What is pyloric stenosis?
Pyloric stenosis is a rare disease in which the valve between the
newborn's stomach and small intestine becomes thick and narrow. This makes it
difficult for food to pass from the baby's stomach to the intestines.
Symptoms
Signs of pyloric stenosis usually appear when the baby is 3 to 5 weeks
old. Babies don't look sick with it, but they vomit profusely. Sometimes they
vomit.
Over time, your child may vomit more often. Some children with this
condition cannot hold food.
However, this does not affect the appetite of infants - they often feel
hungry again shortly after vomiting.
Other symptoms include:
- Signs of dehydration: fewer wet diapers than usual, few to no tears, a sunken soft spot on the head, and sunken eyes
- Fewer soiled diapers than usual
- Weight loss or no weight gain
- Ripples across the baby's stomach
- Lump in the abdomen
- More fussiness
Call your pediatrician if your child has these symptoms.
How it happens
The pylorus is a valve located between the stomach and small intestine.
It remains closed to keep food in the stomach, then opens to allow food to
enter the intestines where it is digested.
In infants with pyloric stenosis, the pylorus thickens and food enters
the small intestine more slowly. When food cannot pass from the stomach to the
intestines, the child rejects it.
Doctors don't know exactly why the pylorus gets bigger, but it may be
partly caused by changes in the gene. Often inherited. If one or both parents
have pyloric stenosis, their child is 20% more likely to have it.
Other things that may make a baby more likely include:
- Gender: Pyloric stenosis is
more common in boys than in girls.
- Premature birth: Babies born before
the 37th week of pregnancy are more prone to this.
- Smoking during pregnancy: Children of smoking
mothers are more than twice as likely to have pyloric stenosis.
- Certain antibiotics: The chances of
having a baby may be higher if the mother took erythromycin or azithromycin in
late pregnancy or while breastfeeding, or if the baby took them in the first
weeks of life.
Diagnosis
Your pediatrician will ask you about your child's symptoms. Tell your
doctor how often he vomits and what the vomit looks like. The doctor will also
check your child's weight and height. They will then feel your child's abdomen
for lumps: the enlarged pylorus looks like an olive.
Your child's doctor may want to take a closer look at one of these:
- Ultrasound: Uses sound waves to create an image of the inside of your baby's stomach.
- Swallowing barium using the upper
gastrointestinal tract: the child drinks a special liquid containing the
chemical element barium, then a special X-ray examination of the stomach is
done. Barium makes the stomach and intestines clearer.
Your child may also need blood tests to check levels of substances such
as sodium and potassium. If your child vomits frequently, they may be losing
too many of these important minerals.
Treatment
Your child will first receive fluids and nutrients intravenously to
treat dehydration. Then an operation will be performed to open the blockage.
Your child will be given medicine to put him to sleep so that the
operation does not harm him. The surgeon cuts the thickened pylorus muscle to
create a wider passage for food to pass into the intestine. This can sometimes
be done with tiny instruments through very small incisions in the child's
abdomen. This is called laparoscopy.
The operation lasts from 15 minutes to an hour.
Your child should be able to return home in a day or two. Babies usually start eating normally again right away, but some may vomit for a few days afterward.