Postoperative abdominal adhesions and bowel obstruction. A survey among Dutch general practitioners

Background : There is increasing interest among specialists in the complications after abdominal surgery due to adhesions.

Objective: Exploration of experiences, attitudes and expectations of general practitioners concerning bowel obstruction and postoperative abdominal adhesions.

Methods : In October 2012 a postal questionnaire was sent to a random sample of 800 Dutch GPs.

Results: The response rate was 45%, 24% (n = 190) filled out the questionnaire completely, 12% (n = 99) had no experience with the subject and 7% (n = 57) had no time to respond. A history of abdominal surgery does play a part in more than 80% of GP's differential diagnosis of abdominal complaints. Seventy-five per cent consider some types of surgery to induce more adhesions. Eighty-five per cent ponder the differentiation between adhesion related complaints and IBS as clear, however difficult (78%) in specific patients. Intestinal transit problems likely due to adhesions are treated with extra fluid (n = 64), more fibres (n = 85) and laxatives (n = 153). Referral to a specialist for adhesiolysis is rarely considered (11%). Forty per cent of the GPs would refer a patient with abdominal pain and suspected adhesions. Seventy-six per cent denote knowledge gaps and low experience in the treatment of intestinal transit problems. Some (n = 23) indicate the need for information about adhesions and obstruction through CME papers.

Conclusion: Respondents are well equipped to deal with abdominal complaints and intestinal transit problems due to postoperative adhesions. Some indicate the need for information about adhesions and prevention of obstruction through CME papers.