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One of the problems with getting colon resection surgery, or the reattachment procedure, is that you have a surgeon who interacts with you for about two days, or not even that long, in the hospital, who will say, "See! I did great work!" and then you never see that surgeon again when you are dealing with things like belly bloat and a tummy that looks like a third boob. But that doesn't mean there's nothing that can be done about your abdominal contour after colon surgery.

Why should colon surgery leave a dent in your abdomen? There are several possibilities, but the most likely is that you are experiencing post-surgical adhesions. An adhesion is just what it sounds like. It occurs when two organs are stuck together. It's a layer of scar tissue formed in response to the inflammation of tissues by surgery (although some people develop adhesions even without surgery). Adhesions can occur just about anywhere in the body, but they are most common after surgeries to the abdomen, female reproductive tract, and heart.

Abdominal adhesions can cause pain that mimics diverticulitis, appendicitis, or ischemic colitis. They may occur on just one side of the intestine, or they can wrap around it. When an adhesion causes intestinal blockage, there can be boborygmus ("tummy rumbles," although sometimes the sound is closer to a dog baying at the moon "Arrrrrooooo!"), diarrhea alternating with constipation, vomiting, acid reflux, heartburn, and gas you can't pass. Adhesions can be thin, something like the consistency of plastic wrap, or thick, like a heavy rubber band. Sometimes an adhesion tugs at a surgical scar to cause a dent in the contour of the abdomen. In this case, you don't really need a "filler." You probably need for the adhesion to be cut, although only your doctor can tell for sure.

What are the symptoms that require immediate medical attention?

  • Intestinal blockage usually causes waves of abdominal pain after you eat, whether or not you exercise. For instance, if you regularly get stomach cramps after you work out after a meal, or coming home when you walk to a restaurant, then the problem may be more likely something like irritable bowel syndrome (IBS). This kind of pain when you haven't exercised is a sign of a "mechanical" problem like an adhesion.
  • If you hear tinkling sounds, like dropping pennies into a fountain or dripping water from a leaky faucet, you may have a bowel obstruction, especially if gas and loose stools quickly follow.
  • Vomiting that relieves bowel pain suggests bowel obstruction.
  • When your belly expands and fills in the scar suddenly, then you really need to see a doctor soon.
  • If you experience back pain, chest pain, or loss of consciousness after these symptoms, you need to be taken to an emergency department by ambulance.

Bowel obstruction is a more urgent problem than an indented scar. People who have one tend to have the other. If the problem is just an indented scar:

  • It's very important to get any infection of the surgical site treated quickly. The white blood cells that kill bacteria also generate the adhesions that cause the dent under the site. The less work they have to do, the less problem you will have with an indentation.
  • Binge alcohol consumption (while not common in people who have had colon resections) triggers inflammatory processes that tighten tissues underneath the scar to pull them downward.
  • Poor control of blood sugar levels in diabetics increases adhesion formation after colon surgery.
  • Using birth control pills, especially if they are low in estrogen (which may still be the best option), causes adhesions, as does pregnancy after colon resection.
  • The heavier you are, the more likely you are to have indentations under a surgical scar. At the very least (not that this should be a problem for most people who have had colon surgery), don't gain weight or go on a diet to lose weight after colon resection.

Surgeons get touchy at the suggestion that their work caused adhesions. That's why you often have to go to a second physician for treatment. Attention to the issues listed above will reduce the problem, but the only way to treat it permanently is surgical.


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