Sphincter of Oddi Dysfunction: Symptoms & Treatment

Instructor: Danielle Haak

Danielle has a PhD in Natural Resource Sciences and a MSc in Biological Sciences

When sphincter of Oddi fails to function properly, the condition is called sphincter of Oddi dysfunction; read this lesson to learn about the sphincter of Oddi and the symptoms and treatment options for its dysfunction.

What Is the Sphincter of Oddi?

Before we can talk about what might go wrong with the sphincter of Oddi, we should probably know what it is! First of all, a sphincter is a muscle, usually found at a crossroads between two sections of the body, that can tighten or relax to help control the flow of substances moving around.

The sphincter of Oddi is located in the upper intestine. It opens (or relaxes) to let bile from the liver and pancreatic juices from the pancreas move into the small intestine, and it closes (or tightens) to prevent materials from the small intestines from moving back up towards the pancreas and liver. It might help to think of sphincters as traffic controllers, ensuring things move only in the direction in which they are supposed to be moving.

The sphincter of Oddi helps regulate the flow of digestive juices from the liver and pancreas into the small intestine.

Sphincter of Oddi Dysfunction

Now that we know what the sphincter of Oddi is, we can talk about what happens when it doesn't function properly. This is known as sphincter of Oddi dysfunction, meaning it doesn't open or close at the right time, preventing the appropriate flow of juices from one part of body to another. When it fails to function properly, two things can go wrong. First, by failing to open, the sphincter of Oddi can cause bile from the liver to back up in the bile ducts; this is called biliary dysfunction. Alternately, by failing to open, it may cause pancreatic juices to back up around the pancreas, causing the pancreas to become inflamed.

Symptoms Associated with Sphincter of Oddi Dysfunction

Though anyone may develop this condition, it's most common in people who have had their gall bladder surgically removed. The primary symptom associated with this condition is abdominal pain, though other symptoms may include diarrhea, fever and chills, nausea, and vomiting. Most of the associated pain is caused by a spasm in the sphincter, rather than the sphincter opening and closing normally. When biliary dysfunction occurs, it may also cause a yellowing of the skin, known as jaundice.

As you can probably tell, these symptoms can be indicative of a number of diseases or conditions, so sphincter of Oddi dysfunction can sometimes be difficult to diagnose. Sometimes it can be diagnosed through blood tests, but other times it's more difficult to detect. A procedure called endoscopic retrograde cholangiopancreatography (ERCP) might be used, though this can be a risky procedure. In ERCP, a small tube is inserted into the bile or pancreatic ducts and a traceable dye is injected. The dye's movement is then monitored through the use of X-ray.

During the ERCP procedure, an additional procedure may be conducted, called sphincter of Oddi manometry (SOM). Just like with ERCP, a small tube is used in the affected area, but in SOM, it's used to test the sphincter's ability to contract (tighten) and relax (open).

Treating Sphincter of Oddi Dysfunction

If sphincter of Oddi dysfunction is diagnosed, a few treatment options are used based on the severity of the condition. Medication can help with pain and prevent irregular spasms of the sphincter and is usually the first form of treatment.

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