With the improvement of modern medical technology and treatment techniques, many abdominal diseases can be completely cured through surgery, so many people think that as long as the lesion is removed through surgery, they can rest easy. However, surgery is like a “double-edged sword”, which may bring complications and sequelae while curing patients’ diseases, among which intestinal adhesions are one of the common complications of laparotomy. Fortunately, most patients with intestinal adhesions do not feel special discomfort, and only a small number of patients show painful pulling of the abdominal wall, especially when the body is in a particular position, which can cause severe abdominal pain, bloating, vomiting and other symptoms, and can even lead to a serious condition, namely intestinal obstruction, the incidence of which is about 3% to 4%.
In an analogy, a normal human body is like a well-run original machine, and surgery is like a modification of the machine to repair it.
In today’s level of medical development, there is still no better way to deal with the problems related to postoperative intestinal adhesions.
A. Why does intestinal adhesion occur?
Under normal circumstances, the surface of all organs in the abdominal cavity and the inner surface of the abdominal wall are covered with a smooth peritoneum, which can secrete lubricating plasma and keep the organs gliding between them without hindrance. The small intestinal bowel is like water plants floating in the water and has considerable mobility in the abdominal cavity. When the peritoneum is damaged biologically, chemically, physically, including surgically, an acute inflammatory response occurs, leaking large amounts of fibrinogen, which in turn forms a fibrous network-like substance that concentrates on the surface of the damaged tissue organ and adheres to the surrounding tissue. As can be seen, adhesions are originally a self-repairing response of the peritoneum and are not harmful in themselves, but can lead to restricted mobility of the intra-abdominal organs. Since the intestinal canal occupies the majority of the abdominal cavity, abdominal adhesions are closely related to the intestinal canal, giving rise to the term intestinal adhesions. The intestinal tube is pulled and fixed in the adhesions, which not only reduces the mobility but also increases the curvature of the intestinal cavity, thus reducing the internal diameter of the intestinal tube and causing different degrees of narrowing of the intestinal cavity. Like a smooth highway into a sheep’s intestine, it will cause poor driving and even traffic jam.
Second, how to diagnose intestinal adhesions?
Although modern medicine has ultrasound, CT, MRI and other imaging methods, these tests can only be used to exclude other diseases that may cause similar symptoms, but cannot be used as a basis for confirming the diagnosis of intestinal adhesions. Only under anesthesia, open surgery or laparoscopic surgery, people can see the true face of intestinal adhesions.
Third, how to prevent intestinal adhesions?
Since surgery is the main cause of intestinal adhesions, the treatment before and after surgery is very important.
1, once the doctor recommended intra-abdominal disease requires surgical treatment, to seriously consider and accept surgery in a timely manner, delayed surgery will delay the treatment of heavy, light will aggravate the inflammation of the abdominal cavity, increasing the chance of intestinal adhesions.
2, some doctors will inject some drugs into the abdominal cavity during surgery, such as dextrose, chymotrypsin, trypsin, hyaluronidase, etc. These drugs have a part in preventing intestinal adhesions, but to completely prevent the occurrence of intestinal adhesions is not possible, and some methods have side effects.
3, once the patient has undergone surgery, if there is no serious abdominal inflammation and other special conditions, generally 24 to 48 hours after surgery intestinal motility gradually recovered.
In order to promote early recovery of gastrointestinal motility function as well as to prevent intestinal adhesions, the following methods should generally be used.
(1) With the permission of the doctor, you should get up and move around as early as possible, and if you cannot get out of bed, you should also turn around more in bed.
(2) Eat according to the doctor’s requirements, and pay attention to the quantity and quality of food, and progress in a gradual manner.
(3) If necessary, you can also apply some drugs and methods to promote intestinal peristalsis under the guidance of the doctor.
Fourth, how to treat intestinal adhesions?
Although we already know the ins and outs of intestinal adhesions, unfortunately, so far there is no effective clinical drugs can be used to treat intestinal adhesions. To deal with intestinal adhesions, surgical release is still the only effective means. However, the problem is that new adhesions will form after surgery and the same problems will recur, so surgery is not a permanent solution.
As we mentioned earlier, most patients with intestinal adhesions have no specific discomfort, and a few patients will present with intestinal obstruction, so our treatment focuses on how to prevent the occurrence of intestinal obstruction.
The common triggers of adhesive intestinal obstruction are.
1, gastrointestinal peristaltic dysfunction caused by improper diet or gastrointestinal inflammation, etc.
2, overeating so that a large amount of food suddenly enters the proximal segment of the intestinal canal that is compressed or pulled by adhesions.
3, strenuous physical activity after meals, so that the proximal intestinal canal of adhesions is twisted due to gravity, etc.
These should be avoided as much as possible. Once diagnosed as intestinal obstruction, some patients can be relieved after conservative treatment such as fasting, gastrointestinal decompression and intravenous infusion, but it may recur again in the future. If intestinal obstruction does not work after the above conservative treatment, or signs of intestinal necrosis appear during the treatment, the patient must be forced to undergo surgery.
How to pay attention to the diet of patients with intestinal adhesions?
In general, the diet of patients with symptomatic intestinal adhesions must follow the principles of small and frequent meals, chew slowly, light, soft, high protein, avoid cold and spicy.
Particular attention should be paid to.
1. chopping or chewing long-fiber food before eating, otherwise it leads to an increase in the size of the food mass, which does not easily pass through the narrow adhesion sites.
2. eating carefully and slowly to avoid rapid passage of large amounts of food through the stenosis site.
3. avoiding foods that are difficult to digest, such as gnocchi and dumplings, to prevent food from blocking the stenosis
4, pay attention to rest after meals and do not do strenuous activities to avoid twisting of the intestinal tube at the adhesions.
While asymptomatic patients do not have to strictly follow the above principles, they should also pay attention to a moderate diet and should not overeat.