pyloric stenosis: a common complication in chronic peptic ulcer disease

This is an automatically translated article.

The article was professionally consulted with Master, Doctor Vu Van Quan - Gastroenterologist - Department of General Surgery & Anesthesia - Vinmec Hai Phong International General Hospital.

The pylorus is located at the end of the stomach at the junction with the duodenal bulb. The pylorus is the muscular valve-like organ that holds food in the stomach until it is ready to be passed down to the small intestine and continued digestion. Pyloric stenosis is a medical condition characterized by partial or complete obstruction of the flow of food and gastric juices from the stomach to the duodenum. The disease develops rapidly, can be dangerous without timely intervention and treatment, and may require a partial gastrectomy.

1. pyloric stenosis is a common complication in peptic ulcer disease

Peptic ulcer is a disease that affects the lining of the stomach or duodenum (the part that connects to the stomach and is the first part of the small intestine). Although there have been great advances in diagnosis and treatment, the disease remains a major health problem because of the large number of patients. The nature of peptic ulcer disease is chronic and easy to recur, and can cause a number of complications, including pyloric stenosis.
When gastric ulcer - duodenal ulcer complications pyloric stenosis: usually manifested as epigastric pain, epigastric mounds, vomiting old food. Because the food stagnates in the stomach, the patient often has a lot of pain when lying down, it gets better when sitting up. When the patient lies down and changes position, he or she can hear the murmur in the abdomen, if the patient lies on the back, the abdomen will be flattened (the abdomen is concave in the boat). People are often thin, pale, tired, craving food but do not dare to eat because eating hurts more.
In many cases, when having pyloric stenosis, the patient will vomit the food of the previous day, accompanied by a strong odor of gastric juice. Vomiting so much will be accompanied by dehydration and electrolytes, making the patient more tired, uncomfortable, thin, blue skin, sunken eyes, dry skin and irritability.

2. How to prevent complications of pyloric stenosis caused by peptic ulcer?

Peptic ulcer is the most common cause of pyloric stenosis, so it is necessary to prevent this disease by: Eating in moderation, always eating slowly, chewing thoroughly. Never eat a lot of sour foods that easily cause stomach ulcers such as pickles, salted eggplants, vinegar, batches, crocodiles, tamarinds, star fruit, lemons...
Completely quit or limit smoking, drinking, Do not drink solid tea or coffee, because these substances can easily cause stomach ulcers. Do not do heavy work immediately after eating. Avoid all mental stress such as anger, jealousy, envy... because that is also the cause of stomach ulcers.

Perform periodical medical examination to promptly detect and treat diseases: stomach cancer, gastric polyp, pyloric hypertrophy, tuberculosis, syphilis, pancreatic head tumor, pancreatic head cancer... to eliminate the cause of pyloric stenosis.

3. Treatment of pyloric stenosis due to peptic ulcer disease

Pyloric stenosis is mainly treated by surgery, before surgery, the patient must be rehydrated with water and electrolytes, and improved by infusion of sweet serum, protein and blood transfusion if necessary. Surgery is aimed at resolving pyloric stenosis and at the same time curing the underlying disease causing pyloric stenosis.
For pyloric stenosis due to chronic peptic ulcer, 2/3 of the stomach is removed; Selective neurectomy, concurrent pylorus enlargement, or neurectomy X combined with gastrojejunal connection. If there is gastric cancer, it is possible to remove the entire stomach or part of the stomach, depending on the location, size, and stage of the tumor.
In case the patient arrives late or is of advanced age and is too weak, a gastrojejunostomy can be used to restore digestive circulation. Patients who are too weak, are elderly, are suffering from chronic diseases such as heart failure, tuberculosis, asthma... are simply connected to the colon.

Currently, Vinmec Hai Phong has applied laparoscopic gastrectomy combined with lymph node dissection for effective treatment of pyloric stenosis due to chronic peptic ulcer. This method achieves a success rate of over 95%, patients only need to stay in the hospital for an average of about 5 days to be able to leave the hospital and resume normal activities. The technique is performed by Dr. Vu Van Quan, who has more than 10 years of experience in digestive surgery and is well trained in laparoscopic surgery. Laparoscopic gastrectomy combined with lymph node dissection has outstanding advantages compared to open surgery:
Surgical customers at the Department of Surgery, Vinmec Hai Phong Hospital enjoy outstanding benefits including:
Short hospital stay, minimizing the cost of stay, reducing the risk of hospital infection. With cases of lithotripsy, inguinal hernia, customers can always go to work after 1 day of discharge from the hospital. Limit the use of antibiotics, reduce the risk of side effects, save costs, patients do not have to worry, fear when administering antibiotics and follow up after taking the drug. Recovery rate reached 90%, re-hospitalization 0%, postoperative infection 0%. The Early Post-Surgery Care Program provides comprehensive care to patients before, during and after surgery, helping to reduce hospital stay, improve treatment quality and reduce costs; reduce the rate of complications. ERAS has been shown to shorten the average length of stay from 8-10 days to 3-4 days. Insurance: Vinmec signed with many large private insurance partners. When customers are hospitalized, they are guaranteed and compensated at the hospital. Save a lot of customer's time and effort. Other advantages : Modern equipment; Service quality according to international standards; Highly qualified doctor; Patients do not need relatives to take care of them because they are cared for by a dedicated and thoughtful nursing doctor...

Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.