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Sphincter of Oddi Dysfunction

Digestion is aided by pancreatic juices released by the pancreas and bile released from the liver. These juices flow through the pancreatic duct and common bile duct, respectively, and empty into the duodenum (first part of the small intestine). The sphincter of Oddi is a circle of muscles present at the ends of these ducts which squeezes and relaxes, controlling the one-way flow of digestive juices into the duodenum.

Sphincter of Oddi dysfunction is a condition in which the sphincter does not contract or relax at the appropriate time leading to backup of digestive juices. This leads to episodes of severe abdominal pain and may also cause the liver and pancreas to swell and become painful. Reflux of the bile is termed biliary dysfunction, while backup of pancreatic juice leads to pancreatitis or inflammation of the pancreas. Other symptoms include nausea, vomiting, chills, fever and diarrhoea which may come and go.

The cause of sphincter of Oddi dysfunction is not very clear but is more commonly seen after gallbladder removal or gastric bypass weight-loss surgery. Woman who are of middle age are also at increased risk of sphincter of Oddi dysfunction.

Sphincter of Oddi dysfunction can be diagnosed with the help of blood tests (to detect the level of liver and pancreas enzymes) and imaging tests such as ultrasound, X-rays, CT scan and MRI. Endoscopic techniques (thin lighted tube with a camera attached is inserted into the digestive tract) such as endoscopic retrograde cholangiopancreatography (ERCP) and magnetic resonance cholangiopancreatography (MRCP) may also be performed to confirm the diagnosis.

Treatment includes administration of medication for pain relief, muscle relaxants, anti-spasmodics or antidepressants. Your doctor may also instruct you on lifestyle changes to cope with the condition including quitting smoking, not drinking alcohol, eating smaller meals, limiting fats, and maintaining a healthy weight. If symptoms are severe your doctor may recommend a sphincterotomy, a surgical procedure performed during an ERCP (a scope inserted through your throat into the stomach) in which the sphincter of Oddi is cut with a tiny blade or thin wire.