Abdominal adhesions: any suggestions for relief?

@hopeful33250 - since I started taking 2tbsp. psyllium fibre every day, I have not had a problem with constipation. With kidney surgery, gallbladder removal, three C-sections and an appendectomy my stomach is like a roadway of scars resulting in adhesions. In Canada I don’t think PFT is covered on our health insurance plan. I do keigal exercises but ironically they create more pain.

@fourof5zs - I too have a problem swallowing, but have found keeping my head down while swallowing helps a lot. Especially with large pills.

Hello @retiredengineer and welcome to Mayo Connect. I'm really sorry to hear of your chronic abdominal pain. After so many surgeries it is understandable but I'm sure it is uncomfortable and I'm glad that you are reaching out for suggestions and help.

On Connect, we are not medical professionals, just patients like yourself, so we cannot give medical advice. I am wondering, however, if you have sought another opinion from a multi-disciplinary health care system such as a university medical school or a facility like Mayo Clinic?

These centers are research-oriented and see many patients with serious health issues and can often treat and diagnose problems more effectively than other health care facilities. Have you been evaluated at this type of medical system?

Chronic pain can be an exhausting problem. I'm wondering if you have considered pain rehabilitation. Pain rehabilitation is different than a pain clinic as they provide non-drug means of dealing with pain. Here is a link to information about the clinic at Mayo, https://www.mayoclinic.org/departments-centers/pain-rehabilitation-center/sections/featured-programs/gnc-20481713.

As you mentioned that you do not want to take pain meds, this article states that one of the goals is Medication Management, "staff members help participants taper off of opioid pain medications and any other medications that are no longer effective in managing pain."

I would like to invite Rachel, @rwinney, to discuss her experience at the Pain Rehabilitation Clinic. She attended the three-week program and can provide you with more information about the benefits.

Will you post again and let me know how you are currently dealing with pain?

Hello @rashida,

I'm glad that you posted again. Given the many abdominal surgeries, your success in using psyllium fiber every day is great and I'm glad that it is providing relief from constipation.

You mentioned that Kegel exercises create more pain. Have you discussed this with your doctor?

Hello @retiredengineer, welcome. I will do my best to try and help as it sounds like you are frustrated and hurting. Thank you for sharing your very unfortunate story. I'm glad @hopeful33250 thought to include me in her response to you regarding chronic pain and rehabilitation.

I'm sorry that you have been through the wringer with your belly. I hear you loud and clear about prescription addictive drugs. I too have taken them in the past and am proud to say I no longer do. Good for you for saying no. Thankfully your diarrhea problem has been solved, you must be thrilled about that.

Have you read through any of this discussion about abdominal adhesions? You might find helpful tips from other members.
https://connect.mayoclinic.org/discussion/abdominal-adhesions/
How long have you been experiencing chronic pain? How have you been handling it overall? Have you found dietary or lifestyle changes to be helpful?

I am not a doctor, but based on all you describe, Central Sensitization Syndrome (CSS) may be worth looking in to. CSS is an upregulation of the central nervous system which can happen after surgeries or traumatic events that causes "chronic" to occur when otherwise acute matters should heal and not be a problem. I have CSS and have learned how to manage my chronic pain and symptoms since attending Mayo Clinic's Pain Rehabilitation Center. Have you ever considered a rehabilitation program?

@hopeful33250 - not since I started taking the psyllium fibre.

@hopeful33250 - doctors can’t figure that out. Any form of exercise - even gentle stretches - can leave me in pain for weeks sometimes. I guess it’s due to fibromyalgia. 🤷🏼‍♀️

After blood tests, ultrasounds, CT scan some years ago (contrast dye of which gave mean allergic reaction), I’ve just given up and live with my pain. I have pretty much got used to being in pain. Tried every kind of pain medication - OTC, prescription, naturop, etc. Some work for a few days then stop working.

I got a pelvic infection from an IUI fertitly procedure that resulted in severe abdominal pain (bowel, bladder etc) about 3 months later.
The doctor performed laparoscopic surgery and found that ALL of my abdominal organs were scarred together in one small tight mass.
He removed the adhesions as much as possible.
One week post op, I started taking serrapeptase (proteolytic ) and nattokinase (fibrinolytic) before bed and in the morning, both on an empty stomach.
From my personal research I found they help with stopping internal scar formation as well as breaking down existing scarring.
I also began nightly castor oil packs on my entire abdominal region.
I think both of these protocols have helped significantly with my post op healing.
I’ve always scarred easily on my external body and was afraid the scarring would just immediately re-form internally.
However, about every 3 months since surgery I have had major bouts of constipation. I feel like it always begins with a couple days of very high fat meals.
My liver does not seem to be helping to break down the fats for me.
Oddly, Psyllium doesn’t help during these times.
During these bouts, I chew my food very thoroughly to begin the digestion process, lots of liquid throughout the day (a little ACV in water about 10 min before I eat) cooked veggies, fruit smoothies, small amounts of proteins, low fatty foods (tiny amounts of coconut oil, cheese, yogurt etc) I also eat fermented foods but think I will incorporate a probiotic as well.
I do yoga for constiparion and have tried various other natural remedies as well, but the constipation relief is very slow. This last time has been about a month and it’s still not back to normal.
I do not understand how my stomach is not bloated since my bowel movements are either non existent or very small compared to normal for these weeks?
I am now trying to find an abdominal adhesion massage specialist in my area.
I am afraid I have a stricture or a peristalsis issue as well. I may try a liquid diet for 10 days to allow “bowel wall ballooning” healing as one of the posters suggested.
I try to avoid prescriptions at all costs but any other suggestions would be most welcome.
Thank you

Is this a low fodmap diet?

Hi Lasirvent. My long post on the bowel management ideas was quite awhile back, and I just received the question about low fodmap. Sorry about my delay in response, as I had to get reoriented. My bowel regimen is working quite well. While I do the low fodmap partially, by default, while managing food choices that work and do not work, the other elements are just as impactful as the fodmap choices. The prescription component is the linzess, which I will likely need for the rest of my life, like a few other meds. (Such is life) .... but the miralax is what I am able to titrate, along with the different types of fiber, fats, and proteins. Liquids are an absolute. I do not allow the stool to get firm. I try not to overload the bowel with heavy/dense fibers. I am now able to freely eat raw greens, except for kale, and other raw vegetables carefully. I always fall back on soups ( low fodmap). The biggest low fodmap shifts have been green onions (vs regular) plus generally substituting vegetable options for the grains. I have increased olive oil as well. these dietary strategies (in a nut shell), along with my regimen of heat, positioning, hot drink (and the linzess... which I did not want, and have tried going without...) have shifted my life. They have allowed me to move forward with my life. I hope this helps, and I hope you discover what works for you. It is multifaceted for sure. Have a good new year!
UP Artist