Pyloric stenosis in babies is a condition that can affect babies in the first few weeks of life. Usually at about 6 weeks. It tends to affect boys more than girls. Pyloric stenosis in babies is a narrowing of the pylorus – the passage between the stomach and small intestine. This narrowing obstructs the movement of milk or food into the intestines. In infant the blockage is caused by the muscles of the pylorus becoming too thick. We do not know why this happens but it can be hereditary (passed on from parents to their children).
What are the symptoms?
In most cases, a baby with pyloric stenosis, start throwing up small amounts of milk feeds. Over a few days this becomes worse until the baby can no longer keep any milk down. This vomiting may become a forceful that the milk is thrown out several feet of the baby’s mouth – this is called projectile vomiting. The vomit may be curdled and yellow in color. If the condition is not treated the baby will become dehydrated and not gain weight.
How is pyloric stenosis in babies diagnosed?
The thickened pyloric muscle can be felt as a small, hard lump, especially during feeding. The muscles around the stomach can sometimes be seen straining and moving as the body tries to push milk through the pyloric. The doctor may want to examine your baby during a feed to see if this happens and to observe any vomiting. Other investigations may be necessary,such as an ultrasound scan.
How is it treated?
Your baby will need to have an operation under general anesthetic. To cut some of muscles which are causing the problem. This operation is called a pyloromyotomy to treat pyloric stenosis in babies.
What are the Risks?
This is a safe operation and the risk of complications is usually small. However, all operations carry some risks. The doctor will talk to you about the risks in more detail. The following complications have a less than 5% (5 in 100 patients) chance of happening:
There is a risk of wound infection.
It is possible that the operation may not succeed and your child may require repeat surgery.
Perforation of the mucosa
The surgeon will try not to open the inner lining of stomach. But it is possible that the inner lining may open up. If that happen the surgeon will stitch the lining immediately. In this case your child may need to stay for a few extra days in the hospital.
In modern anesthesia, serious problems are uncommon. Risk cannot be removed completely. But modern equipment, training and drugs have made general anesthesia a much safer procedure in recent years.
Most children recover quickly and are soon back to normal after their operation and anesthesia. Some children may suffer side effects like sickness or a sore throat. These usually last only a short time and there are medicines available to treat them if necessary.
The exact likelihood of complications depends on your child’s medical condition. And on the nature of the surgery and anesthesia your child needs. The anesthetist can talk to you about this in detail at your pre–operative visit.
This operation is the only accepted treatment of this condition.
Before the operation
Your baby may need an intravenous drip to give fluids as he/she will be dehydrated because of the vomiting. The operation is performed once your child is fully hydrated.
Your baby will also need a naso-gastric tube through the nose and into the stomach. It allows any fluid that collects in the stomach to be removed. Helping to prevent them from feeling sick before and after the surgery.
The doctor will explain the operation in more detail and talk to you about any concerns you may have. An anesthetist will also talk to you about the anesthesia. If your child has any medical problems, such as allergies, please tell the doctor. Doctor will ask you for your written consent for the operation to go ahead. If there is anything you are unsure about, or if you have any questions, please ask the doctor before signing the consent form.