What is the prevalence of sphincter of Oddi dysfunction?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: November 8, 2026 • View editorial policy

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question

Prevalence of Sphincter of Oddi Dysfunction

Sphincter of Oddi dysfunction (SOD) has a prevalence of approximately 1-1.5% in the general post-cholecystectomy population, but this increases dramatically to 9-55% in patients with post-cholecystectomy syndrome, with manometric abnormalities detected in 55-72% of patients when both biliary and pancreatic sphincters are evaluated simultaneously.

Population-Specific Prevalence

The prevalence of SOD varies substantially depending on the clinical population being studied:

General Post-Cholecystectomy Patients

  • 1-1.5% prevalence in unselected post-cholecystectomy patients 1, 2
  • 14% in selected patients specifically complaining of post-cholecystectomy symptoms 2
  • Up to 30% of so-called post-cholecystectomy syndrome cases are attributable to SOD 3

Symptomatic Patients with Post-Cholecystectomy Syndrome

The prevalence increases markedly in this population, ranging from 9-55% 1. This wide variability reflects:

  • Lack of uniformity in patient selection criteria
  • Inconsistent definitions of SOD across studies
  • Different diagnostic methods employed

Patients Undergoing ERCP Evaluation

When patients are referred for endoscopic evaluation and undergo sphincter of Oddi manometry (SOM):

  • 25% prevalence among Brazilian patients referred to ERCP 4
  • 60.1% had sphincter dysfunction when both pancreatic and biliary sphincters were evaluated simultaneously in a large series of 360 patients 5
    • 18.9% had isolated pancreatic sphincter abnormalities
    • 11.4% had isolated biliary sphincter abnormalities
    • 31.4% had abnormalities in both sphincters

Prevalence by Clinical Classification (Milwaukee Criteria)

The frequency of manometrically-confirmed SOD differs substantially by clinical subgroup 2:

  • Biliary Type I: 65-95% (predominantly sphincter of Oddi stenosis)
  • Biliary Type II: 50-63%
  • Biliary Type III: 12-28%

Special Populations

Idiopathic Recurrent Pancreatitis

SOD prevalence ranges from 39-90% in patients with idiopathic recurrent pancreatitis 2. When stratified by pancreatitis type 5:

  • 72.3% in idiopathic pancreatitis
  • 53.9% in chronic pancreatitis
  • 55.9% in patients without pancreatitis

Post-Sphincterotomy Patients

In patients with ablated biliary sphincter 5:

  • 45.9% had abnormal pancreatic sphincter pressure
  • Only 0.6% had isolated biliary sphincter abnormalities
  • 9.3% had abnormalities in both sphincters

Important Clinical Caveats

The reported prevalence is highly dependent on whether both the pancreatic and biliary sphincters are evaluated. Studies evaluating only one sphincter significantly underestimate the true prevalence of SOD 5. The condition is more common in middle-aged women 1.

A critical pitfall: The wide range in reported prevalence (9-55% in post-cholecystectomy syndrome) reflects methodological inconsistencies across studies rather than true population differences. Clinicians should recognize that SOD is substantially more common than the general population prevalence of 1-1.5% would suggest when evaluating symptomatic post-cholecystectomy patients.

References

1
Research

Sphincter of Oddi disorder (SOD): Is it necessary to investigate and treat?

Tropical gastroenterology : official journal of the Digestive Diseases Foundation, 2015

2
Research

Sphincter of Oddi dysfunction.

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 2003

Related Questions

Is ursodiol indicated for the treatment of sphincter of Oddi dysfunction?
Which medications can cause sphincter of Oddi dysfunction?
What is the new name for sphincter of Oddi dysfunction types 1–3?
What is the appropriate dosing regimen of nifedipine for sphincter of Oddi dysfunction?
Can Monjuaro (tirzepatide) cause sphincter of Oddi dysfunction?
What laboratory tests should be ordered to evaluate secondary causes of hypertension in a 30-year-old patient with newly diagnosed hypertension?
What supplement is most effective for preventing or treating exercise‑induced calf muscle cramps in healthy adult half‑marathon runners?
Can occasional intrusive thoughts about a loved one's death occur in otherwise healthy individuals?
What radiographic findings on a chest X‑ray are indicative of lung cancer?
What is the appropriate management of premature muscle fatigue in a healthy adult half‑marathon runner?
How common is post‑cholecystectomy syndrome?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.