New test offers hope for patients with unexplained stomach pain

Less than two weeks after her ERCP-SOM, Emily Riska, of Morgantown, is back to work at the Cheat Lake Animal Hospital. After 10 years of undiagnosed stomach pain, Riska is pain free. 

For 10 years, Emily Riska suffered from unexplained stomach pain.

She endured various tests, all of which came back normal. Riska had little hope when her primary care physician referred her to Faisal A. Dr. Bukeirat, MD, a Mon General Hospital interventional endoscopist. 

“I’d already had so many tests, including the ERCP. I just didn’t want to feel sick anymore,” Riska said.

Dr. Bukeirat saw what none of the other doctors saw, and he did what none of the other doctors could.  And now, Riska is pain free.  

Dr. Bukeirat performed an ERCP-SOM (endoscopic retrograde cholangiopancreatography with sphincter of Oddi manometry) March 4. It’s actually two tests performed concurrently to diagnose unexplained pancreatitis or severe abdominal pain.  Once Dr. Bukeirat found the problem, he was able to fix it while Riska was still under anesthesia.  

“This technology is new to West Virginia,” said Dr. Bukeirat. “Mon General Hospital supports the needs of our community by providing me with the resources to be at the forefront of digestive disease medicine.”

ERCP is a procedure used to diagnose diseases of the gallbladder, biliary system, pancreas and liver. But for patients like Riska, a simple ERCP did not find the problem.

Dr. Bukeirat performed the SOM procedure during the ERCP. The SOM tests for sphincter dysfunction by measuring the pressure of the sphincter of Oddi, a muscular valve surrounding the exit of the bile duct and pancreatic duct.  

A dysfunctional sphincter does not relax at the appropriate time allowing the back-up of digestive juices and causing episodes of severe abdominal pain. Treatment depends on what is found during the procedure.

“After my procedure, Dr. Bukeirat said to me, ‘We found the problem. I fixed it,’” Riska said. “I can’t explain my relief. I really thought it’d be another test and another normal result. I knew there was something wrong, but no one could find it.”

Now, almost two weeks later, Riska is no longer limiting her diet. She doesn’t feel ill after eating, and she isn’t too sick to go to work.

“I hope that other people in a similar situation keep looking for answers,” Riska said.

Patient selection is important to Dr. Bukeirat. He follows guidelines to determine whether a patient is a ERCP-SOM candidate and will evaluate each patient for alternative explanations for their pain before performing the procedure.

“The ERCP-SOM is considered the gold standard of sphincter of the Oddi dysfunction diagnosis, and it will help us diagnose and treat patients who have been dealing with pain for years,” Dr. Bukeirat said.

For more information about gastroenterology diagnosis and treatment, visit mongeneral.com/digestivecare.