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Pyloric stenosis: Treatment, symptoms, advice and help

About pyloric stenosis

Pylorus is the term used for the opening between the stomach and the small intestine. Pyloric stenosis, also termed as ‘infantile hypertrophic pyloric stenosis’, is a narrowing of this pyloric region. Pyloric stenosis is the most common cause of intestinal obstruction seen in infants.

Pyloric stenosis: Incidence, age and sex

It is more often seen in boys than girls, with a ratio of 4:1. The diagnosis is often made by the time the child is 6 months old. It is not a very common condition in the general population.

Signs and symptoms of pyloric stenosis: Diagnosis

Vomiting is the first symptom in most children which may at times occur after every feed. It usually starts by the time the infant is 3 weeks old, but may start any time between 1 week and 5 months of age. Vomiting comes out forcefully and the infant may be hungry and wanting to feed again. Other associated symptoms include abdominal pain, dehydration, and failure to gain weight. There also may be a wave-like motion of the abdomen shortly after feeding and just before occurrence of vomiting.

The condition is usually diagnosed before the baby is 6 months old by taking detailed history of child’s feeding habits. A comprehensive physical examination may reveal signs of dehydration. The infant’s belly may appear abnormally big. Blood chemistry and ultrasonography of the abdomen are some investigations to confirm such diagnosis.

Causes and prevention of pyloric stenosis

Under normal scenario, food passes easily from the stomach into the small intestine through a canal called the pylorus. In pyloric stenosis, the muscles of the pylorus are thickened which prevents the food from entering the small intestine.

The cause of the thickening is unknown, although some theories suggest that genetic factors may play a role. Often, such a condition may run in the family.

Pyloric stenosis: Complications

Vomiting and failure to gain weight in the newborn period are some usual complications.

Pyloric stenosis: Treatment

Pyloric stenosis is considered to be a medical emergency. Immediate treatment requires replacement of fluid loss, electrolytes, and acid-base imbalance. Correction needs to be done and this involves surgery. Surgical procedure known as pyloromyotomy is usually done to split the overdeveloped/thickened muscles. Another procedure called ‘Balloon dilation’ can also be done, but it does not give excellent results. However it may be considered in infants since it does not require general anaesthesia, which may pose an increased risk for infants.