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Related Research

A critical part of our mission is to support patients’ rights to be well-informed about their health. The following studies conducted by third-party researchers are provided to help patients easily access current scientific findings relating to the conditions we treat — adhesions, bowel obstruction, endometriosis and infertility.

See research related to:

  • Adhesions
  • Bowel Obstruction
  • Manual Physical Therapy
  • Endometriosis
  • Infertility


Current strategies and future perspectives for intraperitoneal adhesion prevention.

Brochhausen C, Schmitt VH, Planck CN, Rajab TK, Hollemann D, Tapprich C, Krämer B, Wallwiener C, Hierlemann H, Zehbe R,Planck H, Kirkpatrick CJ. J Gastrointest Surg. 2012 Jun;16(6):1256-74.

Describes how adhesions form from a molecular level and reviews the available options for decreasing adhesions during surgery. Different barriers and surgical techniques are described, however there is currently no proven surgical method or barrier to decrease adhesions by 100%.

Post-operative adhesions after digestive surgery: their incidence and prevention: review of the literature.

Ouaïssi M, Gaujoux S, Veyrie N, Denève E, Brigand C, Castel B, Duron JJ, Rault A, Slim K, Nocca D. J Visc Surg. 2012 Apr;149(2):e104-14

This review presents primary research literature from the last 15 years assessing the rate at which patients developed adhesions after surgery involving the gastrointestinal tract. The reported rates of adhesion formation were between 67-100%. Laparoscopy was demonstrated to have a lower rate of adhesion formation as compared to laparotomy in this study.

Pathogenesis of postoperative adhesion formation.

Hellebrekers BW, Kooistra T. Br J Surg. 2011 Nov;98(11):1503-16.

This review presents data on the disease process of adhesion formation from primary research spanning the last 50 years. The authors systematically looked at the reports from the literature dealing with decreasing adhesion formation after surgery to obtain a set of hypotheses for methods of decreasing adhesion formation. Adhesion formation is presented in this paper as a complex occurrence with multiple factors influencing the formation and type of adhesions formed.

Intra-abdominal adhesions: definition, origin, significance in surgical practice, and treatment options.

Brüggmann D, Tchartchian G, Wallwiener M, Münstedt K, Tinneberg HR, Hackethal A.Dtsch Arztebl Int. 2010 Nov;107(44):769-75

This review of the literature over the course of 50 years gives a general overview of how adhesions form, consequences of adhesions, and current mechanisms for decreasing the formation of adhesions.

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Peritoneal adhesion index (PAI): proposal of a score for the “ignored iceberg” of medicine and surgery.

Coccolini F, Ansaloni L, Manfredi R, Campanati L, Poiasina E, Bertoli P, Capponi MG, Sartelli M, Di Saverio S, Cucchi M, Lazzareschi D, Pisano M, Catena F. World J Emerg Surg. 2013 Jan 31;8(1):6.

This primary research article proposes a system of classification for adhesions to reduce the subjectivity of surgeon-to-surgeon variation for describing the adhesions present during surgery. This is the first publication on standardizing the mechanism for classifying adhesions and was supported by the 2013 Working Group on Adhesive Small Bowel Obstruction (Bologna guidelines).

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Prevalence of pelvic adhesions on ultrasound examination in women with a history of Caesarean section.

Moro F, Mavrelos D, Pateman KK, Holland T, Hoo W, Jurkovic D. Ultrasound Obstet Gynecol. 2014 July; epub ahead of print

This study identified a high rate of adhesion formation diagnosed by ultrasound in women with a previous C-section. The likelihood of adhesions was increased with each abdominal surgery, including multiple C-sections, and incision site infections.

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Bowel Obstruction

Small bowel obstruction: what to look for.

Silva AC, Pimenta M, Guimarães LS. Radiographics. 2009 Mar-Apr;29(2):423-39.

This paper gives an overview of what occurs during a SBO from the radiological side of medicine. Extensive visual examples and descriptions for varying causes and degrees of obstruction are presented, providing a thorough description of the diagnostic tests physicians use to diagnose SBO.

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Bologna guidelines for diagnosis and management of adhesive small bowel obstruction (ASBO): 2013 update of the evidence-based guidelines from the World Society of Emergency Surgery ASBO working group.

Di Saverio S, Coccolini F, Galati M, Smerieri N, Biffl WL, Ansaloni L, Tugnoli G, Velmahos GC, Sartelli M, Bendinelli C, Fraga GP, Kelly MD, Moore FA, Mandalà V, Mandalà S, Masetti M, Jovine E, Pinna AD, Peitzman AB, Leppaniemi A, Sugarbaker PH, Goor HV, Moore EE, Jeekel J, Catena F. World J Emerg Surg. 2013 Oct 10;8(1):42.

This is the official publication by a group of physicians and scientists to assess the current (2013) knowledge and practices directly related to SBOs caused by adhesions. The group outlines the medical interventions and diagnostics performed for patients presenting with SBO symptoms. It provides a protocol of medical treatments commonly received during an SBO episode and explanation of the medical interventions.

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Adhesive small bowel obstruction: epidemiology, biology and prevention.

Attard JA, MacLean AR. Can J Surg. 2007 Aug;50(4):291-300

This review outlines adhesion formation (similar to the adhesion reviews) directly related to adhesions that cause SBOs.

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Natural history of patients with adhesive small bowel obstruction.

Miller G, Boman J, Shrier I, Gordon PH. Br J Surg. 2000 Sep;87(9):1240-7

This primary research defines the relative risk for formation of adhesions for specific types of surgery and the rate of re-obstruction in patients treated for SBO. Colorectal or vertical line surgery had higher odds of developing matted adhesions, while other surgeries (appendectomy, gynecological) had higher odds of developing obstructive bands. The reobstruction rate in patients with matted adhesions was approximately twice that of patients with obstructive bands.

‘Gut health’: a new objective in medicine?

Bischoff SC. BMC Med. 2011 Mar 14;9:24.

This opinion article gives an overview of the gut and why overall gut health is critical for whole-body health. The gut is the intestine and the associated environment of the intestine, including bacteria. The intestine plays a role in prevention of disease and immune system feedback, maintaining normal body function (nutrients and fluid exchange), and affects neurological body systems.

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Manual Physical Therapy

Modeled repetitive motion strain and indirect osteopathic manipulative techniques in regulation of human fibroblast proliferation and interleukin secretion.

Meltzer KR, Standley PR. J Am Osteopath Assoc. 2007 Dec;107(12):527-36

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In vitro biophysical strain model for understanding mechanisms of osteopathic manipulative treatment.

Dodd JG, Good MM, Nguyen TL, Grigg AI, Batia LM, Standley PR. J Am Osteopath Assoc. 2006 Mar;106(3):157-66

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These experimental papers describe the responses of fibroblasts to manual manipulative techniques simulated in the laboratory. The authors found that manipulative techniques reverse inflammation and cause tissues to realign. The second paper also describes tissue strain at a cellular level and why manual medicine can affect tissues.

Osteopathic lymphatic pump techniques to enhance immunity and treat pneumonia.

Hodge LM. Int J Osteopath Med. 2012 Mar;15(1):13-21.

This paper describes the benefits of manual manipulations in patients with pneumonia. Manual manipulation is widely accepted as a method of enhancing the immune system and promoting the movement of the lymphatics, both of which are necessary for patients with pneumonia in order to recover from the lung infection.

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The effects of manual therapy on connective tissue.

Threlkeld AJ. Phys Ther. 1992 Dec;72(12):893-902.

This review provides a summary of the molecular changes that occur during manual treatment and provides data for the lysis of adhesions by manual therapy. It is also a general overview of manual therapy.

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Farquhar C. BMJ. 2007 Feb 3;334(7587):249-53

This is an overview of endometriosis ─ what it is, how it is diagnosed, how common it is, and the available mainstream medical treatments. This review provides the reoccurrence data and complication rates for the treatments.

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Evaluation and treatment of endometriosis.

Schrager S, Falleroni J, Edgoose J. Am Fam Physician. 2013 Jan 15;87(2):107-13.

This review covers the formation, diagnosis, treatment and common complications associated with endometriosis.

The effects of massage therapy on dysmenorrhea caused by endometriosis.

Valiani M, Ghasemi N, Bahadoran P, Heshmat R. Iran J Nurs Midwifery Res. 2010 Fall;15(4):167-71.

Patients suffering from menstrual pain due to endometriosis were treated with abdominal massage and demonstrated a decrease in pain associated with their menstrual cycle.

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Vitamin D and fertility: a systematic review.

Lerchbaum E, Obermayer-Pietsch B. Eur J Endocrinol. 2012 May;166(5):765-78

This review outlines the importance of vitamin D in male and female fertility, and examines the role of Vitamin D in various aspects of hormone regulation. Vitamin D is known to regulate hormones in both men and women, directly affecting fertility by impacting sperm and egg production .

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Stimulatory effect of morning bright light on reproductive hormones and ovulation: results of a controlled crossover trial.

Danilenko KV, Samoilova EA. PLoS Clin Trials. 2007 Feb 9;2(2):e7.

Women with exposure to morning sunlight had higher rates of follicle development and ovulation. This supports the observation that vitamin D plays an important role in fertility.

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WHO systematic review of prevalence of chronic pelvic pain: a neglected reproductive health morbidity.

Latthe P, Latthe M, Say L, Gülmezoglu M, Khan KS. BMC Public Health. 2006 Jul 6;6:177.

This study assessed the rate of pelvic pain in women cited in the literature, noting that the prevalence of pelvic pain in developed countries is reported to be as high as 97%.

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Prevalence of pelvic adhesions on ultrasound examination in women with a history of Caesarean section.

Moro F, Mavrelos D, Pateman KK, Holland T, Hoo W, Jurkovic D. Ultrasound Obstet Gynecol. 2014 July; epub ahead of print

This study identified a high rate of adhesion formation by ultrasound in women with a previous C-section. The likelihood of adhesions was increased with each abdominal surgery, including multiple C-sections, and incision site infections.

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