Ayman KoteishMD and Anthony N KallooMD

The postcholecystectomy syndrome (PCS) refers to a recurrence or persistence of symptoms following cholecystectomy. This is not a true syndrome in that it may be a result of different disease processes as opposed to a classic syndrome that is usually attributable to a single disease. PCS has been incorrectly used synonymously with sphincter of Oddi dysfunction (SOD). SOD is a malfunction of sphincter of Oddi (SO) contractility and is a benign noncalculous hindrance to the flow of bile and/or pancreatic juice through the SO muscle. It is, however, a relatively common cause of PCS. Furthermore, there are differences in nomenclature that are a major source of confusion when referring to SOD, and these include papillary stenosis, biliary spasm, biliary dyskinesia, and sclerosing papillitis. Knowledge of the specific cause of PCS is important to the appropriate management of these patients. Table 135-1 lists the more common causes of PCS. In this chapter we will delineate our approach to address this syndrome, with special attention to SoD diagnosis and management.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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