There are several options to treating Sphincter of Oddi dysfunction. Here is a summary for their success rates.
1) nifedipine - studies are not able to quantify its efficacy.
2) nitrates - again, no controlled studies are available to quantify the efficacy.
3) biliary sphincterotomy - small studies show 85 percent efficacy (measured in long-term improvement) vs 30 percent in the placebo group.
4) botulinum toxin injection - no studies are able to quantify its efficacy.
5) surgery - studies show a 50-60 percent efficacy, however there is a chance of worse outcomes.
As to whether a colectomy is appropriate, it would depend on what disease is causing the symptoms. I would consider a second GI opinion to determine whether SOD manometry should be considered. Another, less invasive test to consider would be a fatty meal ultrasound.
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.
Hogan. Treatment of sphincter of Oddi dysfunction. UptoDate, 2004.
Sorry to hear that your mom is still suffering with her pain. I was curious why a surgeon would want to take out part of someone's colon without clear evidence that something IS wrong with her colon. did I miss something in one of your prior posts?? I wasn't aware that something showed during the colonoscopy....Hope she feels better soon.
Dr. Kevin gave a pretty good answer for 16 dollars, but I was hoping he would answer the question about the eficacy of colectomy for patients with ongoing, mysterious stomach pain of the sort I described my mom is having.
Kristin, I dont think you missed anything. The colonoscopy didn't show anything. What we're working with now is the fact that 1) The super specialist in San Francisco who is affiliated with UCSF medical school does not think SOD is the cause of her symptoms, and he does this stuff all day every day for years and years. His warning about pancreatitis and the potential for ongoing worsening symptoms after the procedure also don't make the ERCP/manometry option sound too good right now.
As to your question about why a surgeon would suggest this. Well, the surgeon did something that is rare for a doctor to do. The surgeon asked my mom, "what do you think is going on?" My mom thinks it's her colon. The medical explanation for that feeling, from my dad, is that if the super specialist doesn't think it's SOD, then what else could it be? That is to say, sort of a process of elimination. The surgeon was actually suprised that the super specialist DIDN'T put a stent in when my mom went down to SF a few weeks ago. However, after reading his report, the surgeon said she could see why he would feel that it isn't SOD, and she admits he knows more about this than she (she had referred my mom down to him in SF). So with the super specialist not thinking SOD is the problem, but rather a motility problem, and with my mom's gut reaction (no pun intented) being that it's her colon which is causing the problems, the idea now is for the colectomy if her symptoms continue. She had a horrible day yesterday, exteeeemely nauseated for hours. Luckily she started feeling better and didn't have to go to the hospital. Today she isn't nauseated, but she is holding her side like she always does, the pain never really goes away completely.
How about you, how have you been? What's been going on?
Has a GES been considered?
As a surgeon who's performed tons of colectomies as well as other abdominal operations, I'd say there's nothing in the info you provided that suggests any role at all for colon resection. Perhaps there's more info. Based on what you've provided, I'd certainly NOT be considering such a thing.