Pyloric Stenosis: Diagnosis and Treatment

Pyloric Stenosis is a condition that appears in infancy. It often affects the first born male in a family, though it can affect subsequent children as well. Pyloric Stenosis is in fact genetic, and is known to be stronger in some families then in others. My own family is proof of that. My father and his older brother had it, my two older brothers had it, my daughter had it, and three of my nephews had it. If there is a family member with it, chances are your infant will as well.

Pyloric Stenosis affects the pyloric valve, which lies at the bottom of the stomach where the stomach connects to the small intestines. The pyloric valve is a muscle that can become enlarged, and once enlarged, needs treatment to reduce the valve's size. Also known as infantile hypertrophic pyloric stenosis, once the pyloric valve is enlarged, the valve blocks the food from leaving the stomach and entering the small intestines.

How Can You Tell If Your Child Has Pyloric Stenosis?

Pyloric Stenosis shows itself as projectile or forceful vomiting shortly after eating. My daughter could go clear across the room. It is a much larger amount then regular spit up, so you will be able to identify it. Frankly, I don't know how you could miss it! If your infant frequently vomits severely, especially without a fever, take them to the doctor's and have them check for pyloric stenosis. Other symptoms are small, infrequent stools, loss of weight, dehydration (how many wet diapers the infant has), and even lethargy.

Diagnosis

Diagnosis is usually a simple matter of a stomach examination an xray and barium swallow (a chalky liquid that shows up easily on xray)or an ultrasound. Keep track of how many diapers the infant wets, how often the vomiting occurs, how far it goes, the appearance of the vomiting, and any changes. Your doctor will ask you many detailed questions, so keeping track from when you first notice something wrong with your infant will make the diagnosis of pyloric stenosis even easier.

During the stomach examination, the doctor will look for a hard lump in the area of the pyloric valve, often called the "olive". If no olive is found, an ultrasound, or barium swallow will be performed.

Treatment Options

If your infant recieves a diagnosis of pyloric stenosis, don't fret. It is easily treatable, and in fact quite common. Based on the severity of pyloric stenosis, treatments range from surgery (pyloromyotomy), medication, or just leaving it alone. My daughter's treatment was simply monitoring, while my nephew's was surgery. Pyloromyotomy cannot be done before one month of age, as the valve has not matured enough before then. While nerve-wracking for the parents, the surgery is quite simple. The scar is rather small, though the method is up to the surgeon. A single scar is the most common. The surgeon cuts through the thickened pyloric valve, opening up the blockage. No part of the valve is removed. After pylormyotomy, your infant will be able to resume their normal feedings, although some post pylormyotomy vomiting can occur, as the valve can remain swollen. A follow up appointment will be scheduled, so address any additional concerns then.

The Danger

The dangerous part of pyloric stenosis is the dehydration and loss of electrolytes that can accompany it. While some children will remain perfectly healthy and thrive even with pyloric stenosis, others can waste away in front of your eyes if left untreated. It is very important that you see your pediatrician as soon as you possibly can so that diagnosis and treatment can be performed. While not normally fatal, hesitating to bring your infant in could result in his/her death. The longer the infant goes without diagnosis, the more likely it is that the infant will become severely dehydrated.

Further Reading:

http://en.wikipedia.org/wiki/Pyloric_stenosis

http://kidshealth.org/parent/medical/digestive/pyloric_stenosis.html

http://www.pedisurg.com/PtEduc/Pyloric_Stenosis.htm

http://children.webmd.com/tc/pyloric-stenosis-topic-overview