Brief Article
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Dec 28, 2009; 15(48): 6080-6085
Published online Dec 28, 2009. doi: 10.3748/wjg.15.6080
Sphincter of Oddi dysfunction: Psychosocial distress correlates with manometric dyskinesia but not stenosis
Ethelle Bennett, Peter Evans, John Dowsett, John Kellow
Ethelle Bennett, Peter Evans, John Dowsett, John Kellow, Department of Gastroenterology and Medicine, Royal North Shore Hospital, University of Sydney, St. Leonards, NSW 2065, Australia
Author contributions: Bennett E performed the research, analyzed the data and wrote the paper; Evans P performed the research and analyzed the data; Dowsett J carried out procedures for data collection; Kellow J designed the research, collected the data and wrote the paper.
Supported by Project Grant from the National Health and Medical Research Council of Australia
Correspondence to: John Kellow, MD, FRACP, Department of Medicine, Royal North Shore Hospital, St. Leonards, NSW 2065, Australia.
Telephone: +61-2-99267355 Fax: +61-2-94363719
Received: July 14, 2009
Revised: October 7, 2009
Accepted: October 14, 2009
Published online: December 28, 2009

AIM: To compare postcholecystectomy patients with Sphincter of Oddi (SO) dyskinesia and those with normal SO motility to determine the psychosocial distress, gender and objective clinical correlates of dyskinesia, and contrast these findings with comparisons between SO stenosis and normal SO motility.

METHODS: Within a cohort of seventy-two consecutive postcholecystectomy patients with suspected SO dysfunction, manometric assessment identified subgroups with SO dyskinesia (n = 33), SO stenosis (n = 18) and normal SO motility (n = 21). Each patient was categorized in terms of Milwaukee Type, sociodemographic status and the severity of stress-coping experiences.

RESULTS: Logistic regression revealed that in combination certain psychological, sociodemographic and clinical variables significantly differentiated SO dyskinesia, but not SO stenosis, from normal SO function. Levels of psychosocial stress and of coping with this stress (i.e. anger suppressed more frequently and the use of significantly more psychological coping strategies) were highest among patients with SO dyskinesia, especially women. Higher levels of neuroticism (the tendency to stress-proneness) further increased the likelihood of SO dyskinesia.

CONCLUSION: A motility disturbance related to psychosocial distress may help to explain the finding of SO dyskinesia in some postcholecystectomy patients.

Keywords: Gender, Functional gastrointestinal disorders, Psychosocial distress, Sphincter of Oddi dyskinesia