet my pain and IBS issues remained. I went for a colonoscopy today. The GI doctor said everything looked fine but said I was experiencing a great deal of pain on the left side during the procedure, which I clearly remember because it was the precise point that my abdominal pain typically happens. He suspects the adhesions have that part of my bowel really tied up causing so much pain. Is a lysis of adhesions the ONLY option I have at this point? The pain is debilitating at times and I'd prefer not to live like this. Thank you!
doctor
Answered by Dr. Ivo Ditah 15 hours later
Brief Answer:
Adhesiolysis (lysis of adhesions) would be the best approach at this time!

Detailed Answer:
Hi and thank you so much for this follow up question.

I do remember you and your health concerns very well. With this added finding and the debilitating nature of this pain, probably considering lysis of adhesions would be a great idea. I will suggest that the doctors try using minimally invasive laparoscopic surgery here. This way, they would make a small opening to insert the instrument and look into the abdomen. With lighting, they would be able to look for adhesions and try to cut them off. I feel we are pretty much left with little options but this to try.

Let me know what your take is and whether there are some more specifics that you would like me to address at this time.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Ivo Ditah 20 hours later
Thank you Dr. Ditah. I was afraid lysis of adhesions would be the only option left. It makes me very nervous due to the possibility of perforation and more adhesions forming after. But the pain is not good and I've been unable to work steadily as an RN, so I know something needs to be done. I appreciate your guidance! Thank you!
XXXX
doctor
Answered by Dr. Ivo Ditah 7 hours later
Brief Answer:
I totally understand your fears!

Detailed Answer:
Hi and thanks for sharing your feelings with me. I understand how much anxiety this can raise. However, with laparoscopy, it is unlikely to create further adhesions as only a small hole would be created to insert the instruments. If lysing proves difficult, I am pretty sure the doctor would rather not do so than cause a perforation.

Bring it up. Discuss with your doctor. Laparoscopy is also used for diagnostic purposes as well. Adhesions are very uncommon after this procedure.

Let me know what your thoughts are on this.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Ivo Ditah

Internal Medicine Specialist

Practicing since :2002

Answered : 3922 Questions

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