Q: I am a 45-year-old female. I had a hysterectomy for fibroids nearly a year ago, and I still get sharp pains in my stomach from time to time. My doctor informed me that it was due to scar tissue or adhesions and there was nothing he could do about it. What is your opinion?
A: Adhesions are the result of the body’s reaction to trauma or surgery.
Strands of a protein known as fibrin are part of the blood clots that form as part of the healing process. Generally these strands dissolve and disappear once the healing process is completed. However, in some people, these strands of protein seem to be thicker and tougher and can even develop their own blood and nerve supply. They can cause some parts of the body to stick together.
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Other non-surgical events can also lead to adhesion formation. These include infection, chemotherapy, radiation and diseases such as cancer or endometriosis where abnormal cells cause damage to internal organs. Adhesions in the female fallopian tubes that lead from the ovary to the uterus can cause blockage and result in infertility.
Adhesions are remarkably common. A 1973 study of victims of road traffic accidents found that up to 67 percent of those that had had previous surgery had some adhesions. This number increased to 81 percent for people who had had major surgery.
It is possible that the scar tissue may shrink, which could solve your problem without further intervention.
The only other solution is more surgery, but this may only make the situation worse because you are more likely to develop additional adhesions the second time around. If the pain is only mild and occasional and there is no other major problem such as bowel obstruction, then your doctor is probably correct and you should leave well enough alone.
For further information, there is a website at www.adhesions.org.
Q: My 12-year-old daughter developed a rash after getting a sore throat and being treated with Amoxil. Is this a penicillin allergy?
A: Sometimes it is difficult to tell if the rash is due to the penicillin or if it was a viral illness where a rash is a symptom along with the sore throat. The only way to be sure is to wait until the rash clears up.
I assume that you discontinued the medication immediately. Later, ask the doctor to give her a skin test using a small dose of penicillin and see what happens.
For some reason, the rate of penicillin allergy seems to be dropping according to new research by doctors at St. Louis Children’s Hospital in San Francisco. They studied 900 children between 1979 and 2003 and analyzed the results of skin testing. To their surprise they found that by 1994, positive results had almost disappeared.
They wondered if this is due to the fact that few children are given injectable penicillin these days. The intramuscular, injectable type is more likely to cause allergic reactions and used to be given almost routinely in doctor’s offices or in the emergency departments of hospitals if a child had a cut that required stitches.
Clare Rowson is a medical doctor with a practice near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
