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The sphincter of Oddi is part of your digestive system. You probably had never heard of it until problems with it led to painful symptoms. Left untreated, sphincter of Oddi dysfunction can cause serious problems with the pancreas and liver. But it can be treated to help relieve your symptoms and prevent future problems. Read on to learn more.
A sphincter is a band of muscle. The sphincter of Oddi surrounds the end of the ducts (tubes) that connect the gallbladder, liver, and pancreas to the upper intestine. The sphincter opens to let digestive juices flow through the ducts from the gallbladder, liver, and pancreas into the upper intestine. To prevent the juices from leaking back into the ducts, the sphincter squeezes closed. If the sphincter squeezes when it shouldn’t (spasm), the juices can’t flow out of the gallbladder, liver, and pancreas. The backup causes the liver and pancreas to become swollen and painful.
The condition may be caused by gallstones. Problems with the pancreas or upper intestine may be involved. And sensitivity to gluten is thought to be a possible cause. But, in most cases, the exact cause is never known.
Symptoms include upper abdominal pain, nausea, and vomiting. They often appear after eating and may last for several hours or days. They may come and go or be continuous. And they may be mild to severe.
If sphincter of Oddi dysfunction is suspected, tests may be done to confirm the problem. These can include:
Blood tests. These check the function of the liver and for inflammation of the pancreas.
Imaging tests. These let the doctor get a closer look at the gallbladder, liver, pancreas, and the ducts connecting them. Tests may include ultrasound, x-rays, or a computed tomography (CT) scan. MRI of the liver may also be done.
An x-ray test called ERCP. An ERCP looks more closely at the ducts and sphincter. During the test, a flexible, lighted tube with a camera on the end is used. This is called an endoscope (scope). The scope is swallowed into the stomach. Images of inside the digestive tract are sent from the scope to a video screen. Using these images, the scope is moved into the small intestine to the sphincter of Oddi. A small tube is put through the scope. Dye is injected through the tube. This makes the ducts and sphincter show up clearly on x-rays. X-rays are then taken. In some cases, air is sent through the tube. The air tests the pressure of the sphincter muscle. This is called manometry.
To relieve symptoms, an anti-spasmodic medication may be prescribed. When taken daily, this medication may help relax the sphincter. If symptoms continue, a procedure to cut the sphincter may be recommended. This procedure uses ERCP. During ERCP, a tiny blade or thin wire is passed through the scope to cut the sphincter of Oddi. Cutting the sphincter prevents spasm and can relieve symptoms.
After treatment, follow up with your doctor as scheduled. Let the doctor know how you are feeling and whether symptoms have improved. Tests are often done to check the condition of the ducts and the pancreas, liver, and gallbladder.
After treatment, call your doctor right away if :
Your symptoms get worse.
Your symptoms go away and come back.
You have new symptoms.
You develop a fever of 100.4°F or higher.
You develop symptoms of jaundice, such as dark urine and yellowing of the skin and whites of the eyes.