Pyloric stenosis is a rare childhood diseased condition where the valve between the new-born's stomach and small intestine becomes thick and narrow. In a healthy baby, a muscular valve (i.e., pylorus) between the stomach and small intestine holds the food in the stomach until it is ready to pass on to the next stage of the digestive process. In the case of pyloric stenosis, the pylorus muscles thicken and become abnormally large, making the pyloric channel or the passage in between extremely narrow and blocking the partially digested food from reaching the small intestine. Statistics show that this condition usually affects 3 out of every 1000 babies born.
Although the exact cause of pyloric stenosis is still unknown, several studies and researches surface an involvement of environmental factors and changes in the gene as a reason behind it. Though, this condition is often passed down from the parents, yet it is not diagnosed at birth and gradually develops afterwards.
The pylorus is a valve that is present in between the stomach and the small intestine. When the food is in the stomach, the pylorus stays closed and it opens only to let the food move into the intestine for further digestion and assimilation. The pylorus in babies suffering from pyloric stenosis, gets thicker while restricting smooth passage of the food into the intestines. When the food cannot pass anymore, the baby usually throws up the food.
Certain causative factors that increase the risk of pyloric stenosis include:
Gender: It is commonly seen in full-term, first-born male infants, and less likely to affect female infants
Race: Pyloric stenosis is more commonly diagnosed in Caucasian babies of northern European origin, and less common in Black people and quite rare in Asians.
Preterm Birth: Babies born before time are more at risk of developing pyloric stenosis.
Genetic Factor: Pyloric stenosis is likely to develop in about 20% of male descendants and 10% of female descendants of mothers who had the condition.
Bottle-Feeding: Several case studies suggest that babies who are bottle-fed formula milk have a higher risk of getting pyloric stenosis than the ones who are breast-fed. Although these studies don't provide any evidence as to whether the cause of the condition is due to the feeding mechanism or due to the formula milk.
Early Use Of Antibiotics: Certain antibiotics prescribed to the pregnant mother or to the babies during the first few weeks of life can aggravate the chances of getting this condition.
Unhealthy Lifestyle Habits: Lifestyle choices like smoking or consumption of tobacco during pregnancy can increase the risk of pyloric stenosis in the baby.
Most babies with this condition appear fine at birth and gradually develop the symptoms over three to five weeks after birth. The common signs and symptoms are mostly related to gastro-intestinal issues and include:
- Sudden forceful vomiting that differs from natural spit-up during feeding
- Constant hunger
- Weight loss or inability to gain weight
- Lump in the abdomen
- Wave-like stomach contractions
- Fewer soiled diapers
If this condition is not treated on time, it can slow down growth and development, cause persistent dehydration, irritation in the stomach and can sometimes even lead to jaundice.
Diagnosis And Treatment
On noticing any of the above-mentioned signs and symptoms, consult a paediatrician or a child specialist right away to treat your little one at the earliest. The doctor usually does a thorough physical check-up by touching the abdomen to look for an olive-shaped lump inside, feel the wave-like stomach contractions, acknowledge the parent's genetic history or any health condition followed by conducting some diagnostics. These include:
- Blood tests to analyse electrolyte imbalance due to dehydration
- Imaging techniques like Ultrasound, X-ray (including barium swallow with upper G.I series) to view the enlarged pylorus and confirm the diagnosis
The normal treatment option is usually a surgical procedure known as pyloromyotomy. The doctor generally provides the baby with oral rehydration fluids and nutrients through an IV to treat dehydration and then conducts the surgery to cut open the thickened pylorus muscle to create a wider passage for the ingested food to travel into the small intestine. Sometimes, this procedure can even be done via the laparoscopic surgery which uses tiny instruments to make small incisions in the baby's belly to cut open the pylorus. In many cases, laparoscopic surgery is better than pyloromyotomy as healing after laparoscopy is faster than pyloromyotomy.