Looks Like Infant Acid Reflux: Pyloric Stenosisby Jennifer Mitchell Wilson B.S. Dietetics, Dietitian, Health Professional
Pyloric stenosis is a condition that affects three in every 1,000 babies born in the U.S. Symptoms of the condition develop between three and 5 weeks of age. In pyloric stenosis the pylorus--the muscle that holds food in the stomach until it is ready to travel to the small intestine--progressively thickens until no food can pass at all. Vomiting that progresses to projectile vomiting, few stools or constipation, mucous in stools, failure to gain weight, constant hunger, dehydration and lethargy are all symptoms of pyloric stenosis.
Early stage symptoms of pyloric stenosis can be very similar to that of infant acid reflux disease. The medications used for acid reflux will not improve symptoms in children with pyloric stenosis. If your child has been diagnosed with acid reflux disease and symptoms persist or get worse your physician may want to run tests to rule out pyloric stenosis.
The first thing your baby's physician will likely do is a basic physical exam. In pyloric stenosis the pylorus is usually enlarged enough that the physician can feel it upon examination. Aggressive peristalsis--the contractions of the abdomen that move food through the GI tract- can also be felt on exam. Blood tests for dehydration and an ultrasound to confirm the condition usually follow.
Once your baby has been diagnosed with pyloric stenosis the only treatment is an immediate surgery called pyloromyotomy. Pyloromyotomy involves the surgeon cutting through the thickened outside layer of the pylorus so the inner layer can bulge out. This allows for food to begin passing into the small intestine normally. In many instances the surgery can be done as a laparoscopic procedure which is minimally invasive.
While it can be very scary to hear that your infant needs surgery this procedure is quite safe with a low risk of complications. Bleeding and infection can occur though they are rare. Many parents are concerned about having to put their infant under with anesthesia but that minimal risk far outweighs the risk of not fixing the pylorus quickly. Most infants go home within 48 hours of the procedure and are fully recovered, with no long-term issues, in one week.
_**Jennifer has a bachelor's degree in dietetics as well as graduate work in public health and nutrition. She has worked with families dealing with digestive disease, asthma and food allergies for the past 12 years. Jennifer also serves the Board of Directors for Pediatric Adolescent Gastroesophageal Reflux Association (PAGER).