DEAR DR. GOTT: I am in my 40s and have had two c-sections. When I had my tubes tied, I was found to have a cyst the size of a grapefruit attached to my right ovary. I then had surgery (because a large incision was needed) to remove the cyst and the ovary. I also have had the Novasure procedure because of severe cramping during menstruation.
I continue to have cramping and have had abdominal ultrasounds, vaginal ultrasounds, a CT scan, and multiple trips to the emergency room. The final diagnosis was scar tissue. The ER doctor told me that he believes that the scar tissue has wrapped itself around my female organs and when I ovulate, it pulls and causes the pain. He said without doing exploratory surgery, he can’t be sure but surgery hasn’t been recommended because apparently, I produce scar tissue really well.
I currently take 600 mg ibuprofen every four hours for three to five days a month when ovulating. If I don’t, my entire right side from middle down to my groin hurts. Is there any other treatment to reduce scar tissue? I have heard there are ways to “break it up”. Should I consider surgery?
DEAR READER: An abnormal accumulation of scar tissue that connects two internal surfaces that shouldn’t be connected is known as an adhesion. This can cause a pulling sensation, cramping, pain, loss of movement, bowel obstructions, and much more, depending on where the adhesion is located.
This problem most commonly affects the bowel and the female reproductive organs, but can occur nearly anywhere in the body, including the joints or even the eyes.
Abdominal adhesions can occur for several reasons, the most common of which is surgery. Beyond that, trauma, infection, cancer, appendicitis, radiation, endometriosis, and inflammation may be to blame. Adhesions in joints may be due to surgery, overuse and because of some forms of arthritis.
To the best of my knowledge, surgery is the only treatment option available, and that itself can lead to future adhesions, so it is avoided whenever possible. There is medication available for some of the symptoms associated with adhesions. You may be one of the lucky adhesion sufferers, since you experience pain only while ovulating. For others, pain may be constant, even debilitating.
I suggest you see your gynecologist for further information, rather than continually seeking out the advice of an emergency room doctor. A gynecologist should be more familiar with adhesions, and should be able to offer advise specific to your case. If there are proven non-surgical options available, he or she will also be your best source for information regarding whether or not one may work for you.
Readers interested in learning more can order my Health Report “Managing Chronic Pain” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Dr. Peter Gott, PO Box 433, Lakeville, CT 06039. Be sure to mention the title when writing or print an order form from my website, www.AskDrGottMD.com.
