Maurice,
As the mother of a daughter who had the "top" gastroenterologist in our area, my knowledge of adhesions (unfortunately for my child) came hindsight. As with many things in life, a proper perspective is often not obtained until one has completed a course.

In short, my daughter was diagnosed and "treated" for Crohn's disease. I had reason to doubt that diagnosis.

During the course of her illness, I sought out many other gastroenterologists and specialists in many areas of medicine. All dead ends. However, we did meet gastro's who agreed with me: they doubted she had Crohn's disease.Yet, none could tell me just exactly what was going on with my child. We got the vague--way overused--IBS conclusion more times than I care to remember. (If a person's life is at a standstill due to immense pain, nausea, vomiting, etc. it is very patronizing to throw that patient in the "IBS" or "depression" can). But, I digress.

What I could not get from ANY gastro or specialist was PROPER medical terminology! I was shown x-rays (repeatedly) that told the story: intestines that were abnormal. ALL gastro's and specialists described the locked down areas as "narrowed," "narrowed bowel," "thread-like bowel," "compromised bowel," rather than scar tissue or adhesions! Because of the hush-hush surrounding this all-too-common problem/medical condition that is known among physicians as an iatrogenic disorder, my daughter needlessly suffered many, many years as I continued dragging her across the country (all the while breaking the bank) in an effort to find out what was wrong with her.

It is an injustice that I intend to change so others will not suffer what my child suffered.

So, in answer to your question: rather than a gastro lacking tools to diagnose adhesions, it is my opinion (hindsight) the gastro's knew all along, but simply refused to speak the word: adhesions. Perhaps the reason for silence among physicians is twofold: #1. Patients who have knowledge of adhesions would then be able to weigh the benefit of surgery against the risk of developing a debilitating condition. #2. Most physicians have no answer for adhesions and know that surgery for adhesions only creates more adhesions.

In my daughter's case, when we finally learned the true cause of illness: adhesions, I was able to find an expert in adhesiolysis. This surgeon had no need to see years and years of worthless medical records. Rather he read my email and replied: Your daughter has adhesions. Bring her to me.

The person posting the question in this thread states her daughter has abdominal adhesions. Enough said. She also states: since her surgery "her health has deteriorated." Enough said. Therefore when you--a doctor--suggest IBS, I am sure you heard my scream all the way from Texas!

I am not a doctor and never give medical advice to anyone, but I have learned when the problem is adhesions--the problem is adhesions. Thus, she needs a doctor who specializes in adhesions, not one more gastro to insult her with an IBS (should be BS) diagnosis! (Sorry, doc, but we have lived this nightmare).

As far as your query about research studies, "sham" surgeries without adhesiolysis versus adhesiolysis, opening and closing of the abdomen, etc., I can tell you--in all honesty--that I do not look at "research studies." I do, however, talk to many, many people who suffer from adhesions (and the many problematic symptoms they cause) who developed adhesions as a result of surgery--both good and bad (sham)--surgery. You know and I know that an estimated 93% of patients who undergo abdominal or pelvic surgery via laparotomy will develop adhesions and more than half of those people will develop a problematic condition known as adhesion related disorder as a result of the surgery--(good or bad surgery).

I enjoyed the discussion of this misunderstood and all too often misdiagnosed illness. Thank you for your questions.