Pyloric stenosis: symptoms, causes and treatment

Pyloric stenosis is a rare condition that occurs when the passageway between the stomach and small intestine narrows. It typically occurs in infants and can cause obstruction that can result in projectile vomiting, abdominal cramps, dehydration, and starvation.

Experts estimate that pyloric stenosis works 2-5 out of 1,000 births. They also report that it usually affects infants younger than 6 months and is less common in older children. Without treatment, pyloric stenosis can affect growth and development.

This article describes the causes and symptoms of pyloric stenosis, as well as information about diagnosis and treatment.

Pyloric stenosis is a rare condition that occurs when the pylorus, a muscular valve that sits at the bottom of the stomach, becomes thick. This narrows the pylorus.

Typically, the pylorus opens and closes to allow food into the small intestine during digestion. If pyloric stenosis develops, it may not happen as it should. Food and liquids cannot easily pass through, making it difficult for the body to digest and absorb them.

Although this condition can occur at any time from birth, it usually develops within 2-8 weeks of age.

Babies with pyloric stenosis often have no symptoms at birth. As they develop, symptoms appear may include:

  • Projectile Vomiting: Initially, a baby with pyloric stenosis may vomit a little, but as the pylorus thickens, the vomiting becomes violent. This means that vomit from the baby’s mouth can travel several feet across the room.
  • Stomach cramps: Before the baby vomits, parents or caregivers may notice wavy ripples in the baby’s upper abdomen immediately after eating. Because the stomach muscles have to do more work than usual to push food into the small intestine.
  • dehydration: Frequent vomiting can cause water loss, leading to dehydration. Dehydration in babies can happen quickly and be life-threatening. A dehydrated baby may have few wet diapers, cry without tears, or become lethargic.
  • Constant hunger: A baby with a narrow pylorus may always feel hungry, especially after vomiting because he is not holding down milk or food.
  • Constipation: Infants with pyloric stenosis may have trouble emptying their bowels because an adequate amount of food and water does not reach the small intestine.
  • weight loss: Infants with pyloric stenosis may have trouble gaining and maintaining weight.

A person should see a doctor as soon as possible if a baby has any of the following signs and symptoms:

If the baby is unable to hold down food or water or is showing signs of dehydration, call 911 or the nearest emergency room number. Signs of dehydration in infants include:

Health experts don’t know what causes pyloric stenosis, but have identified certain risk factors that may increase the likelihood. These include:

  • Family History and Genetics: Babies in families with a history of pyloric stenosis may have a higher chance of developing the condition. search suggestions that siblings have a 20-fold increased risk of developing pyloric stenosis. In the case of identical twins, the risk increases by a factor of 200.
  • Sex: Male infants are 4 times have pyloric stenosis more often than women.
  • first born: Pyloric stenosis is more common in firstborns 30-40% of all cases. Scientists are not sure why this is so.
  • race: According to that Centers for Disease Control and Prevention (CDC)pyloric stenosis is more common in white infants and less common in non-Hispanic Asian and non-Hispanic Black infants.
  • Smoking: smoking during pregnancy can double the risk of having a baby with pyloric stenosis.
  • Use of antibiotics: Taking certain types of antibiotics during their first 2 weeks of life can increase an infant’s chance of developing pyloric stenosis. These include oral azithromycin and erythromycin.
  • bottle feeding: According to an older study from 2012, bottle-fed babies could be 4.6 times are more likely to have pyloric stenosis than those who are not bottle-fed. However, the researchers could not determine why this is the case.

If an infant exhibits any signs or symptoms that might indicate pyloric stenosis, their caregiver should contact a pediatrician immediately. The pediatrician will perform a physical exam to check for an abdominal mass about the size of an olive in the child’s upper abdomen.

You can also order other tests including:

  • blood tests: These can confirm dehydration or an electrolyte imbalance.
  • An abdominal ultrasound: This can show clear images of a thickened pylorus muscle.
  • An upper gastrointestinal series: For this test, a baby drinks a barium liquid before undergoing a special stomach X-ray.

The gold standard treatment for pyloric stenosis is a surgical procedure known as Ramstedt pyloromyotomy. This expands the space in the pylorus, making it easier for food and liquids to pass through.

Ramstedt Pyloromyotomy Procedure

Before the surgery, a doctor will test the baby’s blood to make sure it has healthy fluid and electrolyte levels. If not, the baby will be given IV fluids.

Next, a doctor will administer general anesthesia to keep the baby from feeling any pain. Then a pediatric surgeon begins the operation.

Surgeons can perform a pyloromyotomy in two ways: laparoscopically, which is minimally invasive, and through open surgery.

In a laparoscopic pyloromyotomy, the surgeon makes three small incisions and uses a camera to look inside the abdomen. Then they use small tools to cut the muscle around the pylorus. In an open pyloromyotomy, the surgeon makes a larger incision on the right side of the stomach and severs the pylorus.

The operation usually lasts approx 30 minutes.

After the operation

Around 6 hours After the surgery, the infant can start eating small amounts of food. These amounts can gradually increase as the baby tolerates it.

After that, the baby usually goes home 1-2 days in the hospital. Medical professionals will monitor the baby for post-surgical complications during this time.

After they go home, they will need something special treatment while they recover. This contains:

  • feed as usual when breastfeeding or breastfeeding
  • Do not feed the baby more than 3 ounces of formula every 3 hours for the first 3 days after surgery and slowly increase the amount after that time
  • Care of the cut, keep it clean and dry
  • Avoid full baths for 2 days and instead give sponge baths
  • If the doctor says it’s okay, give the baby acetaminophen to relieve pain

If left untreated, pyloric stenosis can cause the following complications:

  • Hypovolemic shock: A belated diagnosis can lead an emergency where the heart cannot pump enough blood to major organs due to severe dehydration.
  • hematemesis: This is when a person vomits blood. Gastrointestinal irritation can disrupt the lining of the stomach, leading to easy bleeding in the stomach.
  • jaundice: This is a buildup of bilirubin in the body that causes the eyes and skin to appear yellow. This may be due to low levels of hepatic glucuronosyltransferase in the blood.

Pyloric stenosis surgery also involves some potential complications, such as: B. an infection. However, the benefits far outweigh the risks, and most babies recover quickly without adverse consequences.

Talk to a doctor if a baby develops any of the following after surgery:

  • Surgical wounds that are inflamed, swollen, bleeding, or leaking pus
  • a Fever
  • persistent vomiting after most meals
  • a bloated stomach

Here are answers to some frequently asked questions about pyloric stenosis.

Will pyloric stenosis go away on its own?

No, pyloric stenosis cannot get better on its own. It requires treatment by a doctor.

Can pyloric stenosis affect adults?

according to a Review 2018, Pyloric stenosis occurs very rarely in adults. Sometimes it’s idiopathic, meaning the cause is unknown. At other times, it may coexist with other conditions such as ulcers, gastrointestinal tumors, or postoperative adhesions.

What is the long-term outlook for a child with pyloric stenosis?

Left untreated, pyloric stenosis can cause serious complications. However, the outlook for infants who receive the surgery is generally good. Most make an excellent recovery and very few have long-term problems from the condition.

Pyloric stenosis is a rare condition that typically affects infants under the age of 6 months. It occurs when the pylorus, the muscular valve at the bottom of the stomach, thickens.

Infants with pyloric stenosis may not appear ill at first, but as the pylorus narrows, it becomes more difficult for food and water to pass through.

Symptoms of pyloric stenosis include projectile vomiting, stomach cramps, constipation, and dehydration. If anyone is concerned that a child may have pyloric stenosis, they should speak to a doctor right away. A person with pyloric stenosis will need surgery to correct the condition and improve digestive function.

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