Sphincter of Oddi Dysfunction and Pancreatitis Risk?

[Preslynn]

I'm a 29 y/o female, who gave birth for the first time 3 months ago. One month prior to his conception, I had my gallbladder removed (as a result of poor HIDA scan results, althought my U/S was normal). Apparently, there were no gallstones present, but my GI doctor noted that my gallbladder was kinked. I remained pain-free throughout my pregnancy. Shortly after my son's birth (3 months ago), I started feeling the "gallbladder-like" pain all over again. On one occassion, I landed in the E.R. because of the pain. I was administered Morphine, which increased my pain dramatically. I have since learned that such a reaction to Morphine may be indicative of Sphincter of Oddi Dysfunction. My GI doctor is currently running tests to diagnose.
The pain is located in the upper-right quadrant (ribcage area) and radiating to the back. I experience this pain EVERY day since it started after my son's birth (3 months ago). Some days it is worse than others. I will have sporadic pain-free periods throughout the day, too. The pain is not usually unbearable. It's a nagging, achy, dull pain - very similar to the pain I felt before my gallbladder was remvoed. I have not noticed this pain coinciding with eating, and fatty foods do NOT make the pain worse. Based on these symptoms, is there anything else it may be, or does the negative Morphine reaction I have had an endoscopy to r/o more common problems, but the test was normal. I also had an abdominal CAT scan, which was also normal. I am scheduled to have some type of U/S next week.
Some brief internet searching has left me with great anxieties about this condition. Does SOD always result in pancreatitis? How does it lead to pancreatitis in the first place? Is SOD curable? Is it progressive? My GI doctor thinks that I have a SO stenosis. I am so fearful that I'm going to experience this pain indefinately, and moreso, that I will develop pancreatitis and die. I feel too young to be combating something of this nature. What is the prognosis for SOD, and how can I ensure that I am receiving the most appropriate and proactive care? Can you hear the fear? Help!

[lrbwacko]

Try cutting out "yeast" from your diet, ie: yogurt, beer, etc. When I was around your age I also suffered many years from pains as you described. Today I am 45 and I can't say that the pains are completely gone, its so seldom with hardly the intensity, I can say it isn't an issue anymore.
      I'm not a doctor but through my own personal experience I noticed that the nights I ate yogurt before I went to bed I would wake up with pain that was almost unbarrable. The nights I didn't eat yogurt the pain was not quite as bad, however I still suffered almost daily. From what I have read and I belive it was someone from this forum (thank you who ever you are) that some people with this pain, not all, would show a high yeast count. Please bare with me and hopefully this will begin to make sence. Back when I was having these pains, I worked in an industry where there were a lot of beer drinkers. So I too drank beer, a lot, every day, day after day. Then one day, unfortunately, or fortunetly how ever you want to look at it, I developed an allergy to alcohol. After the first couple of sips I would sneeze constintly. I couldn't function so I had to give up the beer(yeast). So by avoiding yeast could be the answer?????? Try it, I hope it works for you. Let me know, good luck.

[gmblnfool]

Has your doctor ever tested you for reflux or tried any reflux medications.  I had very similar symptoms which the doctors thought was gallbladder disease, but turned out to be reflux.

[Kevin Pho, MD]

Although possible, I am not aware of data suggesting a clear connection betweeen SOD and pancreatitis.  Stones present in the bile ducts can lead to inflammation of the pancreas.

SOD can be treated with a sphincterotomy, injection of botox into the sphincter, or surgery.  

If untreated, it can progress and get worse.  

Further evaluation can be done with an ERCP with Sphincter of Oddi manometry.  

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_