PCS encompasses a wide spectrum of diagnoses. Approach and management follow general guidelines, but should be tailored to the individual patient. SOD remains the most challenging entity of this syndrome, both diagnostically and therapeutically. In patients with Type 1 SOD, we perform ES without further testing, such as SM, because there is a general consensus that a structural disorder of the sphincter is at the basis of this disorder (ie, stenosis). In patients with PC biliary-type pain, and a hepatobiliary score > 5, we perform biliary ES. In situations were the Hopkins' scintigraphic score is < 5 (and less commonly, if the score is > 5 in the setting of an atypical presentation), we perform endoscopic retrograde cholangiopancreatography with SOM. In patients requiring pancreatic sphincterotomy, we invariably place a pancreatic stent for up to 2 weeks to minimize the risk of postsphincterotomy pancreatitis.

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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