Pyloric Stenosis (Infants, Adults and Children)

Pyloric Stenosis is a condition that affects many infants around the world every year. Read on to know all about this highly discomforting condition and its causes, symptoms, diagnosis and treatment.

Pyloric Stenosis Definition

It is an abnormal condition that leads to a contracting of the Pyrolus or the orifice into the small intestine from the stomach. The condition is also known as Infantile Hypertrophic Pyloric Stenosis. This is because the condition is mainly seen to arise in infants.

The condition is also known by other names like:

  • Gastric Outlet Obstruction
  • Hypertrophic Pyloric Stenosis
  • Congenital Hypertrophic Pyloric Stenosis

Pyloric Stenosis Age

This disorder arises in boys more frequently than in girls. It usually occurs in newborns and rarely arises in children who are older than 6 months. The problem is usually determined by the time a child becomes 6 months of age.

Pyloric Stenosis Causes

This disorder is usually a result of stenosis or constriction of the Pyrolus or gateway to the small intestine. It leads to a Hypertrophy (enlargement) of the muscle bordering the Pyrolus. There is a spasm in the muscle when the stomach empties itself. The exact reason of this thickening is still obscure. Medical researchers are still confused whether this is a result of congenital problems or a functional hypertrophy of the muscle during the first few weeks after birth.

Food materials usually pass easily into the duodenum (the first segment of the small intestine) from the stomach through a valve known as the Pylorus. The muscles of the pylorus get thickened in this condition. This muscular thickening forbids emptying of contents into the small intestine from the stomach.

Is Pyloric Stenosis Hereditary?

Genetic factors are believed to be a major cause as children are found to be more susceptible to this condition if their parents suffered anytime from Pyloric Stenosis.

Pyloric Stenosis in Adults

This condition may arise in adults who have a constricted Pyrolus as a result of scarring due to Chronic Peptic Ulceration. In adults, this disease is usually different than its variation encountered in children.

Congenital Pyloric Stenosis

It is a benign (non-cancerous) condition that results from Hypertrophy (abnormal enlargement) of the round muscular fibers located in the pylorus.

Pyloric Stenosis Signs and Symptoms

Vomiting is the first of the signs and symptoms of Pyloric Stenosis. It usually occurs when the sufferer is approximately 3 weeks of age. Pyloric Stenosis in newborns may arise at any time when the infant is between 1 week and 5 months in age. It may also occur every time after the infant is fed. Puking is generally forceful and is known as Projectile Vomiting. Suffering infants feel hungry again after vomiting and want to be fed again.

There are some other Pyloric Stenosis Symptoms that arise a few weeks after birth. These involve

  • Belching
  • Abdominal pain
  • Continuous hunger
  • Inability to gain or lose weight
  • Constant fatigue due to lack of enough energy
  • Horizontal ripples in the abdomen shortly after being breastfed and just prior to vomiting due to struggle of the stomach in passing nutrients to the small intestine through the Pyrolus
  • Softness and wrinkles in the stomach of the suffering child
  • Dehydration, that becomes worse with increasing intensity of vomiting

This condition may also reduce bowel movements and urination because of lack of enough nutrients in the body of the infants to form waste materials that can exit as stools.

Pyloric Stenosis Diagnosis

The diagnosis of Pyloric Stenosis in children is usually done before the baby turns 6 months old. A physical examination may show the symptoms of dehydration and a swollen belly in the infant. Physical examination by doctors may also reveal an abnormal pylorus, which may feel like an olive-shaped lump when the stomach area is touched. This is an indication of an expanded pylorus muscle.

An Abdominal Ultrasound Examination is generally the initial imaging test that is performed for diagnosis of this disorder. Other tests that may be carried out include:

  • Blood chemistry panel, which frequently discloses an imbalance in electrolytes
  • Barium x-ray, which reveals constriction of the Pyrolus and inflammation of the stomach

If no lump is felt by physical examination, X-Ray examination may be helpful in checking obstruction of the digestive system. Blood tests may also be performed to determine a drop in the level of sodium or calcium. This suggests that there is not enough absorption of fluids in the body.

Pyloric Stenosis Treatment

Treatment for Pyloric Stenosis in babies usually includes a surgical operation that is known as Pyloromyotomy. Prior to Pyloric Stenosis surgery, fluids are administered to patients through a vein. A small incision is afterwards made in the stomach of the infant. This is typically done near the navel. The additional muscular layers around the Pyrolus can be surgically removed.

The aim of this operative procedure is to tear the overgrown muscles. Pyloric Stenosis in infants is usually managed with operation. Surgery is unnecessary only in mild cases of this disease, which are rare.

In cases where the sufferers are found to be highly sensitive to General Anesthesia, Balloon dilation may be performed for treatment of Pyloric Stenosis. It is not as effective as surgery. It may however be considered for infants when there is high risk of side effects from anesthesia.

Pyloric Stenosis Prognosis

The symptoms of this disease usually resolve after surgery. The suffering infant can generally be fed small, frequent meals a few hours after operation.

In some cases, infection and bleeding may occur as side effects of a surgical operation. Vomiting is common after surgery and generally goes away with time. Pyloric Stenosis recovery is good with right treatment and aftercare.

Can Pyloric Stenosis Return?

Pyloric Stenosis recurrence rarely occurs after a Pyloromyotomy is performed. Digestive and stomach functions usually get back to normal after the operation is carried out. There are generally no dangers of having any permanent damage from this syndrome.

Pyloric Stenosis Complications

Absence of proper care and treatment of sufferers of this disorder can lead to acute complications. Infants can become very thin and fail to digest proper quantity of nutrients. Infants may become incapable of gaining weight during several weeks after their birth. Developmental problems may also arise in such kids. The condition can also give rise to dehydration as suffering infants tend to vomit up fluids continuously. In severe cases, Untreated Pyloric Stenosis can result in jaundice in acute cases, which causes yellowness of the skin or the eyes.

Pyloric Stenosis Scar

Pyloromyotomy operation usually leaves a scar in the skin area where the incision is made. This often looks as an ugly mark over the surface of the skin and remains for many years. Massaging the region with oil on a daily basis for several months can make the scar fade and eventually go away.

References:

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001965/

http://emedicine.medscape.com/article/803489-overview

http://www.umm.edu/altmed/articles/pyloric-stenosis-000138.htm

http://www.mayoclinic.com/health/pyloric-stenosis/DS00815

Published on October 11th 2011 by  under Digestive System.
Article was last reviewed on 11th October 2011.

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