Small bowel adhesions form as a result of the body’s natural healing response to abdominal tissue injury or inflammation. When the peritoneum — the thin membrane lining the abdominal cavity — is damaged, the body initiates a repair process to close the injury. This involves the release of inflammatory cells and proteins, such as fibrin, which act as a temporary “glue” to seal the affected area. Under normal circumstances, fibrin is broken down by enzymes once healing is complete. 

However, if this process is disrupted — due to excessive inflammation, insufficient enzyme activity, or persistent irritation — fibrin persists and develops into fibrous scar tissue. Over time, this scar tissue may extend and bind segments of the small intestine to each other or to nearby structures, forming adhesions. The mechanical friction and movement of the intestines, combined with prolonged inflammatory signals, exacerbate the formation of these adhesions, often leading to structural and functional disruptions in the small bowel.

Small bowel adhesions can affect anyone, but certain factors increase the likelihood of their development. In Singapore, the following groups are particularly at risk:

• Individuals with a history of abdominal or pelvic surgery: adhesions commonly form after surgical procedures like appendectomies, caesarean sections, or bowel resections.
• Patients with previous abdominal infections or inflammation: conditions like peritonitis, Crohn’s disease, or diverticulitis elevate the risk.
• Trauma patients: injuries to the abdomen, whether from accidents or blunt force, can trigger adhesion formation.
• People with repeated abdominal procedures: multiple surgeries in the same area increase adhesion risk due to cumulative tissue damage.
• Those with congenital abnormalities: certain congenital conditions may predispose individuals to adhesion formation.

At Colorectal Care Specialists , we take a patient-centric approach to diagnosing small bowel adhesions, ensuring that every step is thorough and according to your needs. Since adhesions are not usually visible through routine imaging, our specialists rely on comprehensive diagnostic methods combined with a detailed medical history and physical examination. These include:

• Comprehensive medical history and physical examination: understanding your surgical history, symptoms, and abdominal examination findings helps guide the diagnosis.
• Abdominal X-rays: useful in detecting signs of bowel obstruction, such as air-fluid levels or dilated bowel loops.
• CT Scan (Computed Tomography): offers detailed imaging to identify complications like bowel obstruction, even if the adhesions themselves are not directly visible.
• Diagnostic laparoscopy: a minimally invasive procedure that allows us to visually inspect the abdominal cavity for adhesions and address them simultaneously if necessary.

Depending on the severity of your condition, we may recommend the following options:

• Non-surgical management: for mild cases, we emphasise symptom relief through dietary modifications, hydration, and pain management to help you manage your condition effectively.
• Adhesiolysis: a minimally invasive laparoscopic procedure where adhesions are carefully removed to restore normal bowel function. This approach minimises recovery time and reduces the risk of future adhesions.
• Bowel resection: in severe cases where adhesions have caused significant damage or obstruction, we perform precise surgical resection of the affected bowel segments to ensure optimal outcomes.
• Preventive measures: for patients undergoing abdominal surgeries, we utilise specialised surgical techniques and adhesion barriers to reduce the likelihood of adhesion formation.

If you are experiencing persistent abdominal pain or symptoms of adhesions, schedule a consultation (link to ‘Contact Us’ page) with us today for a detailed diagnosis and personalised treatment plan.