Rome IV Diagnostic Criteria for Functional Biliary Sphincter of Oddi Disorder (SOD)
Use in patients post-cholecystectomy with symptoms characteristic of typical biliary pain as defined by Rome IV criteria with elevated liver enzymes or dilated common bile duct, but NOT both. Supportive criteria such as normal amylase/lipase, abnormal sphincter of Oddi (SOD) manometry, or abnormal hepatobiliary scintigraphy can aid in diagnosis if available.
Do NOT use these criteria in patients with:
Atypical symptoms for biliary colic (mild, transient, constant, or daily pain).
Daily opiate use (can dilate bile ducts).
Structural diagnosis that explains symptoms (stones, pancreatitis, pancreatic or liver lesion).
With neither dilated common bile duct nor elevated liver tests.
With both dilated common bile duct and elevated liver tests.
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