Resources with Links relative to helping to prevent
chronic pain caused by post-surgical adhesions.
PLEASE NOTE: These are links to external sites; they
will open in new windows.
Somewhere in the late 1990’s, shortly after
its inception, the International Adhesions Society
coined the term “Adhesion Related Disorder” (ARD)
as a result of its research it had started into the
nature of the problems of adhesions, from the perspective
of the patient. Having adhesions is about much more
than bowel obstruction, pelvic or abdominal pain, and
that’s why we starting calling this ARD:
“Adhesion Related Disorder” (ARD): a constellation
of recurrent bowel obstruction, chronic abdominal or
pelvic pain, chronic diarrhea or constipation. Patients
often develop a variety of psychosocial issues, and
have undergone a number of procedures in an attempt
to diagnose and/or correct a sometimes unidentifiable
It's not just....
Irritable bowel syndrome
Complex Abdomino-Pelvic & Pain Syndrome
Going beyond ARD, the IAS’s own research revealed
the ARD patient is a member of a much larger group
of patients who, in varying degrees, combinations and
sequences experience a range of overlapping and coalescing
symptoms and conditions including endometriosis, interstitial
cystitis (IC), irritable bowel syndrome (IBS), bowel
obstruction, chronic abdominal and/or pelvic pain and
Although ‘‘adhesions’’ may
start out as a single, stand-alone entity, an adhesions
patient may develop a number of related conditions
rendering the severe ARD patient practically indistinguishable
from patients with multiple symptoms originating from
other abdominal or pelvic conditions. Similarly, a
patient starting out with say chronic pelvic pain,
may very well have, or develop bowel and bladder problems,
as well as psycho-social issues that develop as a result
of their condition.
Attempting to treat these conditions as separate entities
for the most part is an exercise in frustration. Although
they may start out as separate conditions, they end
up as essentially one condition - CAPPS. What is needed
is a multi-disciplinary and integrated or holistic
approach. And to start we need to understand these
individual conditions in the context of a family of
conditions to which they belong.
Once we understand the disease we can begin on its
prevention and treatment.
Accordingly we coined the term:
Complex Abdomino-Pelvic & Pain Syndrome
to describe this huge population of patients. We define
“a syndrome of nonmalignant origin consisting
of a complex of symptoms of the abdomen or pelvis that
includes pain, bowel, or bladder dysfunction of at
least 6 months duration.”
about our research and why it was important
to coin the term CAPPS.
This page goes beyond
the standard descriptions of adhesions and their prevention, and discusses the wider
problem of ARD and CAPPS.
CAPPS - General
- Disorders of adhesions or adhesion-related disorder:
monolithic entities or part of something bigger--CAPPS?
This is the landmark paper produced as a result of
IAS research. Click
here for the full text article and
a lay summary and
here for the PubMed abstract.
- Surgical treatment for chronic pelvic pain.
laparoscopy and adhesiolysis: does it help with complex
abdominal and pelvic pain syndrome
(CAPPS) in general surgery? A paper coming from the
Adhesions (CAPPS) clinic
set up by the IAS with Dr.
Redan and McCarus.
Patient's Guide to Adhesions and Related Pain", Dr. Wiseman’s original paper describing
adhesions, their treatment and their relationship to
pain and bowel obstruction. In addition, stories from
patients are featured to illustrate how adhesions (or
suspected adhesions) affect their daily lives and how
they cope with a sometimes-insurmountable problem.
This was the paper that led to the terms ARD, CAPPS
and their descriptions.
Related Disorder by Dr. Clark Gerhart, another
doctor experienced in ARD.
- Evidence for overlap between urological and nonurological
unexplained clinical conditions.
- IAS Research on Severe Adhesion Related Disorder
(ARD); Pattern of Bowel Dysfunction and Obstruction,
Social and Physician Issues: an Internet Survey
- IAS Research on Adhesions Related Deaths
IAS Sister Organization -ISCAPPS
- International Society
for Complex Abdomino-Pelvic & Pain
Pain Research Alliance (CPRA), formerly the
Overlapping Conditions Alliance.
- Campaign to End Chronic Pain in Women
Components of CAPPS
Chronic Fatigue Syndrome
- Chronic Fatigue and
Immune Dysfunction Syndrome Association of America.
Dyspareunia (Painful Sexual Intercouse)
does it hurt when I have sex? – ASRM.
intercourse – painful.
See our endometriosis page here.
- Fibromyalgia – National Library of Medicine.
- Fibromyalgia – WebMD
- Fibromylagia Network
IBS – Irritable Bowel Syndrome
Bowel Syndrome – National Library
Digestive Diseases Information Clearinghouse (NDDIC)
- Irritable bowel syndrome and chronic pelvic pain:
a singular or two different clinical syndrome?
- Defining and diagnosing irritable bowel syndrome
- Irritable Bowel Syndrome Self Help and Support Group
Foundation for Functional Gastrointestinal Disorders (IFFGD).
Interstitial Cystitis (IC), Painful Bladder, Overactive
- Interstitial Cystitis from National Library of Medicine
- Interstitial cystitis/bladder pain syndrome fact
Cystitis/Painful Bladder Syndrome -
- Patients with chronic pelvic pain: endometriosis
or interstitial cystitis/painful bladder syndrome?
cystitis and endometriosis in patients with chronic
pelvic pain: The "Evil Twins" syndrome.
- Interstitial Cystitis Association
- International Painful Bladder Foundation
- Interstitial Cystitis Network and Overactive Bladder
Chronic Pelvic Pain (CPP)
is Chronic Pelvic Pain? – International
Pelvic Pain Society
Pelvic Pain and the Overlap of Pelvic Pain Disorders by Michael Pezzone MD.
Dr. Pezzone is the principal investigator of an NIH
study that looked at the pathways of neurogenic cross-sensitization
of pelvic viscera and its implications for the overlap
of irritable bowel syndrome, interstitial cystitis,
and other chronic pelvic pain disorders.
Pelvic Pain – ASRM
concepts of pelvic congestion and chronic pelvic pain.
An excellent review by the late Dr. Perry, founder
of the International Pelvic Pain Society.
- Chronic pelvic pain in the community--symptoms, investigations,
- Hormone suppression in differential diagnosis of
Pelvic Pain Society – has searchable
database for physicians and other providers.
- Pelvic Pain
Support Network – UK
Pain and Chronic Pain, General Resources
Please refer to our
page containing resources concerning
pain and chronic pain in general.
Complex regional pain syndrome, CRPS; RSDS; Causalgia
- RSD; Reflex sympathetic dystrophy (RSD) syndrome
information from the National Library of Medicine
- Global approach to chronic pelvic and perineal
pain: from the concept of organ pain to that of dysfunction
of visceral pain regulation systems
Sympathetic Dystrophy Association
Please see our Vulvodynia page here.
Conditions/ Procedures that may lead to adhesions
- Endometriosis. Please see our Endometriosis page
- Uterine Fibroids, Myoma, Myomectomy. Please see
our fibroids page here.
- Hysterectomy. Although ANY surgical procedure has
the potential to result in adhesions, we have highlighted
hysterectomy because of its particular prevalence
an ability to result in problems from adhesions.