What is pyloric stenosis?
Pyloric stenosis is when there is a blockage from the stomach to the intestines, not allowing food to pass through. This blockage is caused by the pylorus (a strong muscle at the bottom of the stomach) being larger and tighter than normal. It’s about four times more likely to occur in firstborn male infants and also has been shown to run in families. My youngest brother was born with pyloric stenosis and it scared the daylights out of us.
The first symptom of pyloric stenosis is usually vomiting. At first it may seem that the baby is simply spitting up frequently, almost like reflux. But then spitting up often progresses to projectile vomiting, in which the breast milk or formula is thrown up forcefully in an arc, sometimes spanning a distance of many feet. There’s no way of getting around the fact that this is not normal.
Most infants who develop symptoms of pyloric stenosis are usually between 3 to 5 weeks old. It is one of the more common causes of intestinal obstruction during infancy that requires surgery. Pyloric stenosis is fairly common — it affects about 3 out of 1,000 babies in the United States.
Signs, other than projectile vomiting, include:
• Regurgitated milk may be curdled from mixing with stomach acids.
• The baby may be having fewer, smaller stools because little or no food is reaching the intestines. This may appear as constipation.
• The baby may fail to gain weight or will lose weight – become dehydrated.
Contact your doctor if your baby experiences any of these symptoms. He/she may recommend several tests including blood tests to look for a chemical imbalance. Ultrasound images or a barium swallow test with x-rays can show the enlarged, thickened pylorus.
Surgery for pyloric stenosis is called pyloromyotomy. This involves cutting through the thickened muscles of the pylorus to relieve the blockage. The pylorus is examined through a very small incision, and the muscles that are overgrown and thickened are spread and relaxed
As long as there are no complications, most babies who have undergone pyloromyotomy can return to a normal feeding schedule and be sent home within 24 to 48 hours of the surgery. It is amazing how well babies respond to this surgery which is usually a one time fix. Pyloric stenosis should not recur after surgery.