The Sphincter of Oddi is a valve that controls the bile and pancreatic juices that flow to your small intestine. These juices help with the digestion process and allow food and liquids to pass throughout your system. When working normally, the Sphincter of Oddi enables the digestive process is able to occur naturally and without any issues.
Yet sometimes the sphincter of oddi will spasm, which makes the valve shut down and unable to relax. Natural digestion stops and extremely intense pain occurs in the stomach. Other symptoms can include nausea, vomiting, loss of appetite, weight loss, fever and chills. This is called Sphincter of Oddi dysfunction (SOD).
Doctors are unaware of why or what causes SOD to occur, but there are multiple forms of treatment available for those with the disease.
The two major forms of SOD are:
- Biliary Dysfunction: this occurs when the spams prevent digestive juices to flow and they back up into the bile ducts.
- Pancreatitis: the same digestive juices are stopped due to the sphincters spams, but this time the backup affects the pancreas.
Sphincter of Oddi Dysfunction Symptoms
Along with other digestive disease, the main symptom is extreme abdominal pain. The pain is recurring and will often be so severe one second and then gone the next. If you’re experiencing problems like this, you should seek treatment immediately and do not ignore the symptoms.
Many medical experts like to compare SOD to what a gallbladder attack feels like. The pain is intense and may radiate into different parts of the body.
- Stomach pain
- Throwing up
- Weight loss
- Hunger pangs
Diagnosing Sphincter of Oddi Dysfunction
To determine whether you have SOD or not, you must get a consultation with a doctor. There are many different types of digestive diseases that can cause abdominal pain and the wrong or incorrect diagnosis can cause a litany of problems that you want to avoid at all costs.
Other conditions which cause similar symptoms like abdominal pain include; pancreatic cancer, gall stones in the bile duct or crohns disease. Digestive diseases like SOD can be difficult to diagnose due to these similarities and you must consult with a licensed gastroenterologist. It’s usually relatively easy to decide if you have a fever or the chicken pox because the symptoms are so well defined, this is not the same with sphincter of oddi dysfunction.
To properly diagnose sphincter of oddi, you will have to come in for a full procedure where you will be placed under sedation. Typically during a sphincter of Oddi manometry a small tube will be inserted through the pancreas duct so that the doctor can observe how the valve is functioning in its natural state. Through this observation, they can determine whether it is in fact SOD or if it’s another problem all together.
There are a few tests that are commonly done to test and diagnose SOD. These include but are not limited to blood tests, imaging tests, or other diagnostic tests.
A few popular procedures include:
Sphincter of Oddi Manometry: Your doctor may want to take a close look at the sphincter of Oddi to see if it is functioning normally. This is done by placing a small plastic tube into the pancreas duct or bile duct near the sphincter of Oddi to measure how well it is contracting and expanding. Patients are placed under sedation for the duration of this procedure.
Endoscopic retrograde cholangio-pancreatography (ERCP): This allows the doctor to take pictures and measure the pressure inside of the duct system to gain access to insight unavailable from other tests like CT Scans or diagnostic imagery. ERCP is recognized as an uncomfortable procedure that’s not totally painful, but still far from enjoyable.
Magnetic resonance cholangio-pancreatography (MRCP): A non invasive procedure that does not require any sort of anesthesia and allows the doctor to visualize the pancreatic and biliary ducts. While safer than ERCP, MRCP can have issues like any other procedure that’s purely visual based.
Sphincter of Oddi Dysfunction Treatment and Procedure
Medication is always the first method to treat sphincter of oddi spasms. In some patients they will immediately begin to see some recovery and alleviation of their symptoms. Typically we’ll see a doctor prescribe a mix of medication that reduces the chance of the spasms while also administering some sort of pain reliever. Remember that with sphincter of oddi dysfunction the pain randomly occurs, so it’s not like the pain medication would be necessary for everyday use as it would only have to be taken when necessary. It’s common that with just medication you’ll be able to get over the majority of the symptoms you are experiencing. Unfortunately, not everyone is this lucky.
If medication treatment fails your physician may recommend surgery.
The most popular form of surgery for patients with SOD is called a sphincterotomy. During the sphinterotomy surgery the patient is put under fully and a small incision or cut is made at the top opening of either the pancreatic or the bile duct. This small cut may increase or help with the regulation of gastric and pancreatic juices into the lower intestine. If successful the backup will be removed and natural digestion will occur, freeing the patient from symptoms like abdominal pain.
It should be noted that this surgery does have a high level of complications with 10 – 15% of those going through the procedure having problems like inflammation in the pancreas after. If you are considering getting a sphinterotomy but have not used medication yet, it’s recommended that you try that first.
Additional complications after surgery:
Many people have reported sphincter of oddi dysfunction after a gallbladder removal surgery (cholecystectomy). This is commonly seen with about 10 – 20% of patients coming down with some sort of complication affecting their digestive health directly after this surgery.
If you are reading this now and find yourself agreeing with the symptoms found above, then there is a very good chance that you may be impacted. Consult with your physician right away as he will probably put you on a dosage of medication that will help reduce the sphincter spasms.
Here is a video of a patient with sphincter of oddi disorder talking about their experience with the disease and how treatment effected them.
Where did the name come from?
The sphincter of oddi was named after Ruggero Oddi (July 20, 1864 – March 22, 1913) who was an Italian physiologist and anatomist from Perugia. Oddi was responsible for finding the muscle fibers that wrap around the end of the bile ducts and pancreatic ducts. It wasn’t really understood when he first discovered it, but years later it was named the “sphincter of oddi” because of his findings.