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For Those With Liver Pain, Impaired Sphincter Of Oddi Function


CR5442

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CR5442 Contributor

Been researching this issue a lot more because I couldn't understand how Coeliac disease could have an effect on how a muscle in to the duodenum works. I found it. Basically the compound Cholecystokinin is produced by the small intestine and duodenum which in turn encourages the contraction of the gallbladder and the relaxation of the Sphincter of Oddi. With those who have experienced a lot of liver pain/congestion it might be that the lack of the production of this peptide hormone (because of the damage to the gut) are experiencing a lack of contraction and relaxation, hence the build up of toxic bile in the liver and possibly even one of the causes of all the other 'reactions' that we get - pseudo allergies?

Does anyone know anything else about this mechanism? Is there any supplement out there that can help this situation... by providing part of the chemical pathway for this substance? I am taking Choline Bitartrate at the moment and getting very good gallbladder emptying results but it is still tricky and I need to keep working on it. My acupuncturist relaxed my Sphincter of Oddi the other day but if I'm deficient in the compound because my gut isn't producing it then I suppose the symptoms will all just come back again?!


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Bubba's Mom Enthusiast

Been researching this issue a lot more because I couldn't understand how Coeliac disease could have an effect on how a muscle in to the duodenum works. I found it. Basically the compound Cholecystokinin is produced by the small intestine and duodenum which in turn encourages the contraction of the gallbladder and the relaxation of the Sphincter of Oddi. With those who have experienced a lot of liver pain/congestion it might be that the lack of the production of this peptide hormone (because of the damage to the gut) are experiencing a lack of contraction and relaxation, hence the build up of toxic bile in the liver and possibly even one of the causes of all the other 'reactions' that we get - pseudo allergies?

Does anyone know anything else about this mechanism? Is there any supplement out there that can help this situation... by providing part of the chemical pathway for this substance? I am taking Choline Bitartrate at the moment and getting very good gallbladder emptying results but it is still tricky and I need to keep working on it. My acupuncturist relaxed my Sphincter of Oddi the other day but if I'm deficient in the compound because my gut isn't producing it then I suppose the symptoms will all just come back again?!

I'm nursing along a poorly functioning gallbladder right now. After my HIDA scan I was told to consult a surgeon, but my function is 30%..I'm hoping it will improve now that I'm gluten-free, and off my PPI med.

The CCK is made in the duodenum, then sent to the gallbladder. It tells the GB to squeeze. If there's damage in the duodenum CCK may not be produced in the amount needed to get things going? I'm currently taking digestive enzymes and a supplement of Curcumin (turmeric) 450mg with heavy or fatty meals. The curcumin is a super anti-oxidant/anti-inflamatory that helps the gb function better.

Open Original Shared Link

Scroll down to adverse effects for the mention of gallbladder. They mention a much higher dose than I take..but I fugure every little bit helps?

Do note..if you have gallstones this might cause irritation?

CR5442 Contributor

I'm nursing along a poorly functioning gallbladder right now. After my HIDA scan I was told to consult a surgeon, but my function is 30%..I'm hoping it will improve now that I'm gluten-free, and off my PPI med.

The CCK is made in the duodenum, then sent to the gallbladder. It tells the GB to squeeze. If there's damage in the duodenum CCK may not be produced in the amount needed to get things going? I'm currently taking digestive enzymes and a supplement of Curcumin (turmeric) 450mg with heavy or fatty meals. The curcumin is a super anti-oxidant/anti-inflamatory that helps the gb function better.

Open Original Shared Link

Scroll down to adverse effects for the mention of gallbladder. They mention a much higher dose than I take..but I fugure every little bit helps?

Do note..if you have gallstones this might cause irritation?

Thanks so much for this info. Yes, I suddenly, the other day after having the SoO treated by my acupuncturist realised that this might be the source of all my GB and Liver pain. Here is an article I just found... Open Original Shared Link Looks like we all might have this deficiency to some degree or other. I think it is easier if you don't have other allergies/sensitivities though. Suddenly realised I was Salicylate sensitive when I put on 6lbs of water in five months from taking herbal medicine. Sadly I am doing a degree in herbal medicine and my acupuncturist says I can't tolerate herbs at the mo. Interestingly Curcumin culinary grade (not therapeutic) was fine, the therapeutic grade herbs (much stronger) were not! Let me know what you think of the article?

Bubba's Mom Enthusiast

Thanks so much for this info. Yes, I suddenly, the other day after having the SoO treated by my acupuncturist realised that this might be the source of all my GB and Liver pain. Here is an article I just found... Open Original Shared Link Looks like we all might have this deficiency to some degree or other. I think it is easier if you don't have other allergies/sensitivities though. Suddenly realised I was Salicylate sensitive when I put on 6lbs of water in five months from taking herbal medicine. Sadly I am doing a degree in herbal medicine and my acupuncturist says I can't tolerate herbs at the mo. Interestingly Curcumin culinary grade (not therapeutic) was fine, the therapeutic grade herbs (much stronger) were not! Let me know what you think of the article?

Thanks so much for posting this article! It makes me feel like I'm on the right track?

I continued to lose weight and feel terrible even though I knew I was completey gluten-free. I went to a different GI from the one that DXed me and asked about checking for SIBO. He laughed at me and said "Did Dr. Google tell you to ask about that"? He's the one that tested my gallbladder and said to consult a surgeon. I did a lot of searching for answers before having a surgery. I found articles saying that PPIs can interfere with GB function, and CCK is made in the duodenum where I had a lot of damage. I thought my function might improve once I started to heal? I added the curcumin supplement.

I figured it was worth a try going off the med to see if it helped? The GI insisted I needed to stay on the PPI. I had been on it for years. It's generally recommended that they are to be used for short periods!

I went to Mayo Clinic for more tests when my health wasn't improving. Tests showed that I have a severe SIBO problem and pancreatic insufficiency. I was put on meds for both and I'm feeling hopeful. The Dr. there said he wouldn't advise removing my GB. I wondered if taking the enzymes would be permanent..but the article points to recovery once the villi are healed?

I'm sure glad I didn't rush to surgery, and persued the SIBO testing. Once that's cleared up (which I'm told takes some time) I should be good. :D

CR5442 Contributor

Wow, that's brilliant news! Hope you really manage to piece this all together. Not sure if the article is peer reviewed but might be worth taking it along with you to your next appt. I am taking choline at the moment 1.8g elemental twice a day and honestly it is a life saver for me. I think I don't get enough in my diet because I react badly to eggs and only just tolerate chicken. It encourages the contraction/relaxation of the system delivering bile to the gut and also helps bowel motility... though I'm not sure it's not taking me to the opposite end of constipation! Need to tinker around a bit with the levels.

Let me know how you go with the pancreatic enzymes... how much will you be taking a day? I might give those a try once everything settles down a bit more.

Bubba's Mom Enthusiast

Wow, that's brilliant news! Hope you really manage to piece this all together. Not sure if the article is peer reviewed but might be worth taking it along with you to your next appt. I am taking choline at the moment 1.8g elemental twice a day and honestly it is a life saver for me. I think I don't get enough in my diet because I react badly to eggs and only just tolerate chicken. It encourages the contraction/relaxation of the system delivering bile to the gut and also helps bowel motility... though I'm not sure it's not taking me to the opposite end of constipation! Need to tinker around a bit with the levels.

Let me know how you go with the pancreatic enzymes... how much will you be taking a day? I might give those a try once everything settles down a bit more.

You have me wanting to look into choline now. :D

The pancreatic enzymes I'm taking now are RX Zenpep(pancrelipase, delayed release capsules. They have Lipase 10,000 units, Amylase 55,000 units, Protease 34,000 units. I was told to take 2 capsules with a meal, and one with a snack.

The over the counter ones I was taking seemed better, because they had papain and bromelain too, but for now I'll take the RX and see how it goes? I was taking the over the counter ones (1)with meals, but not snacks.

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    • trents
      You might consider asking for a referral to a RD (Registered Dietician) to help with food choices and planning a diet. Even apart from any gluten issues, you will likely find there are some foods you need to avoid because of the shorter bowel but you may also find that your system may make adjustments over time and that symptoms may improve.
    • Ello
      I wish Dr’s would have these discussions with their patients. So frustrating but will continue to do research. Absolutely love this website. I will post any updates on my testing and results.  Thank you
    • trents
      Losing 12" of your small bowel is going to present challenges for you in nutritional uptake because you are losing a significant amount of nutritional absorption surface area. You will need to focus on consuming foods that are nutritionally dense and also probably look at some good supplements. If indeed you are having issues with gluten you will need to educate yourself as to how gluten is hidden in the food supply. There's more to it than just avoiding the major sources of gluten like bread and pasta. It is hidden in so many things you would never expect to find it in like canned tomato soup and soy sauce just to name a few. It can be in pills and medications.  Also, your "yellow diarrhea, constipation and bloating" though these are classic signs of a gluten disorder, could also be related to the post surgical shorter length of your small bowel causing incomplete processing/digestion of food.
    • Ello
      Yes this information helps. I will continue to be pro active with this issues I am having. More testing to be done. Thank you so much for your response. 
    • trents
      There are two gluten-related disorders that share many of the same symptoms but differ in nature from each other. One is known as celiac disease or "gluten intolerance". By nature, it is an autoimmune disorder, meaning the ingestion of gluten triggers the body to attack it's own tissues, specifically the lining of the small bowel. This attack causes inflammation and produces antibodies that can be detected in the blood by specific tests like the TTG-IGA test you had. Over time, if gluten is not withheld, this inflammation can cause severe damage to the lining of the small bowel and even result in nutrient deficiency related health issues since the small bowel lining is organ where all the nutrition found in our food is absorbed.  The other is NCGS (Non Celiac Gluten Sensitivity or just "gluten sensitivity") which we know less about and are unsure of the exact mechanism of action. It is not an autoimmune disorder and unlike celiac disease it does not damage the lining of the small bowel, though, like celiac disease, it can cause GI distress and it can also do other kinds of damage to the body. It is thought to be more common than celiac disease. Currently, we cannot test for NCGS. Celiac disease must first be ruled out to arrive at a diagnosis of NCGS. Both disorders require elimination of gluten from the diet.  Either of these disorders can find their onset at any stage of life. We know that celiac disease has a genetic component but the genes are inactive until awakened by some stress event. About 40% of the general population has the genetic potential to develop celiac disease but only about 1% develop active celiac disease. The incidence of NCGS is thought to be considerably higher. I hope this helps.
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