pyloric stenosis and regurgitation in neonates

This article is professionally consulted by resident Doctor Le Thanh Tuan - Gastroenterologist - General Surgery Department - Vinmec Nha Trang International General Hospital.

Pyloric stenosis often occurs in infants, but the cause of the disease is not clearly defined by doctors. One of the manifestations of children experiencing this symptom is vomiting, dehydration... This article will provide more information for parents to better understand as well as better treatment methods to help improve the situation. This is for the baby.

Vomiting after feeding is a characteristic symptom of pyloric stenosis, which usually begins a few weeks after birth. If your child has severe vomiting, call the doctor right away. Babies who can't keep food down after eating need help quickly to avoid dehydration, weight loss, and other complications.
All infants regurgitate in a burp-like manner. When a child has pyloric stenosis, the muscle in the lower part of the stomach, called the pylorus, thickens and blocks the flow of food into the small intestine.

About one in five neonates have pyloric stenosis, but it is rarely seen in infants over 12 weeks of age. Some risk factors for pyloric stenosis:
Boys, especially if firstborn Caucasians Preterm birth Cesarean section Mother smoked during pregnancy Parents with pyloric stenosis or history of disease Mother taking certain antibiotics in late pregnancy or while breastfeeding Take certain antibiotics (such as erythromycin and azithromycin) in the first weeks after giving birth.

If your child has pyloric stenosis, he or she may also experience the following symptoms:
Wavelike contractions throughout the upper abdomen after eating and before vomiting, when the stomach muscles try to push food through the pylorus. Anxiety begins with feedings, followed by anxiety and restlessness before vomiting Swollen stomach Persistent hunger Weight loss Signs of dehydration, such as dry mouth, lethargy, fontanelles, and six hours of going without clothes wet diapers. Less bowel movements or constipation Gastroesophageal reflux.

After taking the medical history and performing a physical examination, the doctor may ask the mother for the following tests:
Abdominal ultrasound : This procedure is done quickly and without pain for children. It will use sound waves to create images of the inside of the baby's body to help the doctor see what is happening in the baby's abdomen. Blood tests: These tests will help your doctor measure your baby's electrolyte levels and other related metrics. X-ray with Barium: The baby will drink a bottle of solution containing barium, and then take pictures of the baby's pylorus in action.

Usually to treat pyloric stenosis, the doctor will choose the surgical method. The process is accomplished by pylorectomy, which involves making a single cut in the pylorus muscle. This method is almost always necessary to relax the valves so that they can function properly.

pyloric stenosis can cause complications such as:
Electrolyte imbalance: Electrolytes are usually minerals such as potassium chloride, which are circulated in the body to help with the correction process. many important functions such as the rhythm of the heart. When a child vomits, losing a lot of water will lead to an electrolyte imbalance. Stimulates gastric activity. Due to the repeated vomiting process, it causes stomach irritation for the child. This can even lead to light bleeding in your baby's stomach. Jaundice: This is very rare, but as a child's pyloric stenosis progresses, the color of his skin and eyes will change color. This is caused by a build-up of a liver secretion called bilirubin.

7.1. Risks of pyloric stenosis surgery The method of pyloric stenosis is quite safe, according to which pyloromyotomy is the most common surgery for neonates. This procedure is usually done endoscopically, so it is considered minimally invasive. (Laparoscopy involves small incisions.)
7.2. Length of hospital stay after pyloric stenosis surgery Usually after pyloric stenosis a child will be hospitalized for a period of one or two days. While your child is in the hospital, fluids will be given through an intravenous (IV) line to give fluids and other nutrients. These activities are usually stopped a few days after surgery, and breastfeeding or formula feeding can resume.
7.3. Some Children's Symptoms After pyloric stenosis Surgery The child's abdomen may be sore for a day or two after surgery. Nor should you be alarmed or surprised by a few occasional regurgitation in your child after a pyloric stenosis surgery. In fact, most babies after surgery vomit violently a few more times. This happening can cause you anxiety and fear about your baby's condition. However, you should not worry too much, but discuss more with your doctor.
If your child is still vomiting more than a few days after surgery, call the doctor right away. Because, this can happen very rarely, but it can be in 1 to 2 percent of cases that need a second procedure.

7.4. Long-term effects of pyloric stenosis in children There is almost no long-term effect of pyloric stenosis in infants and young children. After successful surgery, the pylorus will function normally, with no sign of its abnormal size.
Children with pyloric stenosis cause vomiting, dehydration and many other dangerous complications. Therefore, when seeing that the child has symptoms of vomiting continuously after feeding, usually 2 weeks after birth, parents need to take the child to a medical center for examination and treatment, to avoid dangerous complications for the child.
Pediatrics department at Vinmec International General Hospital is the address for receiving and examining diseases that infants and young children are susceptible to: viral fever, bacterial fever, otitis media, pneumonia in children, ... With modern equipment, sterile space, minimizing the impact as well as the risk of disease spread. Along with that is the dedication from the doctors with professional experience with pediatric patients, making the examination no longer a concern of the parents.

Reference source: babycenter.com