Rome IV has reported criteria for a diagnosis of Sphincter of Oddi disorder.
Categories of functional sphincter of Oddi disorder:
(1) biliary
(2) pancreatic
Features of biliary sphincter of Oddi disorder - all of the following"
(1) biliary pain
(2) elevated liver enzyme concentration OR dilated common bile duct (but not both)
(3) absence of bile duct stones or other structural abnormalities
Additional findings with biliary sphincter of Oddi disorder may include:
(1) normal serum amylase and lipase concentration
(2) abnormal manometry at the Sphincter of Oddi
Features of pancreatic sphincter of Oddi disorder - all of the following:
(1) recurrent episodes of pancreatitis (including elevated serum amylase or lipase greater than 3 times upper limit of normal (ULN) or imaging evidence of acute pancreatitis)
(2) endoscopic ultrasound negative
(3) abnormal sphincter manometry
(4) other causes of pancreatitis excluded
