If you’re facing surgery, you’ve probably wondered about what your scar will look like. But have you stopped to think about those other scars – the ones on the inside?
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
You should. These inner scars – tough tissue bands that form between your abdominal tissues and organs – can develop after surgery.
Also known as abdominal adhesions, they make your normally slippery internal tissues and organs stick together. They can also twist and pull your small or large intestines, causing obstructions. And that can cause pain.
But colorectal surgeon Eric Johnson, MD, says they’re a normal surgical outcome. In fact, 93% of people who have abdominal surgery develop an adhesion, and most have no problems. “It’s impossible to predict how much scar tissue you’ll have, though,” Dr. Johnson says. It varies from person to person.
So, if you can’t prevent an abdominal adhesion, how can you minimize this problem? Here’s what Dr. Johnson recommends.
1. Choose a minimally invasive surgery
The No. 1 method for minimizing abdominal adhesions is to have a minimally invasive – robotic or laparoscopic – procedure. These days, most procedures have minimally invasive options, but some surgeons still won’t do them.
“I advise my patients to ask about these alternatives and to request a referral if they want one,” Dr. Johnson says. “There is clear evidence that there is less scar tissue that results from a laparoscopic surgery.”
Lots of things can spark an adhesion: blood or blood clots not being washed away after a procedure, or your organs drying out somewhat during the operation. Minimally invasive surgery cuts these risks, Dr. Johnson says. Since the incisions are smaller, there are no surgical gloves touching the organs and your insides are less exposed to the air, blood loss is also less with these techniques.
2. Don’t put off surgery
You can also limit scar tissue if you have surgery earlier, Dr. Johnson says. Infections, like appendicitis or diverticulitis, can trigger scar growth. “Catching these problems before there’s any bowel rupture can help ward off the infections that lead to more scar tissue,” he says. “These steps also lower your risk of a bowel obstruction.”
3. Try a liquid diet for a day
Most abdominal adhesions don’t cause symptoms, but if they do, crampy gas pains are usually the first one to appear, Dr. Johnson says. Other warning signs – bloating, nausea, vomiting, and constipation – could point to a bowel obstruction.
Doctors diagnose obstructions either with CT scans or with X-rays of the abdominal cavity or intestines. If the blockages are severe enough, they could lead to further surgery and additional scar tissue growth.
“Patients who’ve had surgery should switch to a liquid diet for a day if they start experiencing any abdominal bloating or cramping,” Dr. Johnson says. “That’s frequently all it takes to get discomfort from adhesions under control. If not, and if symptoms worsen, you need to visit the hospital.”
4. Listen to your body
Most importantly, you need to know that if you have scar tissue, you could develop problems at any point – even years after surgery.
“If you’ve had an abdominal operation, pay attention to your body so you can recognize any problems early,” Dr. Johnson says. Abdominal inflammation from other sources, including radiation treatments or Crohn’s disease, can cause problems as well.
Lower abdominal and pelvic surgeries carry a greater adhesion risk, and these scars can get bigger over time.
For women, scar tissue can also lead to fertility problems. Adhesions can prevent fertilized eggs from reaching the uterus, and they increase the risk of ectopic pregnancy.
“By following these suggestions and paying attention to your body, you can have some control over these common adhesions and minimize your discomfort,” Dr. Johnson says.