Endometriosis & Adhesions 

The development of adhesions caused by endometriosis is one of the most damaging effects of this disease. Adhesions in endometriosis are caused by chronic local inflammation and the body's natural healing response


endometriosis adhesions


What are adhesions

Adhesions are not typically classed as a symptom of endometriosis but rather an effect caused by the disease.

Adhesions are bands of fibrous scar tissue caused by inflammation from endometriosis lesions, which can make pelvic organs stick together. They may not cause symptoms for everyone, but they can lead to symptoms like chronic pelvic pain, painful sex, and bowel issues are common for many women. Adhesion can also limit movement and restrict bowel movements.

It is also important to note that adhesions can be caused by previous surgery. This can include abdominal endometriosis surgery, infections, laparoscopy and laparotomy.

Cause of Adhesions

Lesion Bleeding: Trapped blood and fluid from misplaced tissue irritate the internal lining of the pelvis.

Chronic Inflammation: The immune system reacts to the abnormal growths, setting off continuous healing signals.

Surgical Trauma: Past operations to excise or treat endometriosis can also trigger scar tissue formation as a normal part of post-surgical healing.

Advanced Disease: Severe, deep infiltrating endometriosis creates larger raw and inflamed surfaces that easily stick to nearby organs like the bowel, bladder, or ovaries.

Symptoms of Adhesions

Pain is the main symptom, and it’s different from the pain caused by endometriosis. It may feel like something is pulling or tugging on your insides.

Some other symptoms that people with adhesions may experience include:

  • Vaginal pain
  • Abdominal pain
  • Rectal bleeding
  • Nausea
  • Constipation
  • Diarrhea


Are there other diseases that can fused organs together similar to endometriosis?

Yes, several other diseases, infections, and medical events can cause pelvic or abdominal organs to fuse together by creating bands of internal scar tissue known as adhesions. Most of these are common issues for women – Pelvic Inflammatory Disease and prior surgery are common health problems that women have to deal with and having numerous surgeries with endometriosis can lead to yet further damage to the pelvic organs.

Conditions That Fuse Organs

Pelvic Inflammatory Disease (PID): A severe bacterial reproductive infection (often from chlamydia or gonorrhea) that causes heavy inflammation and binds the uterus, ovaries, and tubes together.

Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease cause chronic deep gut inflammation, leading loops of intestines or nearby pelvic organs to stick together.

Prior Abdominal or Pelvic Surgeries: Surgical trauma, manipulation of tissues, or stitches frequently prompt the body to form fibrous scar tissue connecting adjacent organs.

Severe Intra-Abdominal Infections: Conditions such as a ruptured appendix, severe diverticulitis, or peritonitis trigger widespread defensive inflammation that glues tissues in place.


 New Surgical Techniques.


Some of these new surgical methods will be of value to discuss with your surgeon prior to treatment, to assess whether your surgeon has up to date information of these new techniques.

Being able to reduce the formation of adhesions is a big development in surgical treatment, and is also a huge benefit to assist in successful healing and better chances of conception after surgery.

One of the most common treatments for endometriosis is through surgery with a laparoscopy (allowing the surgeon to have a visual look at the organs in the abdominal cavity).

During the surgery the growths of endometriosis are removed, along with any cysts. Unfortunately any type of surgery can lead to scarring and adhesions where organs can stick together. Usually these develop because there is scar tissue in the pelvic region in the sites and locations that the surgeon has removed any endometriosis.

This scar tissue can easily fuse to other organs in the pelvic region that it touches as it heals. Also adhesions can develop in the abdomen/pelvic cavity where two areas of endometriosis come into contact. This is more common with more advanced endometriosis.


Prevention of Adhesions

The best way to prevent adhesions is through experienced surgical techniques, and a surgical method that minimises tissue injury and heavy bleeding. It is important to prevent blood loss at the site of any surgery, since excessive abdominal bleeding increases the likelihood of adhesions.


Surgical Barrier Agents

There are various types of barrier agents which can be used to reduce the risk the growth of adhesions, which include non-absorbent barriers, absorbable barriers and fluids. Each of these methods work by separating damaged tissue during the healing process.

One barrier product that is used is Interceed which is an absorbable barrier which is made from regenerated cellulose. It is a mesh which does not require suturing, and it is draped over the injured tissue and within an eight hour period it forms a gelatinous protective layer which is absorbed into the body in about two weeks. Interceed has reduced adhesion formation by 50 percent.

Another product that is used is Seprafilm, which is an absorbable membrane that becomes a hydrated gel within 24 hours of placement and is absorbed into the body within seven days. This product has been very effective in reducing adhesions in abdominal surgery.


New Surgical Techniques

There are now new surgical techniques that have been developed which can help to minimise this problem from developing.

A new product called Spraygel is currently being tested in the United States. It consists of two liquids that are mixed during spraying, and when mixed they form an absorbable hydrogel.

This fluid adheres and remains intact for five to seven days and then it is absorbed and excreted. It is reported that this product has decreased the frequency and amount of adhesions by 70 percent.

Adhesions Causing the need for Further Surgery

Surgical adhesions - bands of scar tissue that bind internal organs together - begin forming within hours to days after an operation

Many women with endometriosis have had to undergo further surgery simply to remove the adhesions caused by previous surgery. It is estimated that 10 to 15% of women require repeat surgery for this reason. Therefore, if the surgeon can minimise the potential risk in the first place, then the healing process that follows is much better.

Before having surgery ask your surgeon if they are using these new techniques to help reduce the possibility of future adhesions. 


Post-operative Self-Care

Measures of self-care you can use to reduce adhesions after surgery

To reduce the risk of internal scar tissue and adhesions after surgery, you can use gentle physical movement, ensure proper hydration, use gentle abdominal massage once healed and anti-inflammatory supplements.

One notable supplement you can use is Serrapetase which is a protein-breaking enzyme that helps reduce surgical scar tissue and post-surgery swelling by dissolving excess fibrin. Serrapeptase can also help by reducing inflammation which is one of the main issues following surgery and in turn this will help to reduce pain.

When taken orally, serrapeptase is easily destroyed and deactivated by your stomach acid before it has a chance to reach your intestines to be absorbed.

For this reason, dietary supplements containing serrapeptase should be enteric-coated, which prevents them from being dissolved in the stomach and allows for release in the intestine. You should take it on an empty stomach or at least 30 mins before eating or two hours after finishing a meal. A good starting dose is 80,000iu per dose taken twice a day and can be built up to higher doses.

Serrapeptase should not be taken along with blood thinners such as dietary supplements like garlic, fish oil, and turmeric, which may increase your risk of bleeding or bruising.

How soon after surgery can you use Serrapeptase?

You need to wait at least 3 to 5 days after surgery before taking serrapeptase, and only after your surgeon confirms your risk of bleeding has passed. Because serrapeptase has blood-thinning and fibrinolytic properties that break down blood clots, taking it too soon can interfere with proper wound healing and increase bleeding risks.

Additional Support after Surgery

To reduce inflammation and support proper tissue repair after surgery, key options include hydrolysed collagen (10–20g daily), vitamin C (500–1000mg daily) for collagen synthesis and targeted enzymes like bromelain - a pineapple-derived enzyme helpful in the early weeks for reducing acute bruising and localized tissue swelling. Zinc - crucial mineral cofactor for immune function, cellular repair, and preventing delayed wound closure that can worsen scarring.


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About the Author

Hi, I am Carolyn Levett, the Founder here at endo-resolved - I am an Integrative Health Coach having studied nutrition, naturopathy and aromatherapy as well as being a published author of three endometriosis books. I used to suffer from severe endometriosis and was fortunate to be able to regained my health and recover from this disease with the support of nutrition, natural therapies and lots of determination.

My motivation is to help other women with endometriosis to heal their bodies so they may start to overcome this awful disease without having to totally rely on toxic drugs and surgeries which can cause further damage  -  with healing thoughts, Carolyn.



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References:

New surgical methods prevent adhesions - Pubmed

Interceed use to reduce post operative adhesions - Pubmed

Seprafilm adhesion barrier post surgery - Pubmed

https://drseckin.com/faqs-about-endometriosis-and-adhesions/

https://www.webmd.com/women/endometriosis/endometriosis-adhesions

https://pmc.ncbi.nlm.nih.gov/articles/PMC6334013/

https://www.medicalnewstoday.com/articles/endometriosis-adhesions




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