Abdominal infections cause adhesions

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DEAR DR. DONOHUE: Six months ago, I had a burst appendix. I delayed too long in getting to a doctor when I had stomach pain. I went to surgery and spent about 10 days in the hospital with antibiotics because infection had spread from the burst appendix. Two weeks ago, I had another bout of stomach pain and had to go to surgery again for a blockage from adhesions. Did the infection cause the adhesions? – F.T.

ANSWER:
Adhesions are bands or strands of scar tissue. Scar tissue forms after all abdominal surgery. During surgery, handling abdominal tissues causes a degree of injury, and the body responds by forming scar tissue. Abdominal infections are another cause of adhesions. When an appendix bursts, millions of bacteria flood into the abdominal cavity. You had two good reasons for having adhesions.

Strands of scar-tissue adhesions can wrap around organs and the intestines. If a scar band encircles the small intestine tightly, it can stop the passage of food through it – an intestinal obstruction. The band has to be cut in order to free the intestine and permit food to pass through it.

People who are scheduled to have abdominal surgery don’t have to worry that they will eventually develop an intestinal obstruction. Even though scar tissue forms after just about all abdominal surgery, it only rarely wraps around the intestine to obstruct it.

DEAR DR. DONOHUE: I am 48 years old, and I take medicines for diabetes and hypertension. Men also take these medicines, and these medicines often cause them to suffer from sexual dysfunction. But men have medications like Viagra to aid them with sexual dysfunction.

I have a significantly decreased libido, most likely due to my medicines. My gynecologist says there isn’t anything she can do about it. Why isn’t there a medication for women with sexual dysfunction, like there is for men? – T.Y.

ANSWER:
Libido is sexual desire. The purpose of Viagra and similar medications is to restore men’s ability to perform sexually. Those medicines enhance the ability of the penis to fill with blood for the production of an erection. They might have a secondary effect on libido, but that’s not their primary function.

Viagra has been used by women to increase sexual desire. How effective it is remains to be seen. It hasn’t been approved by the FDA for this purpose.

Some blood pressure medicines and possibly some diabetes medicines can cause men to lose potency, and Viagra can restore it. Those same medicines might reduce desire in both men and women. The answer to that problem is to make a change in medicines. That’s almost always possible.

If it turns out your loss of libido isn’t a side effect of medicine but comes from other causes, then those causes have to be addressed. Sometimes physical ailments are the reason. The vagina dries and can make intercourse unpleasant. Lubricants can solve that situation. Fatigue is another factor in loss of libido. Once the cause of fatigue is found and treated, libido returns.

Psychological problems can also underlie diminished desire. If a search of physical causes yields no reason, if a change in medicine doesn’t restore desire, then the input of an expert in sexual function would be most helpful. Your doctor will know of one.

DEAR DR. DONOHUE: Is there a doctor out there who gives a rat’s tail about a vintage old lady like me? I am 84. My mind is willing, but my body isn’t. I have no energy. I am so tired that life has become not very worthwhile. Is there something I can do or take for this? – D.S.

ANSWER:
Fatigue is one of the most common complaints that bring people to the doctor. There is no tonic for fatigue. There are medicines that can root out the causes of fatigue. Every doctor should be willing to look for those causes, regardless of a person’s age.

Older people make up the bulk of a doctor’s practice. Doctors, therefore, have a vested interest in keeping them alive and healthy. If your doctor shows no interest, you have every right to find another.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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