The sphincter of Oddi is a round muscular valve that regulates the flow of bile and pancreatic juice into the duodenum. By controlling the flow of these fluids, it plays an important role in the digestion process. Against the background of impaired patency of the bile ducts, its dysfunction develops.
Location and main functions
Where is the sphincter of oddi located? It is located in the upper part of the duodenum, immediately after the stomach. This organ not only regulates the flow of bile and pancreatic juice into the duodenum, but also prevents the risk of its contents moving back.
Causes of dysfunction
One of the main causes of Oddi sphincter dysfunction is congenital anomalies in its structure - congenital nodes or narrowings that impede the normal flow of bile and pancreatic juice. Some chronic diseases, such as chronic pancreatitis or cholecystitis, can also cause sphincter dysfunction. Liver pathologies such as cirrhosis can also affect his work.
In 75% of cases, injuries and surgical interventions on the biliary tract or pancreatic ducts lead to dysfunction. This can happen both immediately after the operation, and after some time.
Signs
Symptoms and manifestations depend on the degree of dysfunction of the sphincter of Oddi. Most often there are palpable pains in the upper abdomen. They are localized in the right upper quadrant and worse after eating, especially fatty or spicy.
If the pathology leads to impaired bile secretion, jaundice develops. At the same time, the skin and whites of the eyes acquire a specific yellowish tint, the urine becomes darker, and the feces become lighter.
Also, dysfunction of the sphincter of Oddi causes nausea and vomiting, especially after eating. There may also be stool disorders - diarrhea or constipation.
Some patients may experience more rare symptoms such as gas, belching, bloating, loss of appetite, and weight loss for no apparent reason.
Diagnostic Features
The doctor begins the diagnosis by analyzing the patient's complaints and medical history. Very important aspects are the nature of the pain, its relationship with food intake and the presence of additional symptoms.
After that, the specialist directs the patient to laboratory tests. He will have to pass a general and biochemical blood test with the determination of indicators of liver function. Urine and feces are also examined. This helps to identify possible disorders in the liver and biliary system, as well as to determine the level of inflammatory activity in the body.
To confirm the diagnosis and determine the degree of dysfunction of the sphincter, instrumental research methods are used:
- Ultrasound
- MRI
- ERCG (endoscopic retrograde cholangiography).
- Manometry of the sphincter of Oddi.
These methods also allow you to visualize the structure of the sphincter and biliary tract, evaluate their function and identify possible causes of the violation.
Peculiarities of treatment
The goal of treating sphincter of Oddi dysfunction is to eliminate the cause of the pathology and alleviate the symptoms. Depending on the cause and degree of the disorder, the doctor prescribes diet therapy, medication, or surgery.
Diet therapy
Patients are advised to follow a diet that excludes spicy, fatty, fried foods and alcohol. The basis of the diet should be easily digestible proteins, complex carbohydrates, lean meats and fish, vegetables and fruits.
Drug therapy
Treatment is carried out on an outpatient basis. However, if the patient has a pronounced pain syndrome, he is urgently hospitalized in the gastroenterological department.
The main objectives of drug therapy are to relieve spasm, reduce pain, and normalize the outflow of bile and pancreatic juice.
To relieve spasm of the sphincter of Oddi, the doctor prescribes the use of:
- Nitrates.
- Anticholinergic drugs (eg Metocinium iodide).
- Calcium channel blockers (Nifedipine).
These medications often cause side effects - in particular, they affect the cardiovascular system. Therefore, they are used in small doses and in combination with other drugs.
It is also possible to use antispasmodics (papaverine, drotaverine). To relieve spasm, stimulate bile secretion and reduce its insufficiency, the patient is prescribed Hymecromon.
