Pyloric stenosis is a narrowing of the pylorus. The pylorus lies between the stomach and the small intestine, and when it thickens, it prevents food from passing out of the baby’s stomach and into the small intestine. It affects small babies, and the symptoms usually develop about three to five weeks or so after the birth. The cause of the thickening of this valve is not apparent. If you suspect this condition, you need to see a doctor because it will not get better on its own. Once the doctor decides pyloric stenosis is the right diagnosis, your child will need surgery. The surgery is minimally invasive, and your baby will typically recover quite quickly.
Vomiting is one of the first symptoms. At first, this may be mild, but as the problem gets worse, it causes projectile vomiting. Breast milk or formula comes forcefully out of the mouth like a fountain. It may smell curdled because it has already mixed with some stomach acid. Most babies have some reflux after feeding which involves spitting up. If their stools are normal and they don’t have projectile vomiting, you should not suspect pyloric stenosis. Ongoing vomiting can cause an electrolyte imbalance in the body. The doctor may order blood tests to check your baby’s electrolyte levels. He will address the issue of there is an imbalance.
If babies have pyloric stenosis, they may continuously want to feed. An indication food is not going down into the small intestine might be if your baby is still hungry despite having been fed. If your baby has some illness like a stomach bug, it’s usually accompanied by a lack of appetite and other signs of disease like a fever. With this condition, your baby may seem quite well, despite the vomiting. You need to tell the doctor about the persistent hunger. He will probably ask you other detailed questions about how the baby is feeding, vomiting patterns and what the vomit looks like.
You may see stomach contractions that are noticeable after feeding your baby. These look like ripples moving across the baby’s stomach from left to right. This happens because the stomach muscles are trying to force stomach contents down through the narrowed opening. If you observe these ripples, this is another indication that you need to see a doctor immediately. If your baby has pyloric stenosis, the only way to treat it is with surgery. Your doctor will take a history, examine your baby thoroughly and if there is still a lack of clarity about a diagnosis, he will perform further tests.
As little or no food is reaching the small intestine, your baby may have fewer, smaller stools. Some babies become constipated. If your baby has few or no stools over a period of one or two days and has other symptoms, like projectile vomiting, you need to see a doctor right away. Gastroenteritis is another condition that can cause similar symptoms. However, babies with gastroenteritis usually have diarrhea, and stools are watery and loose. If your doctor is unable to diagnose pyloric stenosis with a physical examination, tests like an abdominal ultrasound will allow him to see the thickening of the pylorus. Sometimes a barium swallow may be done instead of the ultrasound.
Babies may fail to gain weight or lose weight due to the blockage. A surgical procedure called a pyloromyotomy is necessary to deal with the situation. The surgeon has to cut through the outside layer of the thickened muscle so the inner lining can bulge out. This opens up the channel and food can pass through. Perform this surgery with a laparoscopy which is minimally invasive and has quick recovery time. This technique involves inserting a tiny scope inside the belly button incision so the surgeon can see the problem. He uses small instruments to do the surgery and fix the problem.
Dehydrated babies are not as active as usual. A sunken spot may develop on top of the head and eyes may also look sunken. Wrinkled skin, crying without tears and cracked lips are other signs of dehydration. If you see that your baby is going for more than six hours between wet diapers, you have cause for concern. A surgeon won’t perform surgery until your baby’s electrolyte levels are normal and he or she is no longer suffering from dehydration. It may take a day of treatment with intravenous fluids to achieve this. Once your baby is hydrated, you may have to stop feedings for a few hours to reduce risks of vomiting during surgery.
When doing the physical examination, your doctor will check for a lump in the baby’s abdomen. If it is firm, movable and feels somewhat like an olive, he will be able to make a diagnosis. When this lump occurs with other symptoms like projectile vomiting, a diagnosis of pyloric stenosis is not difficult. The surgery itself rarely takes as much as an hour, but your baby will probably need to stay in the hospital for 24 hours or more. You will be able to start feeding again gradually. Provide pain medication to your baby. It is normal for the baby to vomit a little for a day or two due to some swelling at the site of the surgery.
The repeated vomiting may lead to stomach irritation. This may even cause mild bleeding. Pyloric stenosis is a severe condition and babies who do not receive a quick diagnosis, and the necessary surgery can have serious problems. With the surgery, babies quickly start to thrive again. Without it, they may develop more stomach irritation and further dehydration. They may suffer from very low blood pressure and malnutrition. Death is infrequent but can happen if symptoms get neglected for too long. To avoid this, do not hesitate to contact a doctor and receive a diagnosis as quickly as possible.
Jaundice due to excess levels of bilirubin in the blood is found in about two percent of babies with pyloric stenosis. In these babies, you might notice a yellowing of the whites of the eyes and the skin. In the vast majority of cases, this does not happen. The cause of the jaundice is unknown. What is known is that it usually goes away quickly after a baby has a pyloromyotomy. Remember that this is rarely seen in babies with pyloric stenosis. If your baby’s skin and the whites of the eyes are yellow and there are no other signs of pyloric stenosis, it is probably due to another illness.
It is rare for complications to occur as a result of a pyloromyotomy. In very few cases, a baby may develop an infection or bleeding. If your baby seems to be in pain and has a fever, you need to consult a doctor immediately. Pyloric stenosis should not happen again. If your baby still has symptoms weeks after surgery, it might be due to another medical issue. Most babies respond very well after the surgery. They go on to thrive and grow just like any other baby.
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