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Why Changes in Tissue Change How You Function

Let’s talk tissue. It’s impressive stuff, with a lot of important jobs.

It holds you together, gives birth to new blood cells and forms the organs that make life possible — and that’s just to start.

But tissue can change as a result of disease, surgery and normal aging. Whatever the reason, changes in tissues alter how you function.

Scar tissue
Scar tissue is a unique type of connective tissue. While it serves a purpose in the healing process, it can occasionally cause problems in the form of adhesions. These fibrous bands of tissue commonly develop in the abdomen after surgery — sometimes even years later.

Adhesions can also result from infection; endometriosis (when tissue that normally lines the uterus grows to areas such as the ovaries or the bowel); and pelvic inflammatory disease, a complication of sexually transmitted infections like chlamydia or gonorrhea.

Adhesions cause tissues or organs to stick together. Most people have no symptoms, but some people feel pain or tightness. For instance, if you have an adhesion on the bladder, you might feel pain when it fills and expands.

"Adhesions can cause tension, and tension causes discomfort," says Bruce Rosenzweig, MD, a urogynecologist at Rush. In some cases, adhesions go beyond pain and cause an obstruction. "If there's a blockage, surgery becomes necessary," he says.

Pregnancy and childbirth
Women may face fertility issues if adhesions kink fallopian tubes or twist them out of place. Often, surgery to remove adhesions can make pregnancy possible. But another surgery means additional adhesions may form down the road.

Because so much has to go right for sperm to meet up with an egg and create a baby, you have to take into account the risk of forming more adhesions.

If you're considering becoming pregnant and have these adhesions, talk to your doctor to weigh a variety of factors, including your age, when deciding whether to remove adhesions or turn to assistive reproductive technology, such as in vitro fertilization.

When tissues go bad
Surgery isn't the only thing that can affect tissue. Disease can as well. Inflammatory bowel disease (IBD) is the overarching term for a number of conditions that damage the tissues of the gastrointestinal tract, causing inflammation, swelling, sores and bleeding. The two most prominent are ulcerative colitis and Crohn's disease.

These conditions are typically first diagnosed among people in their midteens to late 20s and are often similar. But ulcerative colitis affects just the colon and rectum and tends to be located in one area.

Crohn's, on the other hand, can affect any part of the digestive tract from the mouth to the anus, and it can cause multiple areas of disease, with normal tissue in between, says Bruce Orkin, MD, a colon and rectal surgeon at Rush.

Exactly what causes these disorders isn't known, but it's believed to be an immune system malfunction. Typically, your immune system revs up when you're dealing with an infection or other threat and then eases off when the threat is over.

"In people with IBD, it seems the down-regulation doesn't occur normally," Orkin says. The immune system may remain in a heightened state continuously or spiral up and down. Treatment for these disorders is largely the same, often involving medication and dietary changes. However, sometimes surgery is necessary.

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Issues With Tissues

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