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Pyloric stenosis

Introduction:

Pyloric stenosis, which causes problems with an infant' s digestion, happens in 3 out of every 1,000 live births. The pylorus is the lower part of the stomach leading to the small intestine. In infants with pyloric stenosis, the muscles of the pylorus get thick and stop food from getting into the small intestine. Infants may vomit, become dehydrated, and lose weight. They need surgical treatment right away to avoid life-threatening dehydration and electrolyte imbalance.

Signs and Symptoms:

Babies with pyloric stenosis may have these symptoms:

  • Vomiting, often projectile vomiting in the first 3 - 6 weeks of life (may come and go or may happen after each feeding)
  • Always hungry
  • Weight loss
  • Dehydration
  • Lethargy
  • Few or no bowel movements
  • Jaundice (yellowing of the skin and eyes)

What Causes It?:

No one knows that causes pyloric stenosis. Genetics may be involved.

Who's Most At Risk?:

Babies with the following conditions or characteristics are at risk for developing pyloric stenosis:

  • Gender -- much more common in males
  • First-born infants
  • Race -- most common in Caucasians

What to Expect at Your Provider's Office:

If your baby has symptoms of pyloric stenosis, take the baby to the doctor o the hospital right away. Your doctor will do a physical examination, check for gastric symptoms, and use ultrasound to see whether the thickness and length of the pyloric muscle are abnormal.

Treatment Options:

Prevention

Avoid use of erythromycin, an antibiotic, in infants. Babies receiving oral erythromycin may be at increased risk for pyloric stenosis.

Treatment Plan

Pyloric stenosis is usually corrected with surgery.

Drug Therapies

In some infants, treatment with atropine sulfate, given intravenously at first and then continued by mouth, corrects this situation.

Surgical and Other Procedures

Usually, pyloric stenosis is fixed with laproscopic surgey. The surgeon makes a small incision near the baby' s navel and uses a camera and surgical instruments to cut the muscles surrounding the pylorus. Symptoms usually improve about 24 hours after surgery.

Complementary and Alternative Therapies

Pyloric stenosis is a serious medical condition and should be treated by qualified health care providers. Ask your doctor before using any complementary and alternative therapies in an infant.

Making sure that you are eating right and getting enough vitamins and minerals while you are pregnant can help you deliver a healthy baby. Make sure you eat lots of fruits, vegetables, whole grains, dairy, and protein. Take a prenatal vitamin as directed by your doctor. Tell your health care provider about any herbs and supplements you are using or considering using.

Nutrition and Supplements

Your baby may have lost weight or be undernourished. Ask your doctor how to best help your baby get the nutrients he needs after his pyloric stenosis has been treated.

If you are breastfeeding, make sure you eat a healthy diet so that the benefits are passed on to your baby. The following nutritional tips may help a breastfeeding mother:

  • Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash).
  • Eat foods high in B-vitamins and calcium, such as almonds, beans, whole grains (if no allergy is present), dark leafy greens (such as spinach and kale), and sea vegetables.
  • Avoid refined foods, such as white breads, pastas, and especially sugar.
  • Eat fewer red meats and more lean meats, , tofu (soy, if no allergy is present) or beans for protein.
  • Use healthy cooking oils, such as olive oil or vegetable oil.
  • Avoid coffee and other stimulants, alcohol, and tobacco.
  • Drink plenty of water daily.

Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, can help maintain good gastrointestinal health. Refrigerate your probiotic supplements for best results. If you are breastfeeding, ask your doctor before taking probiotics, and whether your baby would also benefit from taking probiotics. Always ask your doctor before giving your child any dietary supplements.

Herbs

There are no herbs that can specifically treat pyloric stenosis. Pyloric stenosis requires conventional medical care. If you are interested in using herbs to help your baby recover from surgery, ask your pediatrician which herbs might help. Do not give any herbs to your child without asking your doctor first.

Homeopathy

Surgery is generally needed to cure pyloric stenosis, but a professional homeopath may use one of the following remedies to treat the vomiting associated with this condition. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.

  • Arsenicum album -- for vomiting immediately following ingestion of food or drink
  • Bryonia -- for people whose stomachs are sensitive to touch but may experience relief from lying on the stomach
  • Phosphorus -- for excessive vomiting immediately following ingestion of food or drink
  • Silicea -- for vomiting after drinking milk (including breast milk) in those who have a delicate constitution and are slow to develop

Massage

Touch is an important part of infant well-being. Gently stroking baby' s hands and feet may reduce stress and be soothing to your baby, especially when he is in the hospital.

Prognosis/Possible Complications:

Your baby needs quick emergency treatment to avoid life-threatening fluid and electrolyte imbalance. If found quickly, the prognosis for recovery and improved growth is very good. Possible complications include vomiting that continues after surgery, gastritis (inflammation of the lining of the stomach), hiatal hernia, or another obstruction.

  • Reviewed last on: 6/21/2010
  • Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

Supporting Research

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Honein MA, Paulozzi LJ, Himelright IM, et al. Infantile hypertrophic pyloric stenosis after pertussis prophylaxis with erythromycin: a case review and cohort study. Lancet. 1999;354(9196):2101-2105.

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