Sphincter of Oddi Dysfunction

Structurally, the SO is a segment of circular and longitudinal smooth muscle that incorporates the distal CBD and pancreatic duct. The SO is often treated as a single sphincter, but the SO is composed of a biliary sphincter (sphincter choledochus) and a pancreatic sphincter (sphincter pancreaticus). The normal function of the SO is to regulate bile and pancreatic juice flow into the duodenum, prevent reflux of duodenal contents into the bile and pancreatic ducts, and promote gallbladder filling. The SO has both sympathetic and parasympathetic innervation, with its activity increased by cholinergic stimulation. Cholecystokinin (CCK) appears to provide the major hormonal regulation of the SO. CCK release results in inhibition of the sphincter and contraction of the gallbladder.

SO dysfunction is a benign, noncalculous obstruction of the flow of bile or pancreatic juice at the level of the pan-creaticobilliary junction. SO dysfunction refers to a functional motor disorder involving the biliary or pancreatic portion of the sphincter leading to intermittent abdominal pain or pancreatitis. Patients are subdivided into those with sphincter stenosis and sphincter dyskinesia. True structural stenosis occurs at the level of the sphincter and papillary orifice, and is believed to be secondary to inflammation and fibrosis. The passage of small CBD stones or recurrent episodes of pancreatitis may contribute to the inflammation and fibrosis of the papillary orifice. Please see Chapter 135, "Postcholecystectomy Syndrome."

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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