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    Rome IV Diagnostic Criteria for Functional Pancreatic Sphincter of Oddi Disorder (SOD)

    Official Rome IV criteria for the diagnosis of functional pancreatic sphincter of oddi disorder.

    INSTRUCTIONS

    Use in patients with recurrent episodes of pancreatitis with characteristic pain and appropriate lab elevations. Other common etiologies of pancreatitis must be excluded with a negative endoscopic ultrasound (EUS). 

    Do NOT use in patients with:

    • Pancreatic type pain without objective evidence of pancreatitis.
    • Single episode of idiopathic pancreatitis.
    • Gallstones or sludge on imaging.
    • Culprit drugs associated with pancreatitis (including over the counter, supplements, narcotics).
    When to Use
    Pearls/Pitfalls
    Why Use

    Use in patients with recurrent episodes of pancreatitis with characteristic pain and appropriate lab elevations. Other common etiologies of pancreatitis must be excluded with a negative endoscopic ultrasound (EUS).

    • Diagnosis can only be made after thorough investigation has been performed excluding other more common causes of pancreatitis.

    • A normal EUS is required to make this diagnosis. Sphincter of Oddi manometry may be considered and if done, it should be abnormal. 

    • Magnetic resonance cholangiopancreatography (MRCP) with measurement of pancreatic duct before and after intravenous secretion could be considered but has not been validated.

    • Role of pancreatic sphincterotomy in pancreatic sphincter of Oddi disorder is unclear.

    • Helps to provide a diagnosis and treatment strategy in patients with recurrent debilitating pancreatitis otherwise without explanation.

    • Helps guide conversations with patients regarding treatment option that has both procedural risk but also potential therapeutic benefit if criteria met.

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    Next Steps
    Evidence
    Creator Insights
    Dr. Douglas Drossman

    About the Creator

    Douglas Drossman, MD, is professor emeritus of medicine and psychiatry at the University of North Carolina School of Medicine. He is founder, President Emeritus and Chief of Operations of the Rome Foundation. He is also the founder of the Drossman Center for the Education and Practice of Biopsychosocial Care and Drossman Consulting, LLC. Dr. Drossman has written over 500 articles and book chapters, has published two books, a GI procedure manual and a textbook of functional GI disorders (Rome I-IV), and serves on six editorial and advisory boards.

    To view Dr. Douglas Drossman's publications, visit PubMed

    Dr. Lin Chang

    About the Creator

    Lin Chang, MD is responsible for the oversight and coordination of the Rome IV calculators on MDCalc. She is a Professor of Medicine at the Vatche and Tamar Manoukian Division of Digestive Diseases at UCLA and is a member of the Rome Foundation Board of Directors.

    To view Dr. Lin Chang's publications, visit PubMed

    The Rome Foundation

    About the Creator

    The Rome Foundation is an independent not for profit 501(c) 3 organization that provides support for activities designed to create scientific data and educational information to assist in the diagnosis and treatment of Disorders of Gut-Brain Interaction (DGBI), also known as functional gastrointestinal (GI) disorders. Their mission is to improve the lives of people with DGBI. Over the last 3 decades, the Rome organization has sought to legitimize and update our knowledge of the DGBIs. This has been accomplished by bringing together scientists and clinicians from around the world to classify and critically appraise the science of GI function and dysfunction. This knowledge permits clinical scientists to make recommendations for diagnosis and treatment that can be applied in research and clinical practice. Diagnosis is based on the use of symptom-based criteria which are used in clinical trials and daily practice. The list of Rome IV categories and the Chair and Co-Chair of each chapter committee are listed below.

    Committees Chair Co-Chair
    Esophageal Disorders Ronnie Fass, MD John Pandolfino, MD
    Gastroduodenal Disorders Nicholas J. Talley, MD, PhD, FRACP Vincenzo Stanghellini, MD
    Bowel Disorders Fermin Mearin, MD Brian Lacy, MD, PhD
    Gallbladder and Sphincter of Oddi Disorders Grace Elta, MD Peter Cotton, MD
    Centrally Mediated Disorders of Gastrointestinal Pain Peter J. Whorwell, MD Laurie Keefer, PhD
    Anorectal Disorders Adil E. Bharucha, MD, MBBS Satish S. C. Rao, MD, PhD, FRCP
    Childhood Functional Gastrointestinal Disorders: Neonate/Toddler Sam Nurko, MD Marc A. Benninga, MD
    Childhood Functional Gastrointestinal Disorders: Child/Adolescent Carlo Di Lorenzo, MD Jeffrey S. Hyams, MD

    Rome IV Diagnostic Criteria Chapters, Chairs and Co-Chairs

    Rome IV Editorial Board: Douglas A. Drossman, MD, Senior Editor, Lin Chang, MD, William D. Chey, MD, John Kellow, MD, Jan Tack, MD, PhD, and William E. Whitehead, PhD.

    To view The Rome Foundation's publications, visit PubMed

    Content Contributors
    • Justin Brandler, MD
    Reviewed By
    • Jan Track, MD, PhD, RFF
    About the Creator
    Dr. Douglas Drossman
    Dr. Lin Chang
    The Rome Foundation
    Content Contributors
    • Justin Brandler, MD
    Reviewed By
    • Jan Track, MD, PhD, RFF