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Pyloric stenosis is a rare disorder that prevents food from entering the small intestine in babies.
A muscle valve (pylorus) between the stomach and small intestine normally keeps food in the stomach until it is ready for the next step of digestion. The pylorus muscles stiffen and grow unusually big in pyloric stenosis, preventing food from reaching the small intestine.
Pyloric stenosis can cause choking, dehydration, and weight loss. Babies with pyloric stenosis may appear to be constantly hungry.
Pyloric stenosis is treated surgically.
WHAT ARE THE SYMPTOMS OF PYLORIC STENOSIS?
Pyloric stenosis symptoms commonly occur three to five weeks after delivery. Pyloric stenosis is uncommon in babies older than three months.
Among the signs are:
After-meal vomiting: The baby may vomit violently, ejecting breast milk or formula many feet away (projectile vomiting). Vomiting may begin mildly and gradually worsen when the pylorus aperture narrows. Vomit may occasionally contain blood.
Constant hunger: Babies with pyloric stenosis frequently desire to feed right after vomiting.
Constriction of the stomach: Soon after feeding but before vomiting, you may detect wavelike contractions (peristalsis) that ripple across your baby's upper abdomen. The stomach muscles are attempting to drive food through the constricted pylorus.
Dehydration: Your baby may wail without tears or get drowsy. You might notice that you're changing fewer wet diapers or diapers that aren't as wet as you expected.
Bowel movement changes: Babies with pyloric stenosis may be constipated because the disease inhibits food from reaching the intestines.
Weight issues: Pyloric stenosis can prevent a newborn from gaining weight and, in rare cases, cause weight loss.
WHAT ARE THE CAUSES OF PYLORIC STENOSIS?
Although the origins of pyloric stenosis are unknown, genetic and environmental factors may be involved. Pyloric stenosis is usually not present at birth and develops later.
WHAT ARE THE RISK FACTORS FOR PYLORIC STENOSIS?
The following are risk factors for pyloric stenosis:
- Sex: Pyloric stenosis is more common in boys, particularly firstborn children, than in girls.
- Race: Pyloric stenosis is more common in whites of Northern European descent, less common in African Americans, and uncommon in Asians.
- Premature birth: Premature babies are more likely to have pyloric stenosis than full-term neonates.
- Early antibiotic usage: Babies who get certain antibiotics in their initial weeks of life, such as erythromycin to treat whooping cough, are more likely to develop pyloric stenosis. Furthermore, babies delivered to moms who used particular antibiotics late in pregnancy may be at a higher risk of pyloric stenosis.
- Bottle-feeding: According to certain research, bottle-feeding rather than breast-feeding may increase the incidence of pyloric stenosis. Because the majority of those who took part in these research used formula rather than breast milk, it's unclear if the higher risk is due to formula or the method of bottle-feeding.
- Family history: Certain families were shown to have greater frequencies of this condition in studies. Pyloric stenosis affects approximately 20% of male offspring and 10% of female descendants of moms who had the illness.
- Smoking during pregnancy: This type of activity almost doubles the likelihood of pyloric stenosis.
WHAT ARE THE COMPLICATIONS OF PYLORIC STENOSIS?
Pyloric stenosis can result in:
- Failure to develop and expand.
- Dehydration. Dehydration and mineral (electrolyte) imbalance can result from frequent vomiting. Many critical functions are regulated by electrolytes.
- Irritation in the stomach. Vomiting repeatedly can upset your baby's tummy and cause minor bleeding.
- Jaundice. A chemical released by the liver (bilirubin) can occasionally accumulate, creating a yellowish coloring of the skin and eyes.
HOW IS PYLORIC STENOSIS DIAGNOSED?
The doctor will begin with a physical examination of your child. When checking the baby's abdomen, the doctor may notice an olive-shaped mass — the swollen pylorus muscles. When checking the infant's belly, wavelike contractions (peristalsis) may be apparent, frequently before the baby begins vomiting.
Your doctor may also suggest:
Blood tests to determine dehydration, electrolyte imbalance, or both.
Ultrasound to visualize the pylorus and confirm the diagnosis of pyloric stenosis
If the ultrasound results aren't clear, X-rays of your baby's digestive system will be taken.
WHAT ARE THE TREATMENTS FOR PYLORIC STENOSIS?
Pyloric stenosis requires surgery to be treated. Pyloromyotomy is frequently scheduled on the same day as the diagnosis. If your kid is dehydrated or has an electrolyte imbalance, fluid replenishment will be administered prior to surgery.
The surgeon just cuts through the outer layer of the enlarged pylorus muscle in pyloromyotomy, leaving the inner lining to expand out. This creates a pathway for food to enter the small intestine.
Pyloromyotomy is frequently performed utilizing minimally invasive surgery. A small incision around the baby's navel is used to introduce a thin viewing instrument (laparoscope). Recovery from a laparoscopic treatment is usually faster than from standard surgery, and the scar is less.
Following surgery:
- For a few hours, your infant may be given intravenous fluids. You can resume feeding your infant in 12 to 24 hours.
- Your infant may want to nurse more frequently.
- Some vomiting may last a few days.
Bleeding and infection are two potential consequences of pyloric stenosis surgery. However, problems are uncommon, and surgical outcomes are generally favorable.