Sphincter of Oddi Dysfunction Questions

[SuesQ]

For about a year I had a constant pain behind my rib cage (upper right quadrant) that felt like I had a tennis ball lodged inside me.  In May 2004 I was diagnosed with common bile duct obstruction and had an ERCP with a sphincterotomy.  About 3 months later the pain behind my rib cage returned.  In October 2004 I had an ERCP with manometry, during which I was diagnosed with Sphincter of Oddi Dysfunction.  Another sphinterotomy was performed.  Unfortunately, the procedure resulted in severe acute pancreatitis.  Four months later, I still have some inflammation, but not that severe.  I am concerned because the pain behind my rib cage is coming back.  

1)  What is the liklihood that the sphincterotomy was not successful and that the SOD is back?

2)  If it is SOD, can it be corrected using external surgical methods? Does surgery pose the same risk for pancreatitis?

3)  What risks are involved with doing nothing, assuming I can learn to live with the pain?

Thanks for your input, I really appreciate it.

[MINIgal]

My gastroenterologist said that a low ejection fraction for the gallbladder can be caused by SOD.  What I recall from how he explained it is that the spasm of the SO prevents the gallbladder from functioning as it should, hence the low ejection fraction.

I had a 16% EF, and had my gallbladder out in early May.  No relief from the pain.  I have it daily.  I isn't really getting worse (overall), so I kind of get used to it, but acts up sometimes and that sucks.  Like when I eat or drink something very cold (as in a lot during the summer!), and the pain really intensifies then.

I'm supposed to see a specialist next month to decide whether to do an ERCP.  I don't know what my blood levels are, but I bought some urine test strips, and the strips frequently show apparently high levels of bilirubin in my urine.  I tested my husband for a "control," and he tested negative.  So, unless my female hormones are causing the test to read incorrectly...

[dakotagal]

How come they don't rule out SOD before removing the gallbladder?  Does anyone know?  I can't seem to find a good answer to that?  Is an ERCP the ONLY test that checks for SOD?  Would a low ejection rate also happen with SOD? If anyone has any answers please post.

[spotbird]

Guaifenesin may help. I had my gall bladder out in May and the pain returned about a month later.  The whole thing has been an ordeal which has caused me to lose what little faith I had in the medical community.  Treatment is hit or miss, complications annoy more than concern treating physicians, but you all know that.  Consequent to my mistrust I have not had my new pain diagnosed, so take my advice with a grain of salt. That said, the pain is identical to the descriptions sphincter of Oddi dysfunction.

Anyway I reasoned that if it is mucus that is causing the problem it is possible Guaifenesin would help, with nothing to lose I tried it.  To my absolute amazment it did reduce the pain and rather quickly. The pain isn

[ginnsu]

I wanted to give an update. I had my ERCP last week. They found a blocked bile duct and a pancreatic duct that was looped.They put a stent in my pancreatic duct and opened the other duct. My pressures were well over 100. The ERCP gave me pancreatitis and I was in the hospital for a week but boy was it worth it to find the answer to all my pain.

[MINIgal]

Wow...  so many people with similar problems, yet so many doctors just write us off.  I never had any kind of pain like this before January of this year (I turned 40 in March).  At first, I'd feel this squeezing, gnawing pain in my mid-back after having a glass of wine at dinner on occasion... I was awakened a few of times during the night here and there with gnawing epigastric and mid-back pain.  Then I had a major attack in early April, and went to the ER.  Blood work and CAT scans were "normal," so they gave me morphine (which I hated) and sent me home.  My doc thought maybe I passed a kidney stone.  

But the pain only subsided and never completely went away.  Finally, a HIDA scan showed 16% ejection fraction, and they yanked my gallbladder (no stones).  I expected full relief, but the pain came back right away.  Got scoped to check for an ulcer; no ulcer.  My gastro then just decided it's "IBS" and wanted to put me on antidepressants.  I declined.

I finally found a doc who will listen to me and not blow me off.  He's referred me to a diagnostic hospital for an ERCP, but I can't get in until next month.

Meanwhile, the pain persists, but I get used to it.  If it gets really bad, I take half a Vicodin, and that usually gives me a few hours of relief.  

Here's my question -- If it is SOD, why does it just show up so suddenly this year?  I'm hardly a heavy drinker (maybe 2 drinks per month), never smoked, etc.  I see all ages in here, so I don't think it's just age-related.  But it does seem to be mostly women -- could hormones trigger the dysfunction?

If anyone has any good stories, I hope they will post.

[dakotagal]

I was curious if you can follow up on your situation.  Your symptoms are identical to mine and you are the only one I have found so far to have pain while sitting-----I am scheduled to have my gallbladder removed but because you are experiencing the same pain as mine and you had yours out----I am not sure if that is the answer to my situation.  I hate to have an unnecessary organ removal!  I would appreciate a follow-up which may answer a few things for me.