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CHICAGO -- Adhesions surrounding the sigmoid colon may be the root of irritable bowel syndrome--like symptoms in some patients with pelvic pain, Dr. Brent W. Bost said at the annual meeting of the American College of Obstetricians and Gynecologists.
The adhesions are filamentous or fibrous attachments that bind the sigmoid colon to the pelvic sidewall tight enough to alter the course of the colon, sometimes causing a slight narrowing or kink that creates a bottleneck effect, explained Dr. Bost of St. Elizabeth Hospital, Beaumont, Tex.
In a poster presentation, Dr. Bost described an observational study in which 146 women underwent laparoscopy for pelvic pain. A total of 56 women were found to have sigmoid adhesions, and among them 34 women had no other reasonable source of their symptoms besides the sigmoid adhesions. Endometriosis and pelvic infection were ruled out.
All 34 women with sigmoid adhesions only had their adhesions lysed using a [CO.sub.2] laser or cautery. The bowel was returned to a normal position. The degree of pain and gastrointestinal symptoms correlated well with the extent of adhesions found during surgery. All of the women had experienced symptoms for at least 6 months; more than 40% had experienced symptoms for longer than 1 year.
Six months ...