question-icon

Suggest remedy for chronic pain when having adhesions below the unbilicus

default
Posted on Mon, 1 Jun 2015
Question: Hello,
I had a D&C for a fetal demise in 2011 that ended in a perforated uterus and bowel. I had a temporary colostomy as the perforations were not discovered until I was very ill and septic. I had numerous complications during the initial repair and colostomy takedown including a kinked ureter, pleural effusion, several abdominal abscesses, c diff infection, etc and spent 2+ weeks hospitalized each of the surgeries. I am now left with chronic abdominal pain, nausea, and other GI issues. I had a lap chole in 2014 and the surgeon informed me that below the umbilicus I have terrible adhesions...to the point that my bowel is adhered to the abdominal wall. Because of these adhesions I have had horrible episodes of pain, some sending me to the ER or Urgent Care. At this point OTC mess like acetaminophen and ibuprofen are doing nothing to dull the pain. I do not wish to undergo lysis of adhesions due to the risks associated and the fact that surgery will most definitely cause additional adhesions down the road. Is this chronic pain common with significant adhesions like I have? What options are offered for the pain? Is this something I should ask my Internist to refer me to a Pain Management physician for? Thank you.
doctor
Answered by Dr. T Chandrakant (6 hours later)
Brief Answer:
Enteroclysi will help in all regards.

Detailed Answer:
Hi.
Nice to see you again with a specific query, and I shall be happy to assist you more.
We already had long discussion in the previous sessions. I will try my best to concentrate on points which you have stress as new.

Noted the history again of the events that took place, and now suffering from chronic abdominal pain, nausea, and other GI issues, pain to the point that you have to rush to ER. OTC do not helps at all, not willing to undergo lysis for the ''fear'' of risks and the thought that further surgeries can cause additional adhesions down the road.

Has Lap Chole in 2014 and the Surgeon informed that there are terrible adhesions below the umbilicus.

Your Questions :
*Is this chronic pain common with significant adhesions like I have?
> As we explore many patients for a reason after many surgeries, many adhesions are seen and the patient may not have pain at all, in fact no issues related to the obstruction or so.
And on the contrary, there can be hardly any adhesion but the pain is chronic and unbearable in many instances.
To tell you the practical aspect of this: the number or amount of adhesion may not correlate to the pain one can have.
Yes, I can understand the Surgeon who has done the Lap choley should have done this as He was already inside the abdomen and might have done adhesiolysis. (Of course he might have his reasons for not doing this).

*What options are offered for the pain?
Enteroclysis= Barium studies under fluroscopy control can predict the cause, the severity, to pin-point which is the thing that is causing pain and in many cases can be a single kink or stricture or so on. If this can be predicted, possibly a perfect surgery can alleviate your pain for ever.
Option is surgery if Barium study is showing the cause.

*Is this something I should ask my Internist to refer me to a Pain Management physician for?
> This is a good idea but only after the work-up of Barium study.
This is so as pain management can work and help you reduce the pain only is there is no mechanical obstruction.

I hope you can decipher what I mean by.

Please feel free to ask for more relevant queries if you need to or if you feel that there is a gap- of -communication.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. T Chandrakant

General Surgeon

Practicing since :1984

Answered : 19540 Questions

premium_optimized

The User accepted the expert's answer

Share on
Suggest remedy for chronic pain when having adhesions below the unbilicus

Brief Answer: Enteroclysi will help in all regards. Detailed Answer: Hi. Nice to see you again with a specific query, and I shall be happy to assist you more. We already had long discussion in the previous sessions. I will try my best to concentrate on points which you have stress as new. Noted the history again of the events that took place, and now suffering from chronic abdominal pain, nausea, and other GI issues, pain to the point that you have to rush to ER. OTC do not helps at all, not willing to undergo lysis for the ''fear'' of risks and the thought that further surgeries can cause additional adhesions down the road. Has Lap Chole in 2014 and the Surgeon informed that there are terrible adhesions below the umbilicus. Your Questions : *Is this chronic pain common with significant adhesions like I have? > As we explore many patients for a reason after many surgeries, many adhesions are seen and the patient may not have pain at all, in fact no issues related to the obstruction or so. And on the contrary, there can be hardly any adhesion but the pain is chronic and unbearable in many instances. To tell you the practical aspect of this: the number or amount of adhesion may not correlate to the pain one can have. Yes, I can understand the Surgeon who has done the Lap choley should have done this as He was already inside the abdomen and might have done adhesiolysis. (Of course he might have his reasons for not doing this). *What options are offered for the pain? Enteroclysis= Barium studies under fluroscopy control can predict the cause, the severity, to pin-point which is the thing that is causing pain and in many cases can be a single kink or stricture or so on. If this can be predicted, possibly a perfect surgery can alleviate your pain for ever. Option is surgery if Barium study is showing the cause. *Is this something I should ask my Internist to refer me to a Pain Management physician for? > This is a good idea but only after the work-up of Barium study. This is so as pain management can work and help you reduce the pain only is there is no mechanical obstruction. I hope you can decipher what I mean by. Please feel free to ask for more relevant queries if you need to or if you feel that there is a gap- of -communication.