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Pyloric stenosis: Symptoms, causes, and treatment – Medical News Today

Pyloric stenosis is a rare condition that occurs when the passage between the stomach and the small intestine narrows. It typically occurs in infants and can cause an obstruction, leading to projectile vomiting, abdominal cramps, dehydration, and hunger.

Experts estimate that pyloric stenosis affects 2–5 in every 1, 000 births . They also report that it usually affects infants under 6 months of age and is less common in older children. Without treatment, pyloric stenosis may affect growth and development.

This article outlines the causes and symptoms of pyloric stenosis, along with information on 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, thickens. This causes the pylorus to narrow.

Typically, the pylorus opens and closes to allow food through to the small intestine during digestion. When pyloric stenosis develops, this cannot happen as it should. Food and fluids cannot get through easily, so the body cannot digest and absorb them.

Although this condition can occur anytime from birth onward, it usually develops within 2–8 weeks of age.

Babies with pyloric stenosis often have no symptoms at birth. When they do develop, symptoms can include :

  • Projectile vomiting : Initially, a baby along with pyloric stenosis may vomit a little, but as the pylorus thickens, the vomiting becomes forceful. This means the be sick can travel several feet across the room from the baby’s mouth.
  • Abdominal cramps : Before the baby vomits, a parent or caregiver may notice wave-like ripples in the baby’s upper abdomen immediately after eating. This is because the particular stomach muscles have to do more work than usual to push food into the small intestinal tract.
  • Dehydration: Frequent vomiting can cause a loss of water, leading to dehydration. Dehydration can happen quickly in babies and can become 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 throwing up, because they are not keeping milk or food down.
  • Constipation: Infants with pyloric stenosis can have difficulty emptying their bowels since a reasonable quantity of food and water is not reaching the little intestine.
  • Weight loss : Infants with pyloric stenosis can have problems gaining and maintaining weight.

A person ought to contact a doctor as soon as possible if a baby has any of the following signs and symptoms:

If the baby cannot keep any food or water down or shows signs of lacks, dial 911 or the number of the nearest emergency department. Signs of dehydration in infants include:

Healthcare experts do not 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. Research suggests that siblings have a 20-fold increased danger of developing pyloric stenosis. In identical twins, the risk increases 200-fold.
  • Sex: Male infants are 4 times more likely to have pyloric stenosis than females.
  • Firstborn infants: Pyloric stenosis is more common among firstborn infants, accounting for 30–40% of all cases. Scientists are not sure why this is.
  • Race: According to the Centers for Disease Control and Prevention (CDC) , pyloric stenosis is more common in white babies and less common within non-Hispanic Asian and non-Hispanic Black infants.
  • Smoking: Smoking during pregnancy can double the risk of having a baby with pyloric stenosis.
  • Antibiotic use: Ingesting certain types of antibiotics during their first 2 weeks of life can increase an infant’s possibility of developing pyloric stenosis. This includes oral azithromycin and erythromycin.
  • Bottle feeding: According to an older 2012 study, bottle-fed babies may be 4. 6 times more likely to have pyloric stenosis than those not bottle-fed. However , the researchers could not determine why this might be the case.

If an infant shows any signs or symptoms that could indicate pyloric stenosis, their caregiver should immediately contact a pediatrician . The pediatrician will perform a physical examination to check if an abdominal mass around the size of an olive is present in the child’s upper abdomen.

They may also order other tests, including:

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

The gold standard treatment for pyloric stenosis is really a surgical procedure known as Ramstedt’s pyloromyotomy . This widens the space inside the pylorus, allowing as well as fluids to pass through more easily.

Ramstedt’s pyloromyotomy procedure

Before the surgery, a healthcare professional will certainly test the baby’s blood to check they have healthy fluid and electrolyte levels. If they do not, the baby will receive IV fluids.

Next, a medical professional may administer general anesthesia , so the baby feels no pain. Then a pediatric surgeon will begin the particular surgery.

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

In a laparoscopic pyloromyotomy, the surgeon will make three small incisions and use a camera to see inside the stomach. They then use small tools to cut the muscle around the pylorus. In an open pyloromyotomy, the surgeon makes a bigger incision on the right side of the stomach and cuts the pylorus.

The surgery usually takes about 30 minutes .

After surgery

Around 6 hours after surgery, the infant can begin having small amounts of food. These amounts may gradually increase as the child tolerates it.

The baby will usually go home after 1–2 days in the hospital. Healthcare professionals can monitor the baby for any postoperative complications during this period.

After going home, they will need some special care while they recover. This involves:

  • feeding as usual in the case of breast- or chestfeeding
  • serving the baby no more than 3 ounces of formula every 3 hours for the first a few days after surgery, slowly increasing the amount after this period
  • caring for the incision wound, keeping it clean and dry
  • avoiding full baths for 2 days, giving sponge baths instead
  • giving the baby acetaminophen to reduce pain if the doctor says this is okay

With no treatment, pyloric stenosis can cause the following complications:

  • Hypovolemic shock : A delayed diagnosis can lead to an emergency where the heart cannot pump sufficient bloodstream to major organs due to severe dehydration.
  • Hematemesis : This is when a person throws up blood. Gastrointestinal irritation can upset the particular stomach’s mucosal lining, resulting in mild bleeding in the belly.
  • Jaundice : This is a buildup of bilirubin in the body, causing a yellowish coloration of the eyes plus skin. This may be due to low levels of hepatic glucuronosyl transferase in the blood.

Surgery for pyloric stenosis also involves a few potential complications, such as infection. However , the benefits vastly outweigh the risks, and most babies recover quickly with no adverse outcomes.

Speak with a doctor if a baby evolves any of the following after surgical treatment:

  • surgical wounds that are inflamed, swollen, bleeding, or leaking pus
  • a fever
  • continued throwing up after most meals
  • a swollen belly

Here are answers to some common questions about pyloric stenosis.

Will pyloric stenosis go away on its own?

No, pyloric stenosis are not able to get better on its own. It requires therapy from a doctor.

Can pyloric stenosis impact adults?

Based on a 2018 review , pyloric stenosis occurs very rarely in adults. Sometimes it is idiopathic, meaning the cause is unknown. At other times, it can appear alongside other medical conditions such as ulcers, gastrointestinal tumors, or postoperative adhesions.

What is the long-term outlook for an infant with pyloric stenosis?

If untreated, pyloric stenosis can cause severe complications. However , the outlook for infants who do receive the surgery is generally good. Most make an excellent recovery, and very few experience any kind of long-term problems due to the situation.

Pyloric stenosis is a rare problem that typically affects infants below 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 sick 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 someone is concerned a child may have pyloric stenosis, they should talk with a doctor immediately. A person with pyloric stenosis needs surgery to correct the condition and improve digestive function.

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