Pyloric Stenosis Definition, Reason, Symptoms, Treatment & Prevention
Definition
Pyloric stenosis is a relatively rare disease and usually occurs in infants. The pylorus is a muscular valve between the stomach and the small intestine. Pyloric stenosis occurs when the muscle thickens and enlarges. This causes the food that is eaten and that has been processed in the stomach cannot enter the small intestine.
This disease is usually known from the first month of birth. Babies over the age of 3 months rarely experience this condition.
Treatment of this condition is important immediately because it can cause several complications, such as:
- failed to thrive
- dehydration
- gastric irritation
- jaundice
Pyloric Stenosis Symptoms
Symptoms of pyloric stenosis usually become apparent 3–5 weeks after birth. Symptoms of pyloric stenosis include:
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Throwing up after eating
Babies usually spit vomit up to a distance of several meters. Vomiting is mild at first and gets worse as the pyloric valve thickens. Sometimes there can be blood in the vomit.
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Baby looks hungry constantly
Babies are usually hungry after vomiting.
Babies with pyloric stenosis usually have difficulty gaining weight. On the contrary, babies with this condition can experience weight loss.
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Abdominal contractions
Wave-like movements of abdominal contractions, or peristalsis, can be seen in the baby’s upper abdomen after eating, but before vomiting. This happens because the stomach tries to push food into the small intestine.
Constipation can occur because food does not reach the small intestine. As a result, no food is digested until and can be excreted through the anus.
Vomiting that is severe enough to cause dehydration. Babies can cry without shedding tears or becoming limp. Babies also urinate less, so you change diapers less often.
Pyloric Stenosis Reason
The exact cause of pyloric stenosis is still unknown. Pyloric stenosis usually does not occur immediately at birth but will occur after birth. Genetic and environmental factors are thought to play a role in causing pyloric stenosis.
Risk factors that are also thought to trigger pyloric stenosis include:
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Family history
Pyloric stenosis can run in families. If a mother has pyloric stenosis, there is a 20% chance that her sons and 10% of her daughters will have the disease.
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Gender
Pyloric stenosis is more common in boys, especially firstborns.
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Ras
Pyloric stenosis is more common in Caucasians from Northern Europe and is followed by African Americans. This disease is rare in Asian people.
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Premature birth
Premature babies are more likely to have pyloric stenosis than full-term babies.
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Use of antibiotics
Mothers who take antibiotics during late pregnancy can increase the risk of their babies developing pyloric stenosis. In some conditions, such as whooping cough, the baby will be given the antibiotic erythromycin. The use of these antibiotics in the first weeks of life can increase the risk of pyloric stenosis.
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Use of milk bottles
Several studies have shown that giving milk through a bottle is more at risk of increasing the risk of pyloric stenosis compared to the mother’s breast directly.
However, in that study, the use of bottles filled with formula milk. So it is still not known whether formula feeding or bottle use increases the risk of pyloric stenosis.
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Smoking while pregnant
Mothers who smoke during pregnancy double the risk of their babies suffering from pyloric stenosis.
Diagnosis
Doctors can suspect pyloric stenosis from the baby’s symptoms. On physical examination, the doctor may be able to feel an olive-shaped lump on the baby’s stomach which is an enlarged pyloric muscle.
The doctor may also be able to observe peristaltic waves in the baby’s stomach. Blood tests are done to detect dehydration or electrolyte imbalance. Investigations such as ultrasound and X-rays can also be done to confirm the presence of pyloric stenosis.
Pyloric Stenosis Treatment
Treatment of pyloric stenosis can only be done with surgery. The surgical procedure for pyloric stenosis is called a pyloromyotomy. This pyloromyotomy is classified as a minimally invasive surgical procedure.
The surgical procedure can be performed laparoscopically, by inserting a tube through the baby’s navel. The surgeon will cut the outer layer of the pyloric muscle, allowing the inner layer to protrude and open the food pipe. Thus food can pass into the small intestine.
Surgery is usually performed as soon as the diagnosis is established. If the baby is dehydrated or there is a fluid imbalance, the baby’s condition must be treated before surgery.
After surgery, usually, the baby is not immediately given food. The baby will be given intravenous fluids for several hours. You can feed him 12 or 24 hours after surgery. Babies can still vomit after a few days of surgery.
Prevention
Pyloric stenosis cannot be prevented. But environmental risk factors, such as smoking during pregnancy, can be avoided. Likewise with the risk factors associated with the use of antibiotics during late pregnancy and early birth, of course they can be avoided.