What is pyloric stenosis?
Pyloric stenosis is a condition that affects newborns, specifically the muscle between the stomach and small intestine. This muscle, called the pylorus, opens, and closes to allow food to pass from the stomach into the small intestine.
In pyloric stenosis, the pylorus becomes thickened and narrowed, making it difficult for food to pass through.
Pyloric Stenosis Symptoms
The most common symptom of pyloric stenosis in babies is forceful and projectile vomiting.
This differs from a "wet burp" after a baby's feeding.
Sometimes, the milk is curdled in appearance because it does not move forward to the small intestine, remaining in the stomach, causing it to form clumps.
Other potential pyloric stenosis symptoms include:
- Lack of energy
- Weight loss
- Fewer bowel movements
- Ravenously hungry despite vomiting
- Frequent, mucous stools
The symptoms of pyloric stenosis can be like other conditions or medical problems. So always consult your child's doctor to figure out what is happening.
Pyloric Stenosis Causes
The exact cause of pyloric stenosis is unknown, but it is thought to be caused by a combination of genetic and environmental factors and is a multifactorial trait.
Multifactorial inheritance is a term for when many different factors contribute to causing a birth defect. Often, multifactorial traits will target one gender more frequently than the other, with males being four times as likely to have pyloric stenosis than females.
The likelihood of a second child being born with pyloric stenosis depends on the gender of the previous child and the to-be-born baby.
Why is pyloric stenosis of concern?
It's important to note that several problems can occur when a baby's stomach becomes blocked.
The most severe issue involves dehydration, as babies have smaller bodies than adults; thus, they lose fluids more easily than older people but cannot tolerate it the same.
In addition, minerals such as potassium & sodium, along with other nutrients necessary for the body’s normal function like protein, are also lost during vomiting - leading to a sick child quickly.
Another problem that vomiting causes is weight loss. A baby who cannot keep down food will not have adequate nutrition to maintain a healthy weight.
Who gets pyloric stenosis?
Pyloric stenosis is most common in infants between one and two months. It is more common in males than females and is more prevalent in Caucasian infants than in other racial groups.
How is pyloric stenosis diagnosed?
A physical examination usually reveals a firm mass, approximately the size of an olive, in the abdominal area.
To ensure an accurate diagnosis and to rule out any other conditions that may have similar symptoms, your physician may order additional tests, including the following:
- Blood tests: To check for dehydration and other abnormalities.
- Abdominal x-rays: Diagnostic imaging that uses electromagnetic energy beams to take pictures of bones, internal tissues, and organs.
- Abdominal ultrasound: A medical examination that uses high-frequency sound waves and a computer to produce images of tissues, blood vessels, and organs. Ultrasounds are used to assess blood flow through various vessels and view
the functionality of internal organs.
- Barium swallow/upper GI series: This test involves drinking a barium solution, which will help outline the gastrointestinal tract's anatomy on an x-ray. It can help to confirm the diagnosis of pyloric stenosis and rule out other causes
Pyloric Stenosis Treatment
Several factors determine the specific pyloric stenosis treatment procedure. These include:
- Your baby's overall health, gestational age, & medical history
- The severity of the problem
- Your baby's tolerance for specific therapies, medications, and procedures
- Expectations for the route of the problem
- The parents' preferences and opinion
While pyloric stenosis is treated with an operation, the doctors may need to treat mineral imbalances and dehydration first. Once the baby is no longer dehydrated, surgery is performed.
During the pyloromyotomy, the surgeon will make a small incision in the stomach and cut through the thickened muscle tissue of the pylorus.
This surgery is usually performed using a laparoscope, which is a long, thin tube with a camera attached. This allows the surgeon to see inside the stomach without making a large incision.
The baby will receive pain medication injected into the incision while in the operating room.
When is surgery needed?
The decision to have surgery is sometimes based on the severity of the symptoms. However, it is recommended that any patient with pyloric stenosis receive surgical repair.
What can I expect from surgery?
The surgeon will make a small incision in the stomach and then enlarge the pylorus. This will allow food and liquids to pass easily into the small intestine.
Your child will receive general anesthesia during the procedure to make them sleepy.
Your child can usually go home within 24-48 hours after surgery, if they have a normal temperature, can eat and drink normally, and can take pain medications by mouth.
Recovery from surgery is typically quick; most children can return to normal activities within a week or two. Talk to your doctor about specific questions or concerns about pyloric stenosis surgery for your child.
Our office is open Monday-Friday from 8:00 a.m.-5:00 p.m. Please call us with any questions or concerns in regards to your child's post-operative care. Our office number is 248-551-2400. After
office hours and on weekends or holidays, your call will be directed to our on call surgeon thru our answering service.