Wednesday, July 13, 2011

Pain After Gallbladder Surgery; Sphincter of Oddi (SOD)

Gallbladder problems often occur in individuals with liver disease, especially those with cirrhosis. Today on the blog is a podcast from Johns Hopkins discussing "the prevalence of pain after gallbladder surgery and an ongoing clinical study to evaluate the predictors and interventions in patients with Sphincter of Oddi (SOD) dysfunction."

Sphincter of Oddi dysfunction

Sphincter of Oddi dysfunction is a condition in which the sphincter (located at the jumction of bile duct and duodenum) fails to relax appropriately. The common bile duct may become distended with bile and pancreatic secretions necessary for digestion. The symptoms of sphincter of Oddi dysfunction are epigastric and right upper quadrant pain that can mimic the pain seen with gall bladder disease.

ERCP, a test in which dye is injected into the bile duct, can suggest sphincter of Oddi dysmotility. (Delayed emptying of the dye is noted in patients with sphincter dysfunction.) Measurement of the sphincter pressures are often performed to confirm the diagnosis.


Anthony Kalloo, M.D., director of the Johns Hopkins Hospital Division of Gastroenterology and Hepatology discusses; Pain after gallbladder removal Sphincter of Oddi dysfunction It’s a big problem.
EPISOD study
ERCP to test pressures
Muscle is like a valve and it may be too tight
Other treatments have been proposed
Sometimes patients have been treated who didn’t need it
Time to pain relief may vary

EPISOD study
Evaluating Predictors & Interventions in Sphincter of Oddi Dysfunction (in patients with recurrent abdominal pain after gallbladder removal)

Do you have persistent or recurrent abdominal pain after you had your gall bladder removed?
Physicians at the Johns Hopkins Hospital are currently conducting a multi-center research study (The EPISOD* Study) to study Sphincter of Oddi dysfunction
You may be eligible to volunteer if you are:
18-65 years old
Have had your gall bladder removed
Have persistent or recurrent pain after your gall bladder surgery

This study involves:
Extensive questionnaires evaluating effect of treatment on pain, quality of life, and emotional and psychological well-being
ERCP study with manometry (an endoscopic test)

All examinations and tests are provided free of charge

This trial will provide valuable information to doctors and other researchers which will lead to improvements in the treatment of future patients with pain after gall bladder surgery.
Additional information about this study may be found online at the NIH Clinical Trials website.


  1. The pain after a gall bladder surgery is really bad. One has to be on medication and bed rest for atleast a week. I suffered immense pain after my gall bladder surgery last year.

  2. i had gall bladder surgery 4 years ago after finding out in my @nd trimester of being pregnant that i had gall stones. I wasnt aware that i had an option i was just told after the baby was born they would take it out. I was in so much pain due to the stones and them putting me into false labor everytime i had an episode i was relieved to hear that they were gonna take it out. Instead of being pain free like i thought i as gonna be i still get the pains at least a few times a week and the nausea is killing me i get sick daily! I dont know what to do!!!

  3. Why isn't a medication being made that would relax the sphincter muscle relieve the pain and not upset our stomacks? All of this poking and proding and slicing the sphincter of oddi just seems to make it worse in most cases of sphincter of oddi dysfunction.

  4. I personally am enrolled. I had my gallbladder surgery when i was 20 now in my 40s out of the blue i had been hospitalized 3times for this pain. I dont know whar part of the study i was in because it was a blind study but to go from so much pain to two yrs later having none? I feel better! It was debilitating and i couldnt work now im back to my life

  5. I had my GB removed 4 weeks ago and have had 2 severe attacks of abdominal and back pain. Spent a few days in hospital but Ultrasound came back clear. Lost weight but don't know what's going on. Anyone got any suggestions? Reading about SOD. Seems like similar symtons.

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