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Pyloric stenosis   

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Pylorus is the lower end of the stomach through which food and other contents of the stomach enter into the small intestine. Pyloric stenosis is thickening of the muscles of the pylorus which narrows the opening and blocks emptying of food into the intestine.

Who are at risk?

It more often occurs in babies, especially boys who are less than or 6 months old. It can also run in families i.e. infants of mothers who had pyloric stenosis might suffer from the same. The symptoms are less common in babies older than 3 months old

Symptoms of pyloric stenosis

  • Profuse or projectile vomiting after feeding
  • Excessive hunger due to severe vomiting
  • Abdominal pain and swelling
  • Visible wave like contractions in stomach
  • Dehydration due to salt and fluid imbalances
  • Lack of energy, irritation
  • Constipation
  • Weight loss or no weight gain

When to take your baby to a doctor?

You can recognize the symptoms very easily and since vomiting after feeding and crankiness will be persistent, you must take your baby to a paediatric without unnecessary delay.

Causes of pyloric stenosis

Doctors say that about 15 % of infants born with pyloric stenosis have a family history of it. An infant is 3 times more susceptible to develop pyloric stenosis if the mother had the disease as compared to the father. However, a baby is not born with the disorder; rather the pyloric muscle thickens over the time of 3 months.

Although the exact cause of pyloric stenosis is not known, doctors believe that babies who had been administered with erythromycin during the first 2 weeks of birth or whose mothers have been under antibiotic therapy during the last semester of pregnancy or while breastfeeding can develop the disorder post birth.

Diagnosis of pyloric stenosis

You need to explain the symptoms to your doctor who will further conduct a physical exam on your baby. The characteristic olive shaped swelling in abdomen indicates thickening of pyloric muscle and the typical waves of peristalsis can assure the underlying problem.

Additionally, ultrasound of the abdomen and upper GI tract and blood tests to check electrolyte concentration will also be suggested for confirming pyloric stenosis.

Treatment for pyloric stenosis

If pyloric stenosis has been confirmed, then the baby will be admitted to the hospital for surgery.  The surgical procedure is known as pyloromyotomy- it involves cutting the outer layer of the thickened pyloric muscle to allow food to move out of the stomach into the intestines properly. Laparoscopy is usually performed wherein the incision is made near the belly button. The incision is covered with a small tape after the surgery.

Simultaneously, IV drip line will also continue to supplement electrolytes.

How to prepare your baby for the surgery?

The operation will be scheduled immediately after the test reports are confirmed. Your doctor will ask you to not feed milk or formula at least 6 hours before the surgery. Your baby will be given general anesthesia before the surgery.

What to expect after the surgery?

The surgery takes about 1 hour to complete and is a successful option for eliminating pyloric stenosis without any complication. Your child may be retained for a day or two in the hospital.  His/her feeding pattern and response will be monitored.

Oral feeding will be resumed but you need to feed very slowly and in small quantity, initially. Breast milk should be fed in a bottle. Your doctor might prescribe pain killers to combat minor postoperative pain.

Your child might vomit due to the anesthesia, which is normal. Gradually, your doctor will increase the formula amount and concentration to maintain healthy weight. You can bathe your baby after 3-4 days but before that warm sponge bath is advised. Do not touch the incision site.

A follow up treatment will be scheduled by your doctor.

All is all, pyloromyotomy is safe and your baby will completely recover from the problems that he/she had been facing previously. So don’t be afraid!

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Written by: Saptakee sengupta
Date last updated: January 30, 2015