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Pyloric Stenosis : Causes, Symptoms and Treatment

Pyloric stenosis is a disease that is classified as rare and usually occurs in infants. Pyloric itself is a muscle valve between the stomach and small intestine. Pyloric stenosis occurs when the muscle thickens and enlarges. This causes 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. Infants 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:

  • failure to thrive
  • dehydration
  • stomach irritation
  • jaundice

Causes of Pyloric Stenosis

The exact cause of pyloric stenosis is still unknown today. 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:

Family history

Pyloric stenosis can be lowered in the family. If a mother experiences pyloric stenosis, it is likely that 20% of her sons and 10% of her daughters will experience a similar disease.




Gender

Pyloric stenosis is more common in boys, especially the first child.

Race

Pyloric stenosis is more common in Caucasian races from Northern Europe and is followed by African-Americans. This disease is rare in Asians.

Premature birth

Premature babies more often experience pyloric stenosis than babies born at term.

Use of antibiotics

Mothers who take antibiotics in old pregnancy can increase the risk of their babies getting pyloric stenosis. In some conditions such as whooping cough, the baby will be given erythromycin antibiotics. The use of these antibiotics in the first weeks of birth can increase the risk of pyloric stenosis.

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 direct breast breast.

However, in the study, the use of bottles was filled with formula milk. So it is still unknown whether formula milk or bottle use increases the risk of pyloric stenosis.

Smoking during pregnancy

Mothers who smoke during pregnancy increase the risk of their babies suffering from doubled pyloric stenosis.

Diagnosis of Pyloric Stenosis

To determine pyloric stenosis, the doctor will conduct a physical examination first. Examinations include signs of dehydration in infants, such as dry skin or sunken eyes and fontanel. The doctor will also check for lumps as large as grapes on the baby's stomach, due to thickening of the pyloric muscles.

To support the diagnosis, the doctor will perform an abdominal ultrasound examination to see the condition of the organs and tissues in the baby's stomach. Esophageal, gastric, and duodenal x-rays (OMD) by giving barium dye (contrast) can also be an option to get a clearer picture of the pyloric.

In addition, additional examinations such as blood tests can be done to find out if the baby has electrolyte problems.

Symptoms of Pyloric Stenosis

Symptoms of normal pyloric stenosis are only seen in weeks 3–5 after birth. Symptoms of pyloric stenosis include:

Vomiting spray after eating

Babies usually vomit spray up to a distance of several meters. Initial vomiting is mild and worsens as thickening of the pyloric valve. Sometimes there can be blood in the vomit.

Babies look hungry continuously

After vomiting, the baby will feel hungry again, and show signs of wanting to be breastfed.

Weight loss

Babies with pyloric stenosis are usually difficult to gain weight. On the contrary, babies with this condition can experience weight loss.

Stomach contractions

Abdominal contraction movements or wave-like peristalsis, can be seen in the upper abdomen of the baby after eating, but before vomiting. This happens because the stomach tries to push food to the small intestine.

Constipation

Constipation can occur because food does not reach the small intestine. As a result, no food is digested until it can be removed through the anus.

Dehydration

Severe vomiting can cause dehydration. Babies can cry without tears or become weak. Babies also urinate less, so you change diapers less frequently.

Treatment of Pyloric Stenosis

Treatment for infants suffering from pyloric stenosis is pyloromyotomy. Before surgery, the doctor will treat dehydration and electrolyte disturbances in the baby through the administration of intravenous fluids.

In pyloromyotomy, the doctor will cut the outer layer of the pyloric muscle thickened so that the inner layer of the pyloric muscle protrudes and opens the pyloric duct. Pyloromyotomy is usually performed by laparoscopic or keyhole surgery. This procedure only makes an incision the size of a key hole in the abdominal wall to insert a tool used to cut the outer layer of the pyloric muscle. With laparoscopic techniques postoperative recovery can be faster.

Surgery in infants with pyloric stenosis is only performed in less than one hour, but the baby will go through the healing process in the hospital for 1-2 days before being allowed to take home. For several hours after surgery, nutrient fluids will be given by infusion until the baby can suckle again.

Keep in mind, the baby may still vomit for several days after surgery, until the stomach works normally. The doctor will also give medication to withstand the pain that usually appears after surgery.

Prevention of Pyloric Stenosis

Pyloric stenosis cannot be prevented. But environmental risk factors, such as smoking during pregnancy, can be avoided. Likewise with risk factors related to the use of antibiotics during pregnancy and early birth, of course can be avoided.



References

References

1. Rosario, J. Kidshealth (2017). Pyloric Stenosis. 

2. Mayo Clinic (2018). Diseases and Conditions. Pyloric Stenosis. 

3. WebMD (2017). What Is Pyloric Stenosis.


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Is a health and wellness enthusiast. In him free time, she loves to travel and taste different types of teas.

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