Sphincter of Oddi dysfunction: psychosocial distress correlates with manometric dyskinesia but not stenosis

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.

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.

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.

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