Summary about Disease
Pyloric stenosis is a condition that affects infants, typically between 2 and 8 weeks of age, in which the pylorus (the muscular valve between the stomach and the small intestine) thickens. This thickening narrows the pyloric channel, preventing food from emptying normally from the stomach into the small intestine. This obstruction leads to forceful vomiting, dehydration, and potential electrolyte imbalances.
Symptoms
The primary symptom is forceful, projectile vomiting. Other symptoms include:
Vomiting typically starts after feeding.
Persistent hunger, even after vomiting.
Dehydration (decreased urination, sunken fontanelle, dry mouth).
Weight loss or failure to gain weight.
Visible stomach contractions (peristaltic waves) after feeding but before vomiting.
Infant may appear irritable or lethargic.
Causes
The exact cause is unknown, but it is thought to be multifactorial. Potential contributing factors include:
Genetic predisposition: Pyloric stenosis tends to run in families.
Environmental factors: Exposure to certain antibiotics, particularly erythromycin, in early infancy has been linked to an increased risk.
Nitric oxide synthase: Potential dysfunction in nerve cells.
Medicine Used
Pyloric stenosis is treated surgically. Medications are not used to directly treat the stenosis itself. However, before surgery, the following may be used:
Intravenous (IV) fluids: To correct dehydration and electrolyte imbalances.
Sometimes a nasogastric tube to decompress the stomach
Is Communicable
No, pyloric stenosis is not a communicable disease. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Since the exact cause is unknown, there are no specific precautions that can reliably prevent pyloric stenosis. However:
Monitor infants closely for signs of vomiting, especially projectile vomiting.
Seek prompt medical attention if vomiting occurs, especially if it is forceful or accompanied by other symptoms like dehydration.
Be aware of a family history of pyloric stenosis.
How long does an outbreak last?
Pyloric stenosis is not an outbreak-related disease. It is an individual condition that develops in infants, not a contagious illness that spreads within a population. The duration of the condition depends on how quickly it is diagnosed and treated.
How is it diagnosed?
Diagnosis typically involves:
Physical examination: A doctor may be able to feel an olive-shaped mass in the abdomen, representing the thickened pylorus.
Ultrasound: This imaging technique is used to visualize the pylorus and measure its thickness. A thickened pylorus confirms the diagnosis.
Barium swallow: Rarely used but can show a narrowed pyloric channel.
Blood tests: To check for electrolyte imbalances and dehydration.
Timeline of Symptoms
Typically appears between 2 and 8 weeks of age.
Initial Stage: Vomiting may be mild and occasional.
Progression: Vomiting becomes more frequent and forceful (projectile).
Later Stage: Dehydration, weight loss, and visible stomach contractions become apparent.
Note: The timeline varies among infants
Important Considerations
Early diagnosis and treatment are crucial to prevent serious complications like severe dehydration and malnutrition.
The surgical treatment (pyloromyotomy) is generally very effective, and most infants recover fully after the procedure.
Parents should be educated about the signs and symptoms of pyloric stenosis and the importance of seeking prompt medical care.
Post-operative care is important to gradually reintroduce feedings and monitor for any complications.