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946578 tn?1258666887

SOD and hypoglycemia

Does anyone with sphincter of oddi dysfunction have any issues withy hypoglycemia or type two diabetes?  I have had all the symptoms of SOD and I am going in to get checked for it.  I have the pain, nausea, elevated liver enzymes, back pain, etc.  I have been misdiagnosed with everything everyone else has... IBS, gaul bladder disease, pancreatitus, acid reflux, I have been told I was faking it for attention, asked if I had broken ribs... This has been going on for five years, I doubt it's broken ribs!!  They insisted on x-rays though.  All my symptoms started after being hit by a car.  Everything comes back normal on tests except my liver enzymes.  I am really hoping it's this SOD... I just want to know what's causing this and that I am not crazy.  It's good to know I am not alone.  But I was wondering if anyone who has been diagnosed with SOD has also had problems with hypoglycemia or diabetes?  My blood sugar freaks out all the time and they have no idea why.  They have done all the test and they can't figure out what is causing my blood sugar to do this.  Some days it will drop down to the 40s if I don't eat every two or three hours.  And sometimes it's gets really, really high when I haven't eaten for half the day.  Sometimes when I go in they say I have hypoglycemia.  Other times they think it's diabetes.  They say that it's hypoglycemia and my pancreas is shutting down, and I will have diabetes soon.  But they have not evidence for that other than my blood glucose being out of wack.  And I know with SOD your bile can end up in your pancreas and cause problems.  So I am wondering if maybe that is what is causing it?  Any ideas?

This discussion is related to Sphincter of Oddi Dysfunction Questions.
14 Responses
140029 tn?1393301742
I probably won't be much help...calgal knows quite a bit about the SOD situation.

Well I don't have it either but I did think I had SOD at one point earlier this year, I demanded to have a MRI (MRCP) which was negative.. I think based on your symptoms you probably are on the correct path.

The pancrease if I remember right when has problems can easily cause diabetes and such like you're having so yes you can be hypogylicemia with a sick pancrease.  Basically the pancrease is backing up in pressure, and the enzymes inside the pancrease are eating the organ along with liver bile causing you to be really sick.  There is a blood test to confirm pancreatitis of some sort but sometimes after the damage has been done the test will show a false negative.  Only accurate usually during acute phases of pancreatitis.

The problem is what is causing it..it is a stone that is stuck or is it a sphincter or oddi dysfunction?  Your blood tests suggest you have some sort of blockage for some reason and you're pretty young to have a stone (it's possible..) so most likely you need some imaging to rule out a stone (MRI/ultrasound) and then most likely you'll need a ERCP with mamomtry (and I know I spelled that wrong).  ERCP's are preeeetty risky..and only should be done by someone who knows what they're doing and has done many ERCP's.  I've heard the majority of people doing the procedure get really sick..like ER room sick.  But not always.  Doctors avoid doing ERCP's unless they really have to, but If you need one I would go to a ERCP specialist that only does those.

There are usually a few ways to treat it, either by placing a stent and doing multiple endoscopes with stents trying to train the muscle and stretch it ..or just cut the muscle and let it stay open (that is if it's not a stone).  If it's a stone it needs to be removed..you didn't mention your gallbladder function..hopefully you've done a HIDA scan making sure that's working ok.  As one system goes downhill..so does another.. gallbladder can cause a ton of problems like sludge and such that can cause blockage.  It's good to rule out stones and gallbladder before you do ERCP but since you're blood levels are all over the place you want to hurry on this and keep pushing.

I'm not sure on diet but i'm guessing you'd want to avoid heavy sugar things that make your pancrease work..maybe take digestive enzymes to help take pressure off your digestive system but i'd ask you GI specalist for advice on that first...but for sure don't delay on that.. you don't want diabetes or lose a pancrease because you sat around too long.  Hang in there..:S
140029 tn?1393301742
also just thinking out loud..sometimes severe ulcers can cause pancreatitis pain and actually work their way into the pancrease...since you got in a car accident your stomach valve or something might be messed up and you might have bile or something backing up so that's another possibility.  That would be ruled on via endoscope but you might have some damage to either the bile duct or stomach valve....it was your right side right?  5 years is a long time..and if you had pancrease issues starting 5 years ago you'd have a LOT of damage done.. so i'm sort of thinking there might be some stomach issue working into your pancrease.  Something is blocking your bile duct that's for sure, and it could be just inflammation.  Either way an MRCP then endoscope if negative then/ERCP would probably be best.
946578 tn?1258666887
I have had four scopes and two MRCPs.  I had ulcers five years ago, but they got rid of them and they haven't come back.  They thought that was what was causing my pain but it's still there.  I have done a hidascan twice and both times it came back normal.  The doctor I was seeing told me he wanted to take my gaul bladder out "just in case."  This was after he told me that maybe it was all in my head.  So I was pretty pist and told him no way, we weren't taking out organs "just to see."  After that he told me he wanted to put a stent in my common bile duct, but at this point I wasn't even listening to this guy.  He couldn't find anythig wrong with my bile duct either, he just wanted me to be a lab rat.  But the hypoglycemia/diabetes wasn't diagnosed until after I stopped seeing that guy so he doesn't know that's a symptom.  The only problem now is I go to a new doctor and they won't really even talk to me.  They just look through my six inch stack of paper work that they have faxed from my previous doctor and just assume I am faking so they won't even try to diagnose me, they will only test for things if I come up with it myself and tell them to.  The last doctor I went to probably couldn't even tell you where my pain is or things I do to relieve it or anything, just simple basic things like that, because she wouldn't even listen to me.  She didn't even look at me, she just kept saying "uh huh, uh huh."  And she was only in the room for five minutes.  I asked her to test for AIP (acute intermittent porphyria) because at the time that was the only idea I had come up with.  She tested for it, called back and said it was negative, and when I asked where we go from there she said, "I don't know."  I am kind of running out of options and don't know what to do.  It's tempting to go back to my old doctor, but at the same time it scares the hell out of me to go to some guy who is ready to yank organs just to see.  I'm stuck.
946578 tn?1258666887
Do you know which CalGal it is?  Is it just plain CalGal or is it CalGal2, 07, 98, or 7822?
140029 tn?1393301742
It's the normal CalGal she seems to know a ton about the ERCP procedure (i'm not sure if she had one herself or not but she always posts a lot about it)

well.. i'm not a doctor but looking at your symptoms if your liver enzyme levels are eleveted *right now* and you're having pain on your upper right quadrent, and you had your gall bladder removed and now your blood sugar levels are going all over the place I would suggest either going to a ERCP specialist to talk about doing a stent like your doctor said/surgery on that valve but I think stent is best because you don't know for sure if it's the bile duct (usually on a MRCP it would show the bile duct swollen because of the back pressure..course it might have relaxed.. you have to catch it in pain during a MRCP..basically you have to catch it while you're under an attack..)

so yeah I would be worried getting diabetes because you sat around too long, hopefully you're under your parents insurance because once you get in my shoes you're pretty much stuck wishing you could get tested but can't afford it so be careful :)

either i'd rush off to a new GI or just go straight to a ERCP specialist in your state or ask your current GI if you can go to a specialist (since you don't like him) and i'm not a doctor in no way but with those symptoms i'd be thinking about a stent in the bile duct to relieve pressure off your liver/pancrease (unless you've been drinking and hitting asprin a lot and have fatty liver but imaging would have shown that..)

Good luck littlethings :S
947382 tn?1262375348
hi! im thinking i might have SOD too. I had my gall bladder removed a year ago and fragments of my gall bladder and stones removed 6 weeks ago. I'm still having pain where my gall bladder used to be, im extremely nauseous all the time and i have reflux. I have low blood sugar but I havent been diagnosed with diabetes or hypoglycemia.

people have told me that its a psychological problem or some bs because they cant figure out whats wrong with me. i know its SOOOO frustrating! i have a rediculously enormous stack of charts, labs and paperwork too its so annoying.

I'm going to a new GI doctor friday and im going to ask about SOD ill let you know what she says in case its helpful to your problems too!
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