S.O.D.Dysfunction

[Sandy64880]

Our daughter is 19 years old and has S.O.D. DYSFUNCTION.She has had two pancreas procedures performed by Dr. Howell at Maine medical Center Portland Me.She is not able to keep food down for more then twenty min.she is down to 98 lbs.and is in terrible pain but  Dr. Howell will not give her anything for it.He says that where she is from Washington County she can not have anything for the pain.We do not beleave this is fair to our daughter she is not a drug addict she was in school and working at the same time and had never taken any drugs until she was taken sick.However our main concern now is to find foods that she can eat before her body begains to shut down.

[CalGal]

The stents are used after the ERCP has been done to keep the duct(s) open to try to minimize the possibility of pancreatitis. It's becoming 'standard' practice these days. Be sure to ask why the stent wasn't used.

What did the manometric pressures read? Typically anything over about 40 suggests the presence of SOD.

Was a sphinterotomy done? That's making a 'cut' in the muscular opening - the sphincter of Oddi.

Does she have sludge in the gallbladder? In many cases the SOD can be caused by the passage of sludge from the GB to the common bile duct. It irritates the duct and causes the spasms.

You mentioned she had 2 procedures done on her pancreas - what were they? Working on the pancreas is very different that SOD. Although with SOD the bile and the pancreatic fluids can back up and it can cause pancreatic issues.

You don't want to be working with a primary doc on this issue. You should be working with someone with a large amount to experience in biliary issues and especially in SOD. It's a very specialized field, and small changes in medications can make large changes in the pressures. Regular docs can inadvertently prescribe something without realizing the impact might not be a good one.

For the spasms, docs will typically prescribe benty, hyoscamine (both in fairly high doses) and if those don't work, they'll try nitroglycerin, or in severe cases (with careful monitoring) calcium channel blockers.

[Sandy64880]

Hi CalGal,
Our daughter has had two ERCP with manometry Procedures done by Dr.Howell he did not say anything about a stent. She has had pancretits but currently does not have it.She does have SOD and can not keep food down we had to take her to the hospital yesterday 1/2/09 to get fluids into her body she had gone 4 days without anything in her.
She still has her gallbladder he did not say anything about removing it.You said there is anti spasm meds that might help her could you give us the name of theses meds so we can ask her primary care Dr. about them.Thanks so much for the information if it helps our daughter we'll be forever greatfull.Sandy

[CalGal]

Sandy, if your daughter truly has SOD - diagnosed via ERCP with manometry - your doc would be remiss if your daughter was given any narcotic-based pain relievers as those meds can drastically increase the pressures in the biliary ducts and cause increased pain. I know that sounds awful, but it's an unfortunately fact as many who have experienced the condition have found out the hard way.

If your daughter is having spasms of the common bile duct or the sphincter of Oddi there are some anti-spasm meds that might be of help, but depending on the type that is used to try to control the condition, she'll have to weigh their benefits against their drawbacks.

What pancreatic procedures were done - ERCP with stenting?

Is your daughter suffering from pancreatitis at the current time?

I assume she had had her gallbladder removed before all this began?