title: Medical treatment for sphincter of oddi dysfunction: can it replace endoscopic sphincterotomy?
abstract: OBJECTIVE
  To report the results of a medical management of sphincter of oddi dysfunction (SOD) after an intermediate follow-up period.
  
  
  METHODS
  A total of 59 patients with SOD (2 men and 57 women, mean age 51 years old) were included in this prospective study. After medical treatment for one year, the patients were clinically re-evaluated after an average period of 30 mo.
  
  
  RESULTS
  The distribution of the patients according to the Milwaukee's classification was the following: 11 patients were type 1, 34 were type 2 and 14 were type 3. Fourteen patients underwent an endoscopic sphincterotomy (ES) after one year of medical treatment. The median intermediate follow-up period was 29.8 ± 3 mo (3-72 mo). The initial effectiveness of the medical treatment was complete, partial and poor among 50.8%, 13.5% and 35%, respectively, of the patients. At the end of the follow-up period, 37 patients (62.7%) showed more than 50% improvement. The rate of improvement in patients who required ES was not significantly different compared with the patients treated conservatively (64.2% vs 62.2%, respectively).
  
  
  CONCLUSIONS
  Our study confirms that conservative medical treatment could be an alternative to endoscopic sphincterotomy because, after an intermediate follow-up period, the two treatments show the same success rates.
authors.affiliation: Department of Gastroenterology, Hôpital Nord, Chemin des Bourrely, 13915 Marseille cedex 20, France. vittonv@yahoo.com
authors.forename: Véronique
authors.initials: V
authors.lastname: Vitton
authors.forename: Salah
authors.initials: S
authors.lastname: Ezzedine
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Gonzalez
authors.forename: Mohamed
authors.initials: M
authors.lastname: Gasmi
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Grimaud
authors.forename: Marc
authors.initials: M
authors.lastname: Barthet
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000627:therapeutic use*; D011446:Prospective Studies; D046628:Sphincter of Oddi Dysfunction / Q000188:drug therapy* / Q000601:surgery; D016717:Sphincterotomy, Endoscopic; D016896:Treatment Outcome; D014287:Trimebutine / Q000627:therapeutic use*
chemical_list: D005765:Gastrointestinal Agents; D009566:Nitrates; D014287:Trimebutine