Pyloric stenosis (patient information)

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 * Assistant Editor-in-Chief: Meagan E. Doherty

Overview


Pyloric stenosis is a narrowing of the pylorus, the opening from the stomach into the small intestine.

What are the symptoms of Pyloric stenosis?
Symptoms generally appear several weeks after birth:
 * Abdominal fullness prematurely after meals
 * Abdominal pain
 * Belching
 * Constant hunger
 * Dehydration (gets worse with the severity of the vomiting and diarrhea)
 * Diarrhea (loose, watery stools)
 * Failure to gain weight or weight loss
 * Wave-like motion of the abdomen shortly after feeding and just before vomiting occurs
 * Vomiting
 * Persistant vomiting after every feeding
 * Projectile vomiting

What are the causes of Pyloric stenosis?
Pyloric stenosis is caused by a thickening of the muscles of the pylorus. This thickening prevents the stomach from emptying into the small intestine. The cause of the thickening is unknown, although genetic factors may play a role.

Who is at risk for Pyloric stenosis?
Risk factors include:
 * Gender: Pyloric stenosis occurs more commonly in boys than in girls
 * Age: Pyloric stenosis is rare in patients older than 6 months. The condition is usually diagnosed by the time a child is 6 months old.

How to know you have Pyloric stenosis (Diagnosis)?
The condition is usually diagnosed before the baby is 6 months old.

A physical exam may reveal signs of dehydration. The infant may have a swollen belly area. The doctor may detect the abnormal pylorus, which feels like an olive-shaped mass, when touching the stomach area.

An ultrasound of the abdomen may be the first imaging test performed. Other tests that may be done include:
 * Blood chemistry panel: often reveals an electrolyte imbalance
 * Barium x-ray: reveals a swollen stomach and narrowed pylorus

When to seek urgent medical care
Call your health care provider if your baby has symptoms of this condition.

Treatment options
Treatment for pyloric stenosis involves surgery (called a pyloromyotomy) to split the overdeveloped muscles. Balloon dilation does not work as well as surgery, but may be considered for infants when the risk of general anesthesia is high. The patient will be given fluids through a vein, usually before surgery.

Diseases with similar symptoms

 * gastroesophageal reflux disease (GERD)
 * gastroenteritis

Where to find medical care for Pyloric stenosis
Directions to Hospitals Treating Pyloric stenosis

What to expect (Outlook/Prognosis)
Surgery usually provides complete relief of symptoms. The infant can usually tolerate small, frequent feedings several hours after surgery.

Possible Complications

 * Vomiting after surgery -- this is very common and generally improves with time
 * Failure to gain weight in the newborn period
 * Risks associated with any surgery, which include:
 * Bleeding
 * Infection