DEAR DR. ROACH: I am 75 years old and in good health. In the past two years, I’ve had four small-bowel obstructions. The pain is excruciating (about a 9 on a scale of 1 to 10), and I have terrible bloating. In the emergency room, I am diagnosed by an abdominal X-ray and then given a morphine IV. The pain is relieved shortly, and the bloating decreases in a little while — I guess it spontaneously goes back to normal. A surgeon told me not to eat nuts or uncooked veggies. Can you please advise me if there is anything I could do to avoid this? — B.E.

ANSWER: After any kind of abdominal operation, adhesions can develop. Adhesions are fibrous bands of tissue that connect structures in the abdomen.

A complete bowel obstruction is a surgical emergency. What you have had are recurrent episodes of partial small-bowel obstruction. Allowing the intestines to rest and become less inflamed is the primary treatment. A clear liquid diet is one way of treating this. More severely affected people require a tube in the stomach to remove all contents (including secretions) from the stomach. If the symptoms are relieved in a short while (usually 12-24 hours), then surgery is seldom necessary.

I agree with your surgeon. To reduce risk of further episodes, many experts recommend reducing insoluble fiber, which is found in nuts and seeds, bran and the skins of vegetables and fruits.