Sphincter of Oddi dysfunction discussion - Digestive Disorders Message Board

Jennio · 03-16-2006, 02:04 AM

Hello, all! I am new to the forum. Four years ago, I was diagnosed with sphincter of Oddi dysfunction. I have had two or three ERCPs with sphicterotomies. The procedures helped to a degree, but I still suffered from far too many attacks (I usually experience elevated LFTs with my attacks, though I have also had pancreatitis as well). Most recently I have had multiple ERCPs with biliary stent placements. This helped a great deal, but it is not a good long-term solution. The stents have to be replaced every 3-4 months, and the procedure is high risk.

So . . . I am now stentless!

My current treatment is to take Robinul Forte 2mg twice a day. I am back to having attacks, unfortunately, but not too much of a surprise. My GI doctor and I are considering more extensive surgery as the next step. I don't know the name of it--essentially it is open abdominal surgery to cut the sphincter. I know it is really risky, can pose complications, and may not help or even worsen the problem. But then again, maybe it is just the thing . . .

I would be interested in hearing other people's experiences with this surgery. Also, I would appreciate in knowing what other treatments people have found successfull or not-so-very helpful. What has worked for you?

Thanks for your help,
Jen

jj9500 · 03-16-2006, 06:17 AM

Jennio - I have been having some strange digestive problems and have had many tests done. Things are coming out normal. The next step the doc said is to get test for SOD. Can you tell me what it feels like when you have an attack. The docs seem to think this could be GERD, but it still happens when I am on my Protonix (PPI meds). My symptoms are: A fullness or pressure in the upper stomach/chest area -where the rib cage meets, it is accompanied by belching which releives it some, then can radiate to the upper back. Almost like someone squeezing your shoulders together iwth a vice grip. When I belch I can taste foods that I've eaten, or some times even regurgitate food. Sometimes this feeling lasts 10 minutes..sometimes 2 hours until it's gone. I usually take a good dose of Maalox Max, Gaviscon, or some tums and it relieves it. How do they test for Sphincter of Oddi? Is it risky? Thanks.

Jennio · 03-18-2006, 04:33 PM

Sorry to hear about your GI troubles. Hope you find this information helpful.

First, a little anatomy lesson. Your sphincter of Oddi is a sphincter muscle that joins at the end of your commoln bile duct and your pancreatic duct. The sphincter empties into the small intestine, where it regulates the flow of digestive enzymes from your gall bladder, liver, and pancreas.

With sphincter of Oddi dysfunction, there is an abnormality of your sphincter of Oddi. It may be too small, or, as in may case, something causes it to spasm. You can think of it as getting a clog in a drain--there is a "clog" in your sphincter, which causes the digestive juices to get backed up. Because of this, attacks are usually accompanied with elevated liver enzymes or elevated pancreatic enzymes (pancreatitis).

Attacks are usually very painful (though I have had more mild ones). The pain is an intense crushing, burning, spasm that centers in my chest and radiates into my back and into my upper abdomen. The attacks can be accompanied by nausea. My attacks can last anywhere from a half hour to 12 hours. Narcotics can help take the edge off the pain, but nothing really helps. You just have to let the attack run its course.

Sphincter of Oddi dysfunction is a rare disorder and difficult to diagnose. One sign that you may have it is that your attacks are accompanied with elevated liver enzymes or elevated pancreatic enzymes. This is fairly simple to check for. It requires a blood test during an attack.

A specialized doctor can also go in and measure the pressure inside your sphicter of Oddi. This procedure is done through an ERCP. It is a high risk procedure; it can cause pancreatitis.

I hope this is all helpful. Good luck!

jj9500 · 03-20-2006, 06:51 AM

Would burping and regurgitation also be signs of an attack. I'm wondering it this is what I have. I was told I could just have sever GERD at time. What triggers these attacks. Is there anything you can do or take to help with attacks? Can this disease be fatal?

pmarc68 · 03-26-2006, 08:45 AM

I am in desperate need of some information regarding SOD. I am currently not diagnosed with this, although this is the way my GI is leaning. My story is this: In May of 2005 I started to have symptoms of gallbladder disease. I would have acute attacks several hours after eating anything that had a high fat content. I had an abdominal ultrasound that revealed gallstones. On July 18th I had a lap chole. Since I had the surgery I have still had similar attacks. I have had an EGD that revealed GERD and was placed on Prevacid Solutabs 30 mg once a day. The pain typically starts when I am sleeping in the early hours of the morning, and wakes me up. It starts in the epigastric region, and is usually mild, but within minutes, it is a sharp, level 10 pain that radiates to my right side, and it feels as though someone has a vice grip around my rib cage. Sometimes if I eat something like a banana prior to it getting to this level of pain, it will subside somewhat. However, sometimes this makes it worse and is only relieved by vomiting. In December, I had an attack that was so severe that I was hospitalized. My LFTs were elevated, and the pain was only relieved with IV narcotics. I had an MRCP at that time that was normal. My Prevacid Solutabs were increased to 30mg twice daily, and that has kept the serious attacks at bay for the most part. My current GI is sending me to see a specialist in SOD in early April for manometry, as he believes that I suffer from SOD.

My question to you is this, do any of you have these symptoms. Typically when do your attacks occur, and are there any triggers that you can identify.

I am leary of undergoing the ERCP due to the risk of pancreatitis, and I'm not sure that the benefit will outweigh the risks.

Any information that you can share is greatly appreciated.

Pam