Know the basics
What is pyloric stenosis?
Pyloric stenosis is an uncommon condition affecting the opening (pylorus) between the stomach and small intestine in infants. The pylorus is a muscular valve that holds food in the stomach until it is ready for the next stage in the digestive process. In pyloric stenosis, the pylorus muscles thicken, blocking food from entering the baby’s small intestine.
How common is pyloric stenosis?
Pyloric stenosis usually happens in newborn babies and is rare in children older than 6 months. It can sometimes happen in adults.
Know the symptoms
What are the symptoms of pyloric stenosis?
The common symptoms of pyloric stenosis are:
- Vomiting after feeding. The baby may vomit forcefully, ejecting breast milk or formula up to several feet away (projectile vomiting). The vomit may sometimes contain blood.
- Persistent hunger. Babies who have pyloric stenosis often want to eat soon after vomiting.
- Stomach contractions. You may notice wave-like contractions (peristalsis) that ripple across your baby’s upper abdomen soon after feeding, but before vomiting. This is caused by stomach muscles trying to force food through the narrowed pylorus.
- Your baby might cry without tears or become lethargic. You might find yourself changing fewer wet diapers or diapers that aren’t as wet as you expect.
- Changes in bowel movements. Since pyloric stenosis prevents food from reaching the intestines, babies with this condition might be constipated.
- Weight problems. Pyloric stenosis can keep a baby from gaining weight, and sometimes can cause weight loss.
Signs of pyloric stenosis usually appear within three to five weeks after birth. Pyloric stenosis is rare in babies older than age 3 months.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
Contact your baby’s doctor if your baby is:
- Frequently vomiting after feeding
- Projectile vomiting
- Less active or seems unusually irritable
- Urinating much less frequently or is having noticeably fewer bowel movements
- Not gaining weight, or even losing weight
Know the causes
What causes pyloric stenosis?
Pyloric stenosis in infants is fairly common but the cause isn’t known. Genes may play a role, since children of parents who had pyloric stenosis are more likely to have this condition.
When pyloric stenosis occurs, the muscle of the pylorus gets too large and thick and blocks the tube leading out of the stomach (the stomach outlet). Liquids and solid foods can’t go from the stomach to the small intestine.
Adults may get a form of pyloric stenisis because of a stomach ulcer, scarring after stomach surgery, or a tumor near the pylorus.
Know the risk factors
What increases my risk for pyloric stenosis?
There are many risk factors for pyloric stenosis, such as:
- Pyloric stenosis is seen more often in boys – especially firstborn children – than in girls.
- Pyloric stenosis is more common in Caucasians of northern European ancestry, less common in African-Americans and rare in Asians.
- Premature birth. Pyloric stenosis is more common in babies born prematurely than in full-term babies.
- Family history. Studies found higher rates of this disorder among certain families. Pyloric stenosis develops in about 20 percent of male descendants and 10 percent of female descendants of mothers who had the condition.
- Smoking during pregnancy. This behavior can nearly double the risk of pyloric stenosis.
- Early antibiotic use. Babies given certain antibiotics in the first weeks of life – erythromycin to treat whooping cough, for example – have an increased risk of pyloric stenosis. In addition, babies born to mothers who took certain antibiotics in late pregnancy also may have an increased risk of pyloric stenosis.
- Bottle-feeding. Some studies suggest that bottle-feeding rather than breast-feeding can increase the risk of pyloric stenosis. Most people in these studies used formula rather than breast milk, so it isn’t clear whether the increased risk is related to formula or the mechanism of bottle-feeding.
Understand the diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is pyloric stenosis diagnosed?
Your baby’s doctor will start with a physical examination. Sometimes, the doctor can feel an olive-shaped lump – the enlarged pyloric muscle – when examining the baby’s abdomen. The peristaltic waves in the baby’s abdomen are another telltale sign of pyloric stenosis.
Your doctor might also recommend:
- Blood tests to check for dehydration or electrolyte imbalance or both
- Ultrasound to view the pylorus and confirm a diagnosis of pyloric stenosis
- X-rays of your baby’s digestive system, if results of the ultrasound aren’t clear
How is pyloric stenosis treated?
Surgery is needed to treat pyloric stenosis. The procedure (pyloromyotomy) is often scheduled on the same day as the diagnosis. If your baby is dehydrated or has an electrolyte imbalance, he or she will have fluid replacement before surgery.
In pyloromyotomy, the surgeon cuts only through the outside layer of the thickened pylorus muscle, allowing the inner lining to bulge out. This opens a channel for food to pass through to the small intestine.
Pyloromyotomy is often done using minimally invasive surgery. A slender viewing instrument (laparoscope) is inserted through a small incision near the baby’s navel. Recovery from a laparoscopic procedure is usually quicker than recovery from traditional surgery, and the procedure leaves a smaller scar.
- Your baby might be given intravenous fluids for a few hours or until he or she can eat. You can probably start feeding your baby again within 12 to 24 hours.
- Your baby might want to feed more often.
- Some vomiting may continue for a few days after surgery.
Potential complications from pyloric stenosis surgery include bleeding and infection. However, complications aren’t common, and the results of surgery are generally excellent.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage pyloric stenosis?
The following lifestyles and home remedies might help you cope with pyloric stenosis :
- Apply warm compresses to the incision site if your baby seems uncomfortable.
- Call your doctor if your baby keeps vomiting, has weight loss or poor weght gain, seems too tired, or has few or no stools for 1 or 2 days.
- Call your doctor if your baby has pain, swelling, redness, bleeding, or drainage at the incision site. Also call your doctor if your baby develops a fever after surgery.
- Don’t forger follow-up doctor appointments.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: December 17, 2016 | Last Modified: April 14, 2017
Pyloric Stenosis. http://kidshealth.org/en/parents/pyloric-stenosis.html. Accessed Mar 3, 2017.
Diagnosis and Treatment of Gastroesophageal Reflux in Infants and Children. http://www.aafp.org/afp/2015/1015/p705.html. Accessed Mar 3, 2017.
Pyloric stenosis. http://www.mayoclinic.org/diseases-conditions/pyloric-stenosis/home/ovc-20163855. Accessed Mar 3, 2017.