Adhesive disease is a pathological condition associated with the formation of adhesions, t. adhesions, in the abdominal cavity.

Where do they come from, these spikes? The thing is that the body takes care of itself and tries to foresee all the possible consequences of the inflammatory process occurring in the abdominal cavity, especially if it has the character of a chronic. That is why any inflammatory process is delimited from the surrounding healthy organs and tissues..

This process is universal. In some areas of our body, it is more pronounced, in some less, but the body always tries to localize inflammation, get by with “little blood”. In the event that some tissue is damaged as a result of inflammation or injury, then in most cases its deficiency is replaced by the so-called connective tissue.. It no longer performs a unique function, but simply fills the void.. And this is also a universal process..

With adhesive disease, the connective tissue has the appearance of whitish membranous adhesions between the abdominal organs. Adhesions can be congenital (with congenital defects and developmental anomalies) and acquired. The latter are much more common and are the outcome of inflammatory diseases of the abdomen or pelvis.. At first, adhesions are loose and can be easily separated, but then they become dense and can even be impregnated with calcium salts, ossify.

Causes of adhesive disease It is known that all organs of the abdominal cavity are covered with thin sheets of peritoneum. It is their inflammation that is the cause of adhesions.. In addition, the cause of the formation of adhesions can be injuries, including as a result of operations, very different - from simple removal of the appendix in appendicitis to urological and gynecological operations. At the same time, prolonged paresis (immobility) of the intestine in the postoperative period facilitates the formation of adhesions..

The causes of adhesions can also be a chemical effect on the peritoneum, hemorrhage in the abdominal cavity, exposure to foreign bodies.

Separately, there are gynecological causes of adhesions: inflammatory diseases of the uterus, appendages and pelvic peritoneum (endometritis, metroendometritis, parametritis, salpingoophoritis, pelvic peritonitis). These conditions are quite common given the wide spread of predisposing factors - prolonged use of the intrauterine device, abortion, sexually transmitted infections (chlamydia, trichomoniasis, gonorrhea, etc.).. Adhesions can also cause endometriosis - a disease in which the tissue that makes up the inner layer of the uterus (endometrium) begins to grow where it should not be, for example, on the sheets of the peritoneum.

When an inflammatory process occurs, the tissues become edematous, a plaque of fibrin appears on the sheets of the peritoneum. This substance comes from the blood vessels. Fibrin glues together the sheets of the peritoneum, thereby realizing the process of delimiting inflammation.. In the future, denser adhesions are formed in these places - adhesions..

Symptoms of adhesive disease The clinical picture depends primarily on the localization of adhesions and the extent of the lesion.. The severity of symptoms can be different - from a latent clinical picture to sudden forms requiring hospitalization.

In urgent cases, adhesive disease is usually accompanied by the development of intestinal obstruction.. At the same time, complaints are pronounced, pain syndrome gradually increases, nausea, vomiting occurs, body temperature rises.. When pressing on the abdomen, there is a sharp pain. Peristalsis (contractions) of the intestine suffers: it can first sharply increase, and then completely disappear. The condition is deteriorating rapidly: dehydration appears due to repeated vomiting, blood pressure drops, severe weakness worries.

Variants of the course of adhesive disease are possible, when symptoms appear and disappear. At the same time, pain, intestinal disorders - constipation, diarrhea are periodically disturbed.. If there is no obvious clinical picture, and only sometimes there are aching pains, constipation, then we are most likely talking about a chronic form of adhesive disease. It is she who is most often found in the practice of gynecologists.. It is important to note that the adhesive process can affect the fallopian tubes, causing them to become obstructed.. Then the main complaint will be the inability to get pregnant for a year or more.

Adhesive process: how is the diagnosis Diagnosing adhesive disease without the use of special research methods is extremely difficult. But it is quite possible to suspect its presence, given the history data - the presence of inflammatory diseases of the abdominal cavity and small pelvis in the past, surgical interventions, past infections.

Ultrasound of the abdominal cavity and small pelvis, magnetic resonance imaging (MRI), X-ray examination, electrogastroenterography can help in making a diagnosis..

The laparoscopy method has a special diagnostic value.. At the same time, a video review of the internal organs is possible using special instruments inserted through very small incisions in the abdominal wall.. One of these instruments carries a tiny video camera lens at its end.. The method is good not only for diagnostic, but also for therapeutic possibilities (the possibility of surgical treatment immediately after diagnosis). In fact, this is an operation, but very less traumatic..

Treatment of adhesions in the abdominal cavity As a rule, conservative methods are used - anti-inflammatory drugs, antibacterial therapy (with confirmed infection), enzymes for resorption of adhesions, various types of physiotherapy treatment (mud, paraffin, ozokerite, electrophoresis with medicinal substances, etc..

Surgical treatment is usually indicated in acute emergency cases (for example, intestinal obstruction) or with persistent recurrent course of the disease, with frequent exacerbations.

Prevention of adhesive disease Healthy lifestyle! It's generally. And more specifically, the correct stereotype of nutrition is very important.. Avoid long breaks between meals. You can’t go hungry all day, and then suddenly eat from the heart. In this case, the filling of the upper and lower intestines will be completely different.. The upper intestines will be crowded and rapidly contracting, while the lower ones, on the contrary, will stick together.. In this case, the spike can easily compress the rapidly working bowel loops.. Therefore, you need to eat often and little by little..

It is very important to monitor the regularity of the chair. It is necessary to take care of the normal functioning of the entire gastrointestinal tract, remembering that it begins with the mouth and teeth. Digestion of food must be of high quality at all stages of digestion.. The same applies to the stomach, which simply “must” be healthy in order to facilitate the subsequent work of the intestines..

Excessive physical activity, including heavy lifting, is also undesirable, especially if the diagnosis of adhesive disease has already been established..

In many ways, the prevention of adhesive disease is within the competence of medical professionals and includes the timely implementation of surgery for acute diseases of the abdominal cavity and small pelvis, washing the abdominal cavity in cases of peritonitis (peritoneal dialysis), antibiotic treatment for a confirmed infection or after surgery, stimulation of intestinal motility,. Therefore, we can say that the inflammatory process in the abdominal cavity or small pelvis does not always lead to the formation of adhesions.. But for a favorable outcome, it is necessary that the treatment be carried out on time and correctly..

Vadim STEPANOV, general practitioner, pulmonologist nedug. en.