Question

I have been having severe intermittent pain on my right side for about 8 months, which started right after having a total hysterectomy. When it first started it felt like I had a broken rib. It now comes every couple of weeks. I have pain on breathing deeply, then my mid-stomach area gets very sore to the touch. My stools get very thin during the episode and I have trouble passing gas. These episodes can last from 3 to 8 days. I have had CT scans, X-rays, liver function tests, gall bladder tests, and everything has come back normal.

Answer

One complication that may occur after a hysterectomy as well as other abdominal surgeries is intestinal adhesions. These are small scars that occur in the abdomen. They may cause the intestines to become fixed as opposed to being loose in the abdomen. When this occurs, the intestines can become partially or totally obstructed and fecal material and gas can no longer pass normally.

If someone has a partial obstruction, she may develop pain in the abdomen as well as bloating, nausea and vomiting. She may be unable to pass gas or stools normally. Once the obstruction is relieved, the symptoms resolve.

Most adhesions occur in the small intestine, but with pelvic surgery such as a hysterectomy, they may occur in the sigmoid colon and cause thinning of stools. Adhesions may be noticed on colonoscopy if they are in the large intestine. Sometimes they can be diagnosed only during surgery to relieve the obstruction.

You might want to consult a GI specialist to see if this type of doctor can help determine the exact cause of your symptoms, and, if it is intermittent partial obstruction, recommend appropriate treatment.