Publication:

Epidemiology, diagnosis and management of patients with biliary dyskinesia and sphincter of Oddi dysfunction: a survey of Indian gastroenterologists

Background A cross-sectional, physician-based survey was conducted to address the relative lack of data on the awareness about and management of biliary dyskinesia and sphincter of Oddi dysfunction among Indian gastroenterologists.

Methods A structured questionnaire containing questions on epidemiology, etiology, clinical presentation, diagnostic investigations, prognosis and management was used. Physician responses were analyzed as descriptive statistics and reported as frequency and percentages.

Results A total 146 gastroenterologists across 137 cities participated in the survey. Majority (76.0%) of physicians stated that <10% of their patients with cholecystitis get diagnosed with BD, while 84.7% stated that <25% of patients with BD have SOD. SOD and BD were reported to be common in females <50 years. Patients recovering from major surgeries/stroke/heart attack/sepsis/extensive trauma were identified by 53.0% of physicians to be at risk for BD. Majority of physicians (69.4%) reported that irritable bowel syndrome (IBS) was a major risk factor for SOD. Cholescintigraphy and hepatobiliary scintigraphy were investigations of choice for BD and SOD according to 55.5% and 33.6% of physicians, respectively. Sepsis was identified as a frequent complication of BD (45.2%). Laparoscopic cholecystectomy was identified by 64.4% participants to result in partial resolution of symptoms in many patients. Calcium channel blockers and antispasmodics were preferred by 55.9% and 30.8% physicians for functional gall bladder disorder, respectively. IBS was the most common indication for prescribing the antispasmodic pinaverium, with the primary objective of pain relief.

Conclusions Findings from this survey provide insights for further research on BD and SOD in India.