Abdominal Adhesions: Symptoms, Causes, Diagnosis, and Treatment

Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: September 2026

TL;DR

Abdominal adhesions are bands of scar tissue that form between organs in the belly and pelvis, causing tissues to "adhere" or stick together. They mainly form between loops of the small intestine, most often after abdominal surgery. Most adhesions never cause symptoms and need no treatment. Problems arise when scar tissue twists or narrows the bowel, causing a small bowel obstruction — a medical emergency with severe pain, bloating, nausea, vomiting, and an inability to pass gas or stool. Imaging cannot detect adhesions directly, and surgery is the only way to know for certain; treatment is reserved for complications like obstruction or infertility.

Quick Answer

What are abdominal adhesions?

• Bands of scar tissue that form between abdominal tissues and organs, making them stick together; they are the most common consequence of abdominal surgery.

• Most adhesions cause no symptoms and require no treatment.

• The main danger is a small bowel obstruction, which is life-threatening without emergency care.

• They are diagnosed from symptoms and history since imaging cannot see adhesions; surgery is the only way to know for sure.

What Are Abdominal Adhesions?

Abdominal adhesions are bands of scar tissue that form between the organs in your belly and pelvis. Mainly, they form between loops of your small intestine. They can also form between an organ and the wall of your abdominal cavity.

The name tells you what they do: the tissue can cause your organs to "adhere," or stick together.

Adhesions occur when there is injury or inflammation in your abdomen. They can even form from normal handling during surgery. In fact, they are most common after abdominal surgery. As a natural part of healing, scar tissue forms that can cause tissues to stiffen and stick together.

How Common Are They?

Abdominal adhesions are the most common consequence of having surgery on your abdomen. The majority of people develop adhesions after abdominal surgery. But most people don't need treatment unless they are experiencing symptoms.

Adhesions are also the most common cause of a small bowel obstruction — a medical emergency involving a complete or partial blockage in your intestines.

What Are the Symptoms?

Most adhesions don't cause symptoms. Sometimes, though, abdominal adhesions can cause your intestines to twist, similar to how a garden hose can become kinked. This can occur shortly after or even years after surgery and lead to a small bowel obstruction.

With an obstruction, food, liquid, air, and waste can't pass through your intestines. You may notice severe abdominal pain, cramping, bloating, nausea and vomiting, abdominal distension (when your abdomen swells outward), and obstipation — being unable to pass gas or poop.

| Symptom | What it means | | --- | --- | | Severe abdominal pain | Possible bowel blockage from twisted or narrowed intestine | | Cramping | Intestine struggling to push contents past a narrowing | | Bloating and abdominal distension | Abdomen swells outward as gas and fluid back up | | Nausea and vomiting | Contents can't move through the blocked intestine | | Obstipation | Inability to pass gas or stool — a key sign of obstruction |

Get to an emergency room (ER) immediately if you're experiencing symptoms of a small bowel obstruction. It can be life-threatening without emergency care.

What Causes Abdominal Adhesions?

Abdominal adhesions form after your body repairs injured tissue inside your abdominal cavity. They're like internal scars. If an organ or tissue inside your abdominal cavity is damaged, your immune system triggers inflammation to heal the tissue. As part of the healing process, the damaged tissue forms scar tissue.

Unlike the scars that form when you skin your knee, adhesions in your abdomen don't peel and fade as if they were never there. Instead, damaged surfaces can stick together.

Approximately 75% of diagnosed adhesions form as a result of abdominal surgery. But they can form in response to any injury, condition, or treatment that causes inflammation in your abdomen.

| Cause | How it leads to adhesions | | --- | --- | | Abdominal surgery | Tissue is injured and heals with scar bands; roughly 75% of diagnosed adhesions follow surgery | | Abdominal or pelvic infections | Inflammation from infection creates scar tissue as tissue heals | | Appendicitis, Crohn's disease, diverticulitis | Inflammatory conditions damage tissue and trigger the scarring process | | Endometriosis, pelvic inflammatory disease (PID) | Inflammation and tissue damage in the pelvis form scar bands | | Radiation therapy to the abdomen | Radiation injures tissue, which heals with scarring | | Peritoneal dialysis | Repeated treatment of the abdominal lining causes inflammation |

What Are the Risk Factors?

The biggest risk factor associated with abdominal adhesions is abdominal surgery, especially open surgery, surgery on the lower digestive organs, multiple abdominal surgeries, and emergency surgery.

| Risk factor | Adhesion risk | | --- | --- | | Open surgery (laparotomy) | Adhesions occur in more than 90% of open surgeries | | Laparoscopic surgery | Slightly less common than with open surgery | | Surgery on colon or rectum | Higher risk — surgery on lower digestive organs | | Multiple abdominal surgeries | Each operation adds to the risk | | Emergency surgery | Higher risk than planned operations |

Open surgery (laparotomy) involves a single large incision. During laparoscopic surgery, surgeons operate through a few small cuts instead of one large one, which is why adhesions are slightly less common with that approach.

What Are the Complications?

Most adhesions don't cause problems. But when they do, the complications can be serious.

The first complication is a small bowel obstruction. Scar tissue can cause loops of small bowel to twist or narrow, resulting in a blockage. Without emergency treatment, an obstruction can lead to a life-threatening infection called peritonitis.

The second is chronic pain. Adhesions can prevent your organs from moving around freely, which may cause long-term visceral pain in your pelvis or abdomen.

The third is infertility. Scar tissue can prevent eggs and sperm from meeting so that conception can happen. Scar tissue inside your uterus can prevent a fertilized egg (embryo) from implanting. Adhesions inside the uterus are called intrauterine adhesions or Asherman's syndrome.

| Complication | What happens | Why it matters | | --- | --- | --- | | Small bowel obstruction | Scar tissue twists or narrows bowel loops, blocking passage | Can lead to peritonitis, a life-threatening infection | | Chronic pain | Organs cannot move freely | Long-term visceral pain in the pelvis or abdomen | | Infertility | Scar tissue blocks egg-sperm meeting or embryo implantation | Intrauterine adhesions are called Asherman's syndrome |

How Are Abdominal Adhesions Diagnosed?

Your healthcare provider will ask about your symptoms and medical history. Symptoms like abdominal pain plus a history of abdominal surgery may cause your provider to suspect adhesions.

Here is the catch: imaging technology can't detect abdominal adhesions. But imaging studies can detect intestinal blockages that may be related to adhesions.

X-rays and CT scans of your abdomen can show blockages in your small intestine, and a CT scan can show how severe the obstruction is. A hysterosalpingogram (HSG) can show blockages in your uterus or fallopian tubes.

Surgery is the only way to know for sure if you have adhesions.

| Test | What it can (and can't) do | | --- | --- | | Symptom history and physical exam | Suggests adhesions when pain follows abdominal surgery | | Abdominal X-ray | Can show intestinal blockages related to adhesions, but not adhesions themselves | | CT scan | Shows blockages and how severe the obstruction is; cannot see the scar bands | | Hysterosalpingogram (HSG) | Shows blockages in the uterus or fallopian tubes | | Surgery | The only way to confirm adhesions with certainty |

How Are Abdominal Adhesions Treated?

Most adhesions don't cause symptoms or require treatment.

There is also a fundamental dilemma: additional surgeries cause more adhesions. Your surgeon can cut bands of tissue that are stuck together so that they become "unstuck." But as soon as the operation is done, there's no way to prevent the tissue from sticking together again.

For that reason, your healthcare provider will likely avoid surgery unless there's a major medical problem that needs to be fixed, like a bowel obstruction. You may also need surgery to remove uterine adhesions that prevent you from getting pregnant.

| Situation | Typical approach | | --- | --- | | Adhesions without symptoms | No treatment; watchful waiting | | Chronic adhesion-related pain | Over-the-counter pain medication, or referral to a pain specialist; soft tissue mobilization may help | | Bowel obstruction | Emergency treatment, usually surgery | | Uterine adhesions causing infertility | Surgery to remove the adhesions |

For pain relief, your healthcare provider may recommend over-the-counter pain medications, or may refer you to a pain specialist if you have painful adhesions. Some studies suggest that a form of physical therapy called soft tissue mobilization can help reduce adhesion-related pain, though more research is needed to understand its potential benefits.

The only way to break up scar tissue in your stomach is through surgery to remove the adhesions, and your provider will walk you through the benefits and risks based on your symptoms.

On food, there aren't "bad" foods you should avoid if you have adhesions. If you have a partial bowel obstruction, your provider may recommend soft foods or foods low in fiber, since these pass through your intestines more easily.

Can You Prevent Abdominal Adhesions?

There's nothing you or your surgeon can do to prevent abdominal adhesions entirely.

However, adhesions are less common with laparoscopic surgery because of the smaller cuts. Increasingly, surgeons choose laparoscopic surgery over open surgery for many abdominal procedures.

Your surgeon may also place barriers between tissue surfaces during surgery to prevent scar tissue from causing them to stick together. These barriers come in solid, liquid, gel, and spray forms that dissolve in your body. Still, even with barriers, scar tissue is an unavoidable part of the healing process. Research is ongoing to locate solutions that can reduce the scarring that leads to complications.

What Is the Outlook?

You may have extensive abdominal adhesions and never have any symptoms at all. Some adhesions improve on their own over time, and unless they're causing problems, healthcare providers usually choose to avoid removing them.

Surgery may be needed if you have repeated bowel obstructions or a complete blockage. Sometimes surgery is necessary despite the risks of developing more adhesions. Your healthcare provider can help you weigh the pros and cons based on your symptoms.

When Should You Seek Care?

Contact your healthcare provider if you're experiencing unexplained abdominal pain or if you're having trouble pooping or passing gas. You may have adhesions or a partial bowel obstruction.

A complete bowel obstruction is life-threatening. Seek emergency medical attention immediately if you experience severe abdominal pain or cramps, significant abdominal swelling or bloating, or nausea or vomiting.

Conclusion

Abdominal adhesions are a paradox: they are the most common consequence of abdominal surgery, yet most people who have them never feel a thing. These internal scar bands form as a natural part of healing, and unlike a knee scrape, they don't fade — the scarred surfaces simply keep sticking together.

The danger isn't the adhesions themselves but what they can do. A scar band can twist or narrow the small bowel years after an operation, creating a blockage that stops food, liquid, air, and waste from passing. That is a medical emergency, and timing is everything.

Because imaging can't see the scar bands and surgery is the only definitive diagnosis, the practical takeaway is to know your history. If you've had abdominal surgery and develop unexplained pain, swelling, or trouble passing gas or stool, don't wait it out — seek care promptly, and go straight to the ER for signs of obstruction.

Have a history of belly surgery and new, unexplained abdominal pain? Contact your healthcare provider right away. Severe pain with bloating, nausea, or vomiting means the ER — not the calendar.

Frequently Asked Questions

What are abdominal adhesions? Bands of scar tissue that form between abdominal tissues and organs, causing them to stick together. They most often form between loops of the small intestine and are the most common consequence of abdominal surgery.

Do abdominal adhesions always cause symptoms? No. Most adhesions cause no symptoms and require no treatment. Symptoms usually appear only when the scar tissue twists or narrows the bowel enough to cause a blockage.

What are the symptoms of a small bowel obstruction? Severe abdominal pain, cramping, bloating, nausea and vomiting, abdominal distension, and obstipation — the inability to pass gas or stool. This is a life-threatening emergency requiring immediate ER care.

How are abdominal adhesions diagnosed? Through symptoms and a history of abdominal surgery. Imaging cannot detect adhesions directly, though X-rays and CT scans can show related intestinal blockages, and an HSG can show uterine or fallopian tube blockages. Surgery is the only way to confirm adhesions for certain.

How are abdominal adhesions treated? Most need no treatment. Surgery is reserved for complications such as bowel obstruction or uterine adhesions causing infertility. Because new surgery causes more adhesions, providers avoid operating unless absolutely necessary.

Can abdominal adhesions be prevented? Not completely — scar tissue is an unavoidable part of healing. Adhesions are less common with laparoscopic surgery than open surgery, and surgeons may place dissolving barrier films, gels, or sprays between tissue surfaces, but no method fully prevents them.

How common are abdominal adhesions after surgery? Very common: the majority of people develop adhesions after abdominal surgery, and adhesions form in more than 90% of open abdominal surgeries. They also cause roughly three-quarters of diagnosed cases and are the most common cause of small bowel obstruction.

References

This article is based on medically reviewed clinical information, including Abdominal Adhesions, supplemented by peer-reviewed research on adhesion prevention and treatment, including a scoping review of regenerative medicine therapies for prevention of abdominal adhesions in the Journal of Surgical Research and the StatPearls entry on adhesiolysis (NIH National Library of Medicine).

This article is for educational purposes only and is not a substitute for professional medical advice. A complete bowel obstruction is life-threatening; severe abdominal pain with swelling, nausea, or vomiting requires immediate emergency medical attention.