Adhesions: A second opinion

For years my mother has suffered from adhesions in her stomach. The attacks happen every few weeks and can be severe, requiring emergency morphine injections. Her GP does not think there is any solution and refuses to consult another doctor. She has prescribed amitriptyline, an antidepressant for the elderly (my mother is 66). Can we demand a second opinion, or make a formal complaint?

Dr Fred Kavalier answers your health question:

Sir William Osler, a doctor who lived a century ago, said: "Adhesions are the refuge of the diagnostically destitute." He was suggesting that people with abdominal pain are fobbed off with this diagnosis. Adhesions are real, and can be very painful. They are bands of fibrous tissue that stick loops of intestine together. They often form after abdominal surgery or radiotherapy, because the intestine gets bruised.Many people with adhesions get no symptoms, but some get serious problems, including pain and obstruction of the intestine. If the diagnosis of adhesions in your mother is correct, the treatment she's getting from her GP may be sensible. I suggest first that your mother see a gastroenterologist or abdominal surgeon. If she has adhesions, her best source of help might be a pain specialist. A nutritionist may help, but I don't think there's much research into dietary management. Amitriptyline is an effective pain-reliever in small doses.

Please mail your questions for Dr Fred to health@independent.co.uk. He regrets that he is unable to respond personally to questions.