Pyloric Stenosis

Pyloric stenosis is a medical condition that affects the pylorus, which is the passage between the stomach and the small intestine. It is characterized by the thickening of the muscle around the pylorus, leading to narrowing of the passage and obstruction of food flow from the stomach into the small intestine.

Causes

The exact cause of pyloric stenosis is not fully understood, but it is believed to be related to a combination of genetic and environmental factors. In infants, pyloric stenosis is often associated with the use of erythromycin, a type of antibiotic, in the first few weeks of life. Other potential risk factors include:

• Family history of pyloric stenosis
• Premature birth
• Low birth weight
• Exposure to certain medications during pregnancy or after birth

Symptoms

The symptoms of pyloric stenosis typically develop in infants between 3-6 weeks of age and may include:

• Vomiting, which can be projectile and may contain blood
• Weight loss or failure to gain weight
• Dehydration
• Constipation
• Abdominal pain or discomfort

Diagnosis

The diagnosis of pyloric stenosis is typically made based on a combination of physical examination, medical history, and diagnostic tests. These may include:

• Ultrasound: to visualize the thickening of the pylorus muscle
• Barium swallow study: to evaluate the flow of food through the stomach and small intestine
• Endoscopy: to visually examine the inside of the stomach and small intestine
• Physical examination: to check for signs of dehydration, weight loss, and abdominal tenderness

Treatment

The treatment for pyloric stenosis typically involves surgical intervention to widen the narrowed passage. The most common procedure is a pyloromyotomy, which involves making a small incision in the thickened muscle to allow food to pass through more easily.

In some cases, medical management may be attempted before surgery, using medications to help relax the pylorus muscle and improve food flow. However, this approach is typically only effective for a short period of time, and surgery is often necessary to provide long-term relief.

Complications

If left untreated, pyloric stenosis can lead to serious complications, including:

• Dehydration and electrolyte imbalance
• Malnutrition and weight loss
• Gastroesophageal reflux disease (GERD)
• Infection or perforation of the stomach or small intestine

Prognosis

The prognosis for infants with pyloric stenosis is generally excellent, with most making a full recovery after surgical treatment. However, it is essential to seek medical attention promptly if symptoms persist or worsen over time.