sphincter of odi dysfunction

[jcinpain]

A few years ago I was dx'd with sphincter of odi dysfuntion.  A stint was put in the bile duct and I felt better for some time.  I have chronic right side flank and right side back pain.  I suffer from a continual headache that is always present.  Sometimes I feel flu like symtoms, chills nausea and overall ill feeling.  Any analgesic meds I take make my flank pain worse.  Narcotics are an absolute no no for me because of this condition.  I suffer from chonic neck and back pain due reconstructive surgeries for scoliosis.  I want to know if there is a cure for SOD?  My combined pains are overwhelming.  My dx for this condition was vague.  I had my gallblader out before the stint was put in and it was not the cause of my flank pain. Also most of my colon was removed because of chronic constipation.  That surgery resolved that problem but not the flank pain. I have seen too many doctors with too little answers.  To complicate things my kidney on the right is dead and I wonder if that is causing pain. I am currently seeing a kidney doc to see if this is perhaps adding to or causing the pain afterall.  I have been dealing with this literal thorn in my side for over ten years please advise.

Thankyou
JoAnn

[Kevin Pho, MD]

Surgery or endoscopic therapy would be more invasive interventions for SOD.  This can include injection of the Sphincter with botulinum toxin or a sphincterotomy.  

Regarding the flank pain, a CT can be considered to evaluate the kidneys for stones or other lesions.  I agree with a referral to a nephrologist.

If the tests remain negative, and no further intervention can be done for the Sphincter of Oddi, a referral to a pain management specialist can be considered for optimization of pain management.

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_

[Inghana]

Hey,
I just had a quick question. A few of us our complaining of uncontrollable gas. Gas that we can't feel. Was that a symptom that was attributed to the sphyncter dysfunction? Can you tell me if this is something that you had?
Sorry to hear about your pain,
Jessica

[Scarlett6]

I am sorry you are suffering from this problem. I don't know whether or not there is a cure for this or not. I am wondering if this is what is wrong with me.

After gallbladder removal, I have experienced elevated Lipase on several occasions. A glass of wine causes severe pain under the left ribcage, as does a meal heavy with fat, though not always.

Two incidents happened at different emergency rooms though that lead me to believe I have this dysfunction or something wrong with my pancreas. Both times, I was given Opiates for other problems, and both times it left me in such severe pain under the left rib cage area, I thought I would die. The last time I ended up rolling around on the parking lot asphalt in agony. I have read that the Opiates can cause severe SOD spasms.

I would like to know how how you found out this was the problem.
Thanks,
Cathie

[AG23]

I have been having pain in the gallbladder area since I had it out also.  I was fine for a couple of months and then bam pain, pain, pain.  I went and had ct scan, ultrasound, MRI, endoscopy and a colonoscopy which all came back fine except for GERD and a hiatal hernia.  I basically had to eliminate all fats from my diet and was put on prevacid.  The GI doc says if that doesn't work, it could be SOD and there was nothing to be done except for live with the pain. He said surgery is too risky and there isn't any pain management for this because the med's only make it worse.  I will be seeking a second opinion but just wanted to let you know you are not alone.

[Lisa187]

Hello JoAnn (and everyone),

I’m sorry to hear that you have so much pain.  I had my gallbladder removed about 12 years ago and now I’m starting to have similar painful symptoms.  I have pain every minute of the day. The pain is in my upper right abdominal area and radiates in back shoulder.  Sometimes it hurts so much and other days it’s manageable but still its there and it doesn’t go away.  I had this pain for 6 months.  I feel dizzy, shortness of breath, pressure in my chest and sharp like knife pain. I had CT scan, CT scan of my lungs (blood clot), upper GI x-ray and upper endoscopy (ulcer); everything is normal.  I’m going to see GI doctor on 7/18 and I’m going to talk to him about a procedure called EUS.  It’s an upper endoscopy with an ultrasound equipped. I think I have stones stuck in my common duct bile or SOD.  My whole life has changed due to this pain.  I’m starting to get constipated, which I never had this problem.  I wanted to ask you if your constipation started before or after you got your stint put in your bile duct?

Thanks,
Lisa187

[jcinpain]

I'm sorry for all the pain we suffer.  In response to your question, My constipation was a problem way before the stint was put in.  I now wonder if the sitnt had been put in much earlier maybe I wouldn't have had to have most of my colon removed.  I should add that the stint was put in about five years ago and last year the pain sarted up again.  A ct scan revealed that the stint is no longer present.  Not sure what or how that can be.  I am seeing a new internal medicine dr. I hope she can refer me to a good GI doc that can help.  I live in a small town on the Wisconsin/IL border.  The new dr. is in chicago.  I hope I get results.
JoAnn

[tuff case]

I have/had SOD.  I have the Bilinary valve cut once via ERCP and then less than a year later had it cut further and alos had my pancreatic valve cut the 2nd time.  After the second one they put in a temporary stint that he went in a removed a couple fo days later, had he left it in could would have passed through my system.  The only reason for the stint was to keep me from getting pancreatitis after the procedure.  If the the cutting of the vilves did not work then they would have had to put ina more permanent stint.  Just was not sure if yours was suppose to be permanent or not.  I have heard the the SOD comes back in the sense that you may need to be treated for it again.  Did they cut your bile ducts initially.  Also I live in the Northern IL and went to a great GI, he also practices downtown Chicago at UIC, and had me see his mentor their.  I was just wondering what the name of the GI Dr. is that your Dr referred you to in Chicago.  If you want to email of line ***@****
Good Luck to you.  I hope you are able to find some reolution to your pain.
Amy

[jcinpain]

Hello Amy
I saw an excellent new GI doc yesterday in skokie.  He specializes in treatment for SOD.  Cant' tell you how relieved I was to be in his care!  He told me the way they now treat SOD is very different from just a couple of years ago. They don't like to do stints anymore cause they are temporary and can cause problems.  He also feels that the typical manometry test(pressure in duct)is not a good idea because it irritates the pancreas and has a greater chance of causing pancreatitis.  He said the best course of tx is a sphinchterotomy (cautery of the sphincter).  There is still some risk of post procedure pancreatitis but it is much lower than the previous treatments.  Also this procedure is a permanent fix for SOD if that's what in fact it is. I'm told there is not a true definite way to dx this condition. Since I had relief from the stinting my chances are good that I will respond to this course of treatment. I'm told Many patients have their gallbladders removed in an attempt to relieve this nasty pain/sick feeling.  I am having my procedure on July 26th at Lutheran General Hosp. in Park Ridge IL.  I am a little scared but I feel so sick that I am almost willing to do anything to get better.  I have suffered too many years with this affliction to not take the chance.  I now have HOPE!!!
JoAnn

[gsc]

I was diagnosised with SOD and was told no treatment or cure. The dr said everything was to risky. I stay in constant pain and everything I eat hurts. Are there really no drugs to relieve some of this. I live in a small country town and the dr said they can't even do the surgery here but i do not want any surgery. Surely there is some treatment.

[kko]

I am reading all of these comments and would like to know what everyone thinks about my symptoms.  I am a 31 year old female, and i had my gall bladder removed 5 years ago.  At the time of the gall bladder pain i was experiencing a severe pain just below my sternum.  It felt like someone had their hand in my stomach as was ripping out my gut.  Yes it was that severe.  The pain radiated around to my shoulder and back.  The doctors did a HIDA scan and determined that while I did not have stones i needed to have a cholecystectomy.  My current problem is that the exact same pain i was experiencing before i had the gall bladder removed is back and has been back since almost immediately after the surgery.  I have had 12 episodes of this debilitating pain in the last 40 days.  When the symptoms begin the pain starts gradually then begins to increase in intensity to the point where i am doubled over and hyperventilating myself.  Sometimes it will last for 15 minutes but can last up to an hour at a time.  It almost feels something like a spasm.  I also have chronic GERD and have had 3 endoscopes in the past 7 years.  Each time the Dr. finds the same thing.  Ulcers.  So i try a ne PPI and it works for awhile and then just stops.  I am just now realizing that the two symptoms are probably not related and are completely seperate.  I am tired of taking medicine that does not work and i am tired of not getting any answers to what this stomach pain is all about.  Also, you should all know that occasionally vomiting is a side effect of the GERD and often i will have ingested a meal up to 15 hours earlier yet when i vomit the food is not digested at all.  Any suggestions/comments?

[GAmissy]

Please HELP!!!! I'm 32. I had my gallbladder removed in 93 while I was 4mths preg. with my 1st child.(gallstones)In 97 after 3rd child I had a complete hysterectomy. In 98 started having chronic(severe)constipation. In 05 I was admitted in hospital with severe rightsided abdominal pain,nausea, vomiting had appendix removed but the next day pain was still present with extremly high liver enzymes. HIDA scan was preformed no stone was seen but the dye wouldnt flow until several attempts was made. 2 months later most of my colon was removed(col. inhertia) A couple months later admitted for pancreatitis(dont drink, never have), after 3rd admit for pancreatitis(with 10 day stay ICU)I was sent to MUSC had a stint put in pancreatic duct and pressure measured(which was way too high)had sphicter.(4 total)Pain was almost gone for a couple months but came back.Back to ER same upper right sided pain,etc now the liver enzymes Lipase and GGT elevated, pancreas seems ok for time being.Of course pain meds and No one knows how,why,or even what is wrong with me. It is really taking alot out of me. ANY HELP????????? THANKS Missy

[beemerwhite]

Hi i am a 23 year old female, who has been having serious problems for the past two years. At first i had all the symptoms everyone is refering to, the doctors first thought gall stones, so the gal bladder was removed.  The pain continued, so an ERCP was performed, since then i have had five sets of stents put in i have had SOD, they have cut the duts, widened the ducts everything and the pain continued. I have had pancreatitis as a result about six times. I was then sent to Adelaide where i saw a professor who performed a divison of the sphincter oddi dysfunction, this was unsuccessful. So i then had to go back there two months later to get open surgery, this lasted eight months, and now the pain is back.  I have just had two more stents put in on Wednesday, and the pancratic one will be removed next Friday, they will leave the bile duct stent in for two to three months and if this fails which they are tipping will, they tell me i will have to have open bypass surgery.  I am not sure what this is and what is involed but it is basically replumbing of my insides, ifanyone knows more information on this surguery i would love to hear about it. It is apparently very invasive and quite risky :( Thanks i hope someone can help.