Possibilities of modern pharmacotherapy in patients with dysfunction of the sphincter of Oddi

Pain in the right hypochondrium is one of the most frequent complaints in patients with diseases of the biliary system. According to statistics, every tenth person experiences unpleasant sensations in the upper right abdomen after drinking alcohol, fatty, fried or salty food, as well as after psychoemotional and physical exertion. The most common of the pathologies of the biliary system is the sphincter of Oddi dysfunction (SOD). SOD is a clinical syndrome caused by a functional disorder of sphincter of Oddi (SO), which leads to the development of abdominal pain syndrome, increased activity of liver and / or pancreatic enzymes, dilatation of the common bile duct and the main pancreatic duct. One of the methods of treatment of SOD is drug therapy, accompanied by the following groups of drugs: antispasmodics, nitrates, choleretics, antidepressants, etc. At the same time, many medications show low efficacy against SOD, or cause pronounced side effects. At present, for the treatment of sphincter of Oddi dysfunction, the domestic drug from the group of myotropic antispasmodics, hymecromon, Holicron, has the optimal characteristics in terms of price-quality ratio in the Russian pharmacological market. The drug has a selective antispasmodic effect on SO, and also has a choleretic effect. Mechanism of antispasmodic action is an increase in the concentration of nitric oxide (II) and cyclic mononucleotides, which through a cascade of biochemical reactions leads to a decrease in the number of calcium ions in the cell and a decrease in the tone of smooth myocytes of SO and gallbladder. The drug is absorbed into the blood in a small amount, which excludes its systemic effect and determines the selectivity of the effect on the biliary system. According to the results of clinical testing and consideration of a specific clinical case, it can be concluded that the use of hymecromone (Holicron) reduces the severity of pain syndrome and reduces dyspepsia syndrome, good tolerability and absence of side effects that would require withdrawal of the drug are also recorded.