title: Postoperative abdominal adhesions and bowel obstruction. A survey among Dutch general practitioners.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: a Department of Family Medicine , CAPHRI School for Public Health and Primary Care, Maastricht University , Maastricht , the Netherlands.
authors.forename: Raymond M F M
authors.initials: RM
authors.lastname: Leclercq
authors.affiliation: b Department of General Surgery , NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University , Maastricht , the Netherlands.
authors.forename: Kevin W Y
authors.initials: KW
authors.lastname: Van Barneveld
authors.affiliation: b Department of General Surgery , NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University , Maastricht , the Netherlands.
authors.forename: Marc H F
authors.initials: MH
authors.lastname: Schreinemacher
authors.affiliation: b Department of General Surgery , NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University , Maastricht , the Netherlands.
authors.forename: Roxanne
authors.initials: R
authors.lastname: Assies
authors.affiliation: a Department of Family Medicine , CAPHRI School for Public Health and Primary Care, Maastricht University , Maastricht , the Netherlands.
authors.forename: Mascha
authors.initials: M
authors.lastname: Twellaar
authors.affiliation: b Department of General Surgery , NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University , Maastricht , the Netherlands.
authors.forename: Nicole D
authors.initials: ND
authors.lastname: Bouvy
authors.affiliation: a Department of Family Medicine , CAPHRI School for Public Health and Primary Care, Maastricht University , Maastricht , the Netherlands.
authors.forename: Jean W M
authors.initials: JW
authors.lastname: Muris
mesh_terms: D000005:Abdomen / Q000601:surgery; D015746:Abdominal Pain / Q000188:drug therapy / Q000209:etiology; D000082:Acetaminophen / Q000627:therapeutic use; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D004043:Dietary Fiber; D004326:Drinking; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000628:therapy*; D054368:Laxatives / Q000627:therapeutic use; D008297:Male; D009426:Netherlands; D010276:Parasympatholytics / Q000627:therapeutic use; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy*; D012017:Referral and Consultation; D011795:Surveys and Questionnaires; D000267:Tissue Adhesions / Q000150:complications*
chemical_list: D018712:Analgesics, Non-Narcotic; D004043:Dietary Fiber; D054368:Laxatives; D010276:Parasympatholytics; D000082:Acetaminophen
keywords: Intestinal obstruction; adhesions; general practice; postal survey; surgery-induced