Sphincter of Oddi Dysfunction

[marelle]

I am a 45 yr old female. My Gall Bladder(5 yrs) and appendics (10 yrs) removed.  After doing some tests I was diagnosed with SOD 2 1/2 years ago and had a sphincterotomy.  I just recently started having severe attacks and my gastro doctor did an ERCP.  He said my bile duct was almost completely blocked because of scar tissue and did another sphincterotomy with a pretty good incision.  He said this is not uncommon and hopefully it doesn't happen again.  He also said there are rare cases of people that have to have this done every couple years.  This would be terrible.  I waited 3 weeks before seeing him and another week before the procedure was done.  Can SOD and bile duct blockage cause long term problems with my pancreas and liver?  He also did a liver function test and everything was within a normal range except my total protien was low.  During this time I had also developed high blood pressure, URQ pain radiating to back and across, and itchy palms and feet.  Do you think these symptoms might have been caused by the blockage and waiting so long to get medical care?

[Kevin Pho, MD]

It is possible that the symptoms are caused by blockage of the bile duct.  Continued blockage of the biliary duct can lead to damage of the liver as well as recurrent pancreatitis.

Options to consider would be a biliary stent to keep the ducts patent - however this would require another procedure to remove the stent.

Failing that, a sphincterotomy via a surgical (vs an endoscopic) approach can be considered.  Studies have shown that the more invasive surgical approach is associated with a decreased rate of scarring.  

This option can be discussed with your surgeon or gastroenterologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b

[malcom]

hi marelle, i am suspecting having SOD myself. left abdominal pain which gets worse after eating and weight losss due fear of eating and all the ecams came negative. Can you tell me whatv it is like when you had SOD.  Thanks and good luck.

[Frankie 17]

I have had Sphicter of Oddi dysfunction for 5 years now.  When I presented with my symptoms (RUQ pain radiating to the right shoulder and nausea) I had extrememly high LTF's (AST was 535).  Being that I had my gallbladder removed in 2000, they felt that  gallstones probably wasn't the cause.  I was soon after sent to have manometry with balloon dilation and a sphincterotomy in 2003.  I was fine for about 18 months but then the symptoms started to present again.  I was then sent to have a stent placed which was removed 6 weeks later.  The doctor said that my pressures were extrememly elevated.  After the stent removal, I was fine for about 6 weeks but again, the symptoms returned.  I just recently had 2 more stents place and was told to have them removed in 6-8 weeks.  I am anxious because I feel that my symptoms will only come back in due time...I am only 26 years old.  Might it be best to have a surgical sphincterotomy?  Would this be the next step or would it be better to have a biliary bypass surgery?