@tracey1327 I wanted to add some additional context to my situation, because I think this is where I keep getting stuck with providers.

My MRCP has been normal with no ductal dilation, and my liver enzymes are mostly normal — even when labs and imaging were done during a pain flare. Because of this, no one is willing to proceed with ERCP.

From what I understand, this pattern is most consistent with what has historically been called Type III Sphincter of Oddi dysfunction (or functional biliary pain under newer criteria). I’m also aware that multiple studies have shown ERCP and sphincterotomy to be largely ineffective in this group, with a real risk of complications.

That’s part of what makes this so frustrating. On one hand, I’m being told there’s “nothing objective” to treat. On the other hand, I’m living with daily RUQ pain that significantly affects my quality of life.

After having gallbladder surgery and having my symptoms become dramatically worse, I’m honestly terrified of making things even worse with an invasive procedure like ERCP — especially knowing the risks and the low likelihood of benefit in cases like mine.

I feel stuck in this no-man’s-land where the pain is real, the impact is real, but the lack of abnormal tests seems to shut down further thought or creativity from the medical side.