The efficacy of endoscopic treatment of sphincter of Oddi dysfunction with endoscopic sphincterotomy remains controversial.
Previous studies have shown a positive impact on patient symptoms after treatment, but these reports have been largely qualitative and evaluated on short-term response.
Doctors at the University of Alabama, USA, evaluated the long-term outcome of endoscopic sphincterotomy in 33 patients with suspected sphincter of oddi dysfunction.
19 of the 33 patients were confirmed as having sphincter of Oddi dysfunction after sphincter of Oddi manometry. 17 of these patients underwent endoscopic sphincterotomy.
2 out of 14 patients with normal sphincter of Oddi manometry underwent endoscopic sphincterotomy.
The remaining 16 patients underwent sham endoscopy as a control group.
| Long-term pain continues after endoscopic sphincterotomy.
|The Amercican Journal of Gastroenterology|
After a mean follow up of 18 months, 5 of the 19 patients who underwent endoscopic sphincterotomy were taking narcotics for persistent pain and 2 were taking antidepressants. 15 patients identified the endoscopic therapy as a source of pain relief.
This represented an improvement, compared to controls who did not undergo endoscopic sphincterotomy.
However, almost uniformly, despite endoscopic sphincterotomy, patients continued to have pain, consistent with most known chronic pain disorders.
The authors of the study suggest a multifactorial cause for this chronic pain.