I have had my gallbladder removed and a sphincterotomy via ercp. I still have pain when I eat. My doctor prescribed cholestyramine. This coats my stomach and allows me to eat non-acidic foods without pain. Carafate is another drug that can do the same.
I have not been diagnosed with SOD, but have been diagnosed with chronic small duct pancreatitis. I have had a few "break through attacks" since started Viokase 16 (4 pills 4 times a day)(pancreatic enzymes). The first attack I had after beginning the enzymes I asked my doctor if it was possible that the enzymes would cause an attack. His response was no.
He indicated in my case (I have gastroparesis (slow stomach emptying) and take Erythromycin 4 times a day to help my stomach empty)the most likley cause of the break through attack was consumption of alcohol (which wasn't possible because I don't drink) or the fact that my stomach was not emptying properly. I had to alter the way I took the enzymes and go to a strict clear fluid only diet for three days. I was lucky and that helped. If it hadn't it would have been a trip to the hospital for me.
Yes it was sphincterotomy via ERCP done twice due to closure. As for the pain meds I didn't start them until the pain was already severe so it doesn't seem likely that it is causing the problem. I did however wonder if the pancreas enzyme pills they put me 3 times a day were contributing to it.
I have had a long-standing diagnosis of Sphincter of Oddi dysfunction...chronic, but not severe.
In February of this year, I had a total hip replacement. The hip replacement was relqatively easy, but the reaction I had to the pain relieving drugs was a killer! I know I had a bad reaction to Dilaudid and Vicodan, and really don't know what others they gave me...however...it flared up the pancreatic problem, and I developed a pancreatitis. My SGPT went up to 424, Lipase 104, and Alkaline Phosphatase 205. My GI doc said that some narcotics have been shown to cause spasms in sphincters (like the pancreatic sphincter). I was just thinking that perhaps whatever drug you're taking for the abdominal pain may be aggravating the problem.....just a non-scientific thought.
Hello - thanks for asking your question.
Without examining you or your studies, it would be difficult to say exactly what is going on. From your description, it seems that you underwent a sphincterotomy via ERCP. Studies show that this is an effective method to reduce pain scores - approximately 80-90 percent of patients report relief. Unfortunately, pancreatitis is a known complication - you may inquire about the possibility of a pancreatic stent which can reduce this complication.
However, there is always the possibility that the sphincterotomy did not alleviate the obstruction. Other options would be surgical approaches which has the benefit of reduced scarring compared to the endoscopic approach. Perhaps our surgical colleague on the board can comment on this.
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.
Thanks,
Kevin, M.D.
FYI - I will be away from August 1-9th. I will look forward to answering your questions when I return.