Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

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Inpatient care

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Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The Rome IV Diagnostic Criteria for Functional Biliary Sphincter of Oddi Disorder is a clinical calculator used in the field of gastroenterology. This calculator is specifically designed for patients who are suspected of having functional biliary sphincter of Oddi disorder, a condition characterized by recurrent biliary-type pain or pancreatitis with a dilated bile or pancreatic duct but without any obvious structural abnormalities.

The clinical utility of this calculator is to aid in the diagnosis of functional biliary sphincter of Oddi disorder. It uses a combination of clinical symptoms, laboratory findings, and imaging results to determine the likelihood of this disorder. The criteria include recurrent episodes of upper abdominal pain, absence of gallstones or other structural abnormalities, and abnormal sphincter of Oddi manometry or elevated liver enzymes during episodes of pain.

Exclusion criteria for the use of this calculator include the presence of other structural or metabolic diseases that could explain the patient's symptoms, such as gallstones, pancreatitis, or liver disease. Additionally, patients who have had their gallbladder removed (cholecystectomy) may not be suitable for this calculator, as the symptoms of functional biliary sphincter of Oddi disorder can mimic those of post-cholecystectomy syndrome.

Rome IV diagnostic criteria for functional biliary sphincter of Oddi disorder

# Criteria
 # Mandatory criteria for biliary pain
A. Located in the epigastrium and/or right upper quadrant (+1)
B. Builds up to a steady level and lasts >= 30 minutes (+1)
C. Occurs at different intervals (not daily) (+1)
D. Severe enough to interrupt daily activities or lead to an emergency department visit (+1)
E. Not significantly (< 20%) related to bowel movements (+1)
F. Not significantly (< 20%) relieved by postural change or acid suppression (+1)
# Supportive criteria for biliary pain
G. Nausea and vomiting (+0)
H. Radiation to the back and/or right infra-subscapular region (+0)
I. Waking from sleep (+0)
# Mandatory criteria for sphincter of Oddi disorder
J. Elevated liver enzymes or dilated bile duct, but not both (+1)
K. Absence of bile duct stones or other structural abnormalities (+1)
# Supportive criteria for sphincter of Oddi disorder
L. Normal amylase/lipase (+0)
M. Abnormal sphincter of Oddi manometry (+0)
N. Hepatobiliary scintigraphy (+0)

# Conditions
- score == 8
- true
- score == 0

Sphincter of Oddi dysfunction

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Diagnostic procedures

Surgical interventions