Personalized Treatments for Functional Disorders of the Sphincter of Oddi: A Short Muscle with a Long History of Discussion and Controversies

The sphincter of Oddi (OS) is a small group of smooth muscles that plays a crucial role in the regulation of the flow of biliopancreatic secretions into the duodenal lumen. Its motility, including phasic contractions and relaxation, is under complex neurohumoral control. Organic or functional obstruction of the OS is an important factor in severe diseases, such as cholangitis and pancreatitis, as well as in functional disorders and recurrent abdominal pain. In this review, we summarize the function of the OS, its disorders, and their diagnostic methods and potential therapeutics. While organic diseases of the papilla often require invasive, mainly endoscopic, treatment, functional disorders should be managed with conservative, individualized treatment, and involve the patient and their family in decision-making.