Could this be Sphincter of Oddi Dysfunction???!!!

[RuggedCross]

Hello, thank you all for taking time to read and answer my questions.  I'm a 36 year old female and I had my gallbladder removed in 2006 because I had attacks due to sludge and a 7% ejection fraction.  Everything was great until about a year ago (the last trimester of my pregnancy).  I started experiencing random "pinching smasms" on my upper right side, under my ribs.  At first I thought it was due to my internal organs being cramped from my growing baby.  I mentioned it to my OB-GYN and she did a liver panel and said everything was normal.  She said, "It's probably your gallbladder."  She was stumped when I replied, "But I don't HAVE a gallbladder!"  

So it's been a year and these stabbing-like, pinching smasms are still there.  It's not ALL the time and when they do occur, they're not overly painful - just a little more than bothersome.  I'd say a 3 on a scale of 1-10.  I don't experience vomiting, fever, or diarrhea; only bothersome spasms in the upper right abdomen under the ribs that come and go throughout the day.  I don't really notice a pattern of when these spasms occur, but then again I haven't really made a point to pay attention.

I've read about Sphincter of Oddi Dystfunction and it sounds like the pain is excruciating!!!  Are there varying levels of this condition in terms of pain?  I wonder if I just have a mild form of this condition?  I'm definitely able to go about my daily functions, but all the while I'm constantly aware of the pain. I have an appointment on 6/27 with a GI doc, but I wanted to be armed with information and perhaps read about some your experiences with this type of colicky pain after gallbladder removal.  THANKS!  :)  

[k2626]

Did you find answers? Similiar issues but left sided pain and right. Elevated lipase to a degree-but drs say its not my panc as Ive had 5 EUS in 4.5 yrs that show a perfect pancreas.

[Reruho]

The best information I have found on SOD has been the John Hopkins website. My computer is being goofy so I can paste a link. It will explain it all and really help you understand what is going on.

i am convinced I now have SOD and I am convinced it is the result of a delay in being diagnosed with Biliary Dyskinsesia. I am a Type III, which has the poorest response to treatment.

My pain does not disable me but it is still there. It is very similar to my GB pain. I have tightness along my diaphragm and back pain. The pain comes and goes and does not follow any schedule. I have found that Valarian, which is an herb that was used to treat digestive issues. Now days, you hear about Valarian being a sleep aid. I take 6 capsules and it knocks out the pain better than the Bentyl ever did. I read about it in a holistic health book.
Reta

[Christopher R Watters, MD]

The diagnosis of sphincter of Oddi dysfunction (SOD) is frequently a challenge. A group of the leading authorities on functional GI problems was formed to help develop diagnostic criteria for these entities. This is the Rome Foundation ( RomeCriteria.org ). To diagnose SOD, all of the following criteria need to be met:
Functional Gallbladder and Sphincter of Oddi Disorders
Diagnostic criteria Must include episodes of pain located in the epigastrium and/or right upper quadrant and all of the following:
    Episodes lasting 30 minutes or longer
    Recurrent symptoms occurring at different intervals (not daily)
    The pain builds up to a steady level
    The pain is moderate to severe enough to interrupt the patient’s daily     activities or lead to an emergency department visit
    The pain is not relieved by bowel movements
    The pain is not relieved by postural change
    The pain is not relieved by antacids
    Exclusion of other structural disease that would explain the symptoms
Supportive criteria
The pain may present with one or more of the following:
    Associated with nausea and vomiting
    Radiates to the back and/or right infra subscapular region
    Awakens from sleep in the middle of the night

SOD is divided into three categories depending on other factors such as dilation of the common bile duct and documentation of abnormal liver function tests associated with the painful episodes.  You will notice that other reasons for the pain must first be excluded. This typically requires upper endoscopy, imaging such as a CT and/or MRCP to start. Your GI doc will first focus on the other possibilities and attempt to exclude them before a diagnosis of SOD could be made.