Pyloric Stenosis

Pyloric Stenosis


Pyloric stenosis is a problem that affects babies between birth and 6 months of age, causing severe vomiting that can lead to dehydration. It is the second most common problem requiring surgery in newborns. The lower part of the stomach that connects to the small intestine is known as the pylorus. In pyloric stenosis, the muscles in this part of the stomach enlarge, narrowing the opening of the pylorus and eventually preventing food from moving from the stomach to the intestine. So, what is pyloric stenosis that causes severe vomiting in babies between birth and 6 months old? Does every heavy vomiting baby have pyloric stenosis?

What is Pyloric Stenosis?

What is pyloric stenosis?” The answer can be given as a condition that may affect the gastrointestinal system in infants. It can cause a baby to vomit forcefully and frequently and lead to other problems like dehydration. Pyloric stenosis needs immediate medical care.

What Happens in Pyloric Stenosis?

Food and drink pass through the pylorus, which is the lower part of the stomach, to enter the small intestine. When an infant has pyloric stenosis, this narrowing of the pyloric duct prevents food from emptying from the stomach. Pyloric stenosis (also called infantile hypertrophic pyloric stenosis) is a type of gastric outlet obstruction, which means an obstruction from the stomach to the intestines. Pyloric stenosis affects about 1 in 1000 babies. It is more likely to affect first-born male babies and also runs in families – if a parent has pyloric stenosis, then a baby has up to a 20% risk of developing it. Most babies with it develop symptoms 3 to 5 weeks after birth.

Causes of Pyloric Stenosis

It is thought that babies who develop pyloric stenosis are not born with this condition, but the condition develops after birth. The cause of this thickening is not certain, it could be a combination of several things.

  • Firstborn male babies are at higher risk. It is less likely in baby girls.
  • About 15% of infants with pyloric stenosis have a family history. The parent who has had this condition before is also important. If the mother has pyloric stenosis, a baby is three times more at risk.
  • Babies whose mothers smoked during pregnancy are at higher risk.
  • Some babies who need antibiotics shortly after birth may be at higher risk.

When Does Pyloric Stenosis Occur?

Babies are not usually born with pyloric stenosis. However, thickening of the pylorus begins to occur in the weeks after birth. Symptoms of pyloric stenosis usually appear between 2 and 8 weeks of age. However, it may take up to 5 months for symptoms to become evident. In rare cases, older children may experience pyloric obstruction.

What Are the Signs and Symptoms of Pyloric Stenosis?

Symptoms of pyloric stenosis typically begin when a baby is about 3 weeks old. These symptoms are:

  • The first symptom is usually vomiting. At first, it is thought that the baby is vomiting frequently, but then there is a sudden gush of breast milk or formula from the mouth. Severe vomiting usually occurs shortly after the end of feeding, but in some cases it can happen hours later. Despite vomiting, a baby with pyloric stenosis will usually feel hungry and want to feed again shortly after vomiting.
  • Babies with pyloric stenosis usually defecate less often. This is because little or no food reaches the intestines. Defecation may also be in the form of constipation or mucus poop.
  • Most babies with pyloric stenosis do not gain or lose weight.
  • Dehydrated babies are less active than normal and their skin may look wrinkled. It's important to call your doctor if your baby has any of these symptoms.

How Is Pyloric Stenosis Diagnosed?

The doctor will ask detailed questions about the baby's feeding and vomiting patterns, including what the vomit looks like. He will also check for a lump in the abdomen. During palpation, the doctor can make a definitive diagnosis if the doctor feels an olive-sized lump, which is usually hard and mobile.

How Is Pyloric Stenosis Treated?

When a baby is diagnosed with pyloric stenosis, the baby is hospitalized and prepared for surgery. Any dehydration or electrolyte problems in the blood are usually corrected with intravenous (IV) fluids within 24 hours. Doctors perform a surgery called a pyloromyotomy to remove the blockage. The surgery can also be done by laparoscopy. Most babies return to normal feeding 3 to 4 hours after surgery. The baby may vomit in small amounts for as little as 1 day due to swelling in the surgery area. If there are no complications, most babies who have had a pyloromyotomy can return to their normal feeding schedule and go home within 24 to 48 hours after surgery. After a successful pyloromyotomy, your baby does not need to follow any special feeding schedule. Your doctor will likely want to examine your child at a follow-up appointment to make sure the surgical site is healing properly and your baby is eating well and gaining weight.

When Should I Call the Doctor?

Pyloric stenosis is a condition that requires immediate treatment. Call your doctor if you observe the following conditions in your baby:

1. Severe vomiting after feeding

2. Losing or not gaining weight

3. The baby is less active than usual or is very sleepy

4. The baby has few or no defecations for a period of 1 or 2 days

Can Pyloric Stenosis Be Prevented?

There is no way to prevent pyloric stenosis. Observing the signs and symptoms of pyloric stenosis in infants means you should seek medical help as soon as possible. Getting treatment early helps prevent problems like malnutrition and dehydration.

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