Pyloric stenosis is a condition that affects infants, typically occurring within the first few weeks of life. It involves the narrowing of the pylorus, the passage between the stomach and the small intestine, which can lead to severe vomiting, dehydration, and weight loss. Early recognition of the signs of pyloric stenosis is crucial for prompt treatment and positive outcomes.
Key Signs and Symptoms
Projectile Vomiting: The most prominent symptom of pyloric stenosis is forceful, projectile vomiting that occurs shortly after feeding. Unlike normal spit-up, this vomiting is often forceful enough to project several feet away. Vomiting becomes more frequent and severe over time, usually starting around 3 to 5 weeks of age. It can happen after every feeding, leading to significant distress for both the baby and parents.
Persistent Hunger: Despite frequent vomiting, infants with pyloric stenosis often remain hungry and may demand to be fed again soon after vomiting. This is because their stomachs do not retain the ingested milk or formula.
Dehydration: Due to constant vomiting, affected infants can quickly become dehydrated. Signs of dehydration include dry mouth and lips, decreased number of wet diapers, sunken soft spot (fontanel) on the baby’s head, and lethargy or excessive sleepiness.
Weight Loss or Poor Weight Gain: Infants with pyloric stenosis often do not gain weight as expected. In fact, they may lose weight due to the inability to keep food down. Parents may notice their baby’s growth slowing or stagnating, which can be alarming and warrants immediate medical attention.
Visible Peristalsis: In some cases, parents might observe visible waves of peristalsis (muscle contractions that move food through the digestive tract) moving across the baby’s abdomen after feeding. This occurs because the stomach muscles work harder to try to push food through the narrowed pylorus.
Palpable Olive-Shaped Mass: A healthcare provider may detect a small, firm, olive-shaped mass in the upper right side of the baby’s abdomen during a physical examination. This mass is the enlarged pyloric muscle.
When to Seek Medical Attention
If you notice any of the above signs in your infant, it is important to seek medical attention promptly. Early diagnosis and treatment are essential to prevent complications such as severe dehydration and electrolyte imbalances.
Diagnosis and Treatment
Diagnosis
Medical History and Physical Examination: The healthcare provider will take a detailed medical history and perform a thorough physical examination, focusing on the abdominal area.
Ultrasound: An abdominal ultrasound is the most common and effective diagnostic tool for pyloric stenosis. It can visualize the thickened pyloric muscle.
Blood Tests: Blood tests may be conducted to check for electrolyte imbalances caused by frequent vomiting.
Treatment
Surgical Intervention: The primary treatment for pyloric stenosis is a surgical procedure called pyloromyotomy. This surgery involves splitting the thickened pyloric muscle to allow food to pass from the stomach to the small intestine normally.
Post-Surgical Care: After surgery, most infants can begin feeding within a few hours and typically recover quickly, with a significant improvement in symptoms.
Pyloric stenosis is a serious but treatable condition that requires prompt medical attention. Recognizing the signs of pyloric stenosis, such as projectile vomiting, persistent hunger, dehydration, poor weight gain, visible peristalsis, and the presence of a palpable mass, is crucial for early diagnosis and treatment. If you suspect your baby might have pyloric stenosis, consult a healthcare provider immediately to ensure timely intervention and care.
