Introduction
Pyloric stenosis is a condition that affects infants, typically between 2 and 12 weeks of age, in which the pylorus (the muscular valve between the stomach and the small intestine) thickens and narrows. This narrowing blocks the passage of food from the stomach into the small intestine, leading to forceful vomiting and other complications. Pyloric stenosis requires prompt diagnosis and treatment, usually with surgery, to ensure proper nutrition and growth.
Causes
The exact cause of pyloric stenosis is not fully understood, but it is believed to involve a combination of genetic and environmental factors. The pyloric muscle gradually thickens over time, leading to a narrowing of the pyloric channel. Risk factors include:
- Being male (pyloric stenosis is more common in boys)
- Being firstborn
- Family history of pyloric stenosis
- Exposure to certain antibiotics (such as erythromycin) in early infancy
Symptoms
The hallmark symptom of pyloric stenosis is forceful, projectile vomiting, which typically begins around 2 to 6 weeks of age. Other symptoms may include:
- Vomiting after every feeding
- Persistent hunger
- Weight loss or failure to gain weight
- Dehydration (decreased urination, dry mouth, sunken eyes)
- Constipation
- Visible peristaltic waves (muscle contractions) across the abdomen
- A small, olive-shaped mass that can sometimes be felt in the abdomen
Diagnosis
Diagnosis of pyloric stenosis involves a physical examination and diagnostic tests. A healthcare provider may:
- Palpate the abdomen to feel for the thickened pylorus
- Order an abdominal ultrasound to visualize the pylorus and assess its size
- Perform blood tests to check for dehydration and electrolyte imbalances
Treatment Options
The primary treatment for pyloric stenosis is surgery, specifically a pyloromyotomy. This procedure involves cutting the thickened pyloric muscle to widen the channel and allow food to pass through. Pyloromyotomy is typically performed laparoscopically (using small incisions and a camera), which results in a shorter recovery time.
Before surgery, infants are usually given intravenous fluids to correct dehydration and electrolyte imbalances. After surgery, feeding is gradually reintroduced, and most infants recover fully within a few days.
Prevention
There is no known way to prevent pyloric stenosis, as the exact cause is not fully understood. However, early diagnosis and prompt treatment can prevent serious complications.
When to Seek Medical Care
Seek medical attention immediately if your infant experiences:
- Forceful, projectile vomiting
- Persistent vomiting after every feeding
- Signs of dehydration (decreased urination, dry mouth, sunken eyes)
- Weight loss or failure to gain weight
Takeaway
Pyloric stenosis is a condition that affects infants, causing forceful vomiting and potential complications. Early diagnosis and surgical treatment are essential for restoring normal digestion and ensuring healthy growth.