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Pyloric StenosisWhat is pyloric stenosis?Pyloric stenosis is a problem that causes forceful vomiting. It affects babies from birth to 6 months of age. Symptoms usually start around 3 to 5 weeks of age. It can lead to dehydration. This condition is the second most common reason why newborns have surgery. The pylorus is the lower part of the stomach that connects to the small intestine. In pyloric stenosis, the muscles in that part of the stomach enlarge. This causes the opening of the pylorus to get narrow. This stops food from moving from the stomach to the intestine. What causes pyloric stenosis?Pyloric stenosis is a birth defect. This means that your child is born with it. This condition may run in some families. It’s a multifactorial trait. This means that many things caused it. The factors are often both genetic and environmental. Pyloric stenosis is 4 times more common in males than females. Who is at risk for pyloric stenosis?A child is more likely to have this condition if the child:
What are the symptoms of pyloric stenosis?The most common symptom is forceful, projectile vomiting. This kind of vomiting is different from spit-up or a wet burp. Large amounts of breastmilk or formula are vomited. It may go several feet across a room. Your baby’s vomit may look curdled. This is because the milk stays in the stomach and doesn’t move to the small intestine. The stomach acid curdles it. Other symptoms may include:
A baby with pyloric stenosis is often very hungry and wants to eat. The symptoms of this condition may be similar to symptoms of other health problems. Make sure your child sees his or her healthcare provider for a diagnosis. How is pyloric stenosis diagnosed?Your child’s healthcare provider will check his or her health history. He or she will also give your child an exam. Your child may need tests to diagnose pyloric stenosis. Blood testsThese tests check if your child is dehydrated or has mineral imbalances. Abdominal ultrasoundThis test uses sound waves to show images of your child’s internal organs and of blood flow through various vessels. Abdominal X-raysThis test shows images of your child’s internal tissues, bones, and organs. Abdominal ultrasoundThis test shows images of your child’s internal organs and blood flow through various vessels. Upper gastrointestinal (GI) seriesAn upper GI series looks at the organs in the upper part of your child’s digestive system. These include the esophagus, stomach, and duodenum. The duodenum is the first section of the small intestine. For this test, your child will swallow barium. This is a metallic liquid that coats the inside of his or her organs. This helps them show up on an X-ray. Then your child’s healthcare provider will take an X-ray of these organs. How is pyloric stenosis treated?Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Children with this condition must have surgery. But your child’s dehydration and mineral imbalances may need to be treated first. Water and minerals can be replaced through intravenous (IV) fluid. Once your baby is no longer dehydrated, he or she will have surgery. Your child will need anesthesia. His or her surgeon will make a small cut (incision) above your baby’s navel. Then the surgeon will fix the pyloric muscle. Your baby will stay in the hospital for 2 to 3 days. Most babies get better quickly after surgery. Your baby will likely only be able to drink clear liquids such as an electrolyte drink at first. But feedings are often started within 4 hours of the procedure. Babies may still vomit for several days after surgery. This is because of swelling of the surgical site of the pyloric muscle. The swelling often goes away within a few days. Most babies will be able to have normal feedings by the time they leave the hospital. What are the complications of pyloric stenosis?This condition can cause dehydration. When babies vomit often, they don’t get enough fluids to meet their nutritional needs. Minerals that the body needs are also lost through vomit. These include potassium and sodium. Babies who are dehydrated and don’t have enough minerals can get sick very quickly. Pyloric stenosis can also cause weight loss. A baby who vomits most of or all of his or her feedings won’t gain enough weight to stay healthy. Living with pyloric stenosisBabies who have surgery for this condition often have no long-term problems. Pyloric stenosis usually doesn’t reoccur. When should I call my child's healthcare provider?Call your child’s healthcare provider right away if your baby has forceful, projectile vomiting.Key points about pyloric stenosis
Next stepsTips to help you get the most from a visit to your child’s healthcare provider:
What does vomit look like with pyloric stenosis?The vomited milk might smell curdled because it has mixed with stomach acid. The vomit will not contain bile, a greenish fluid from the liver that mixes with digested food after it leaves the stomach. Despite vomiting, a baby with pyloric stenosis is usually hungry again soon after vomiting and will want to eat.
What does it mean when baby vomits green?Vomiting green bile can indicate a bowel obstruction, which needs immediate attention. A baby who is vomiting and sick, failing to thrive or has reflux should be a cause for concern.
Can pyloric stenosis cause bilious vomiting?Babies with pyloric stenosis usually have progressively worsening vomiting during their first weeks or months of life. The vomiting is often described as non bilious and projectile vomiting, because it is more forceful than the usual spit ups commonly seen at this age.
What is the character of vomit in patients with pyloric stenosis?Vomiting after feeding.
This is known as projectile vomiting. Vomiting might be mild at first. But over time, it becomes more severe as the pylorus opening narrows. The vomit may sometimes contain blood.
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