Is your little one vomiting continuously after feeding? Is he constantly crying? Does he look lethargic and dehydrated? It's normal for a parent or a parent to be very worried at times like these. Most of the time, you might think that this is some kind of virus or bacterial infection that your baby has contracted. But behind these severe symptoms is a condition called Pyloric Stenosis , which is a rare but completely curable condition with surgery. So, let's talk about this in detail without any fear.
What is Pyloric Stenosis?
Simply put, Pyloric Stenosis is a condition that only occurs in young babies. It is a condition in which the muscle between the baby's stomach and small intestine thickens and enlarges.
Think about it, the stomach is a place in our digestive system where food is temporarily stored and fermented until it becomes liquid. Then that food needs to go to the next step of digestion, which is the small intestine. Now, the strong gate-like muscle that connects the end of the stomach to the beginning of the small intestine is called the pylorus .
Normally, in a healthy baby, this pylorus muscle opens and closes, allowing food to pass down smoothly. But in a baby with Pyloric Stenosis, this muscle gradually thickens and tightens, completely blocking the passage of food down. Then, no matter how much milk the baby drinks, the milk does not go into the intestines, but fills up in the stomach, and it cannot be tolerated and comes out as severe vomiting . As a result, the baby does not get enough nutrition, loses weight, and becomes dehydrated.
But remember, Pyloric Stenosis is a rare condition. And, if diagnosed correctly, it can be completely cured with a minor surgery. So don't worry.
How exactly does the doctor diagnose this condition?
When you tell your baby about his symptoms, the doctor will first examine the baby carefully. When the doctor feels the baby's belly, sometimes this thickened pylorus muscle can be felt like an 'olive'. But it is not always felt.
Therefore, the best and most accurate way to confirm this condition is to have an abdominal ultrasound scan . This allows the baby to clearly see whether the pyloric muscle is thickened and how thick it is, without any pain.
What are the main symptoms of Pyloric Stenosis?
It's normal for a small baby to vomit a little and spit up a little. But the symptoms of Pyloric Stenosis are much more severe. Be aware of this.
| Symptom | What does this mean? |
|---|---|
| Projectile Vomiting | This is the main symptom. After a while after drinking milk, instead of the usual trickle of milk from the mouth, vomiting occurs violently, as if it were being sprayed about a meter away. The amount of vomiting increases day by day. |
| Being hungry all the time | After vomiting, the baby will feel hungry again. Because the milk that was drunk was passed out before it could be absorbed by the body, the baby will always be hungry. If the baby is still crying after drinking the milk, it could be because of hunger. |
| The feeling of the stomach muscles contracting | If you look at your baby's stomach before vomiting after drinking milk, you can see the muscles in the upper part of the stomach moving back and forth like waves. This is the stomach's attempt to push the food through the blocked passage. |
| Dehydration | The baby is dehydrated because he is not getting enough fluids. The number of wet diapers per day decreases, there are no tears when he cries, the baby is very sleepy, and shows signs of a dry mouth. |
| Weight loss or lack of weight gain | Because the body is not getting enough nutrition, the baby stops gaining weight, or even starts losing weight. |
These symptoms usually start when the baby is about 3-5 weeks old. This condition is very rare in babies older than 3 months. So if your baby is a few weeks old and has severe vomiting and dehydration, see a doctor immediately .
What is this surgery called Pyloromyotomy?
Pyloromyotomy is a relatively simple and safe surgery to treat Pyloric Stenosis. It is performed by a Pediatric Surgeon.
This surgery is often performed laparoscopically , which is called "keyhole surgery."
1. The surgery begins after the baby is first given general anesthesia and is sound asleep. Therefore, the baby does not feel anything.
2. The surgeon then makes a very small incision in the baby's abdomen, near the navel, and inserts a thin tube with a small camera (laparoscope) through it. This camera allows the inside of the abdomen to be viewed on a screen.
3. Then, one or two more small incisions are made and the very delicate instruments needed for the surgery are inserted.
4. Finally, the doctor cuts only the outer layer of the thickened, enlarged pylorus muscle, loosening the muscle without damaging the delicate membrane inside. This is like cutting and loosening a tight rubber band.
When the muscle is relaxed in this way, the blocked passageway opens, allowing the milk in the stomach to pass unhindered into the small intestine.
What are the benefits and risks of this surgery?
Pyloromyotomy is the only and best treatment for Pyloric Stenosis.
- Advantages: After the surgery, the baby will be able to drink milk normally again and absorb the nutrients. Vomiting will almost completely stop. The baby can be taken home from the hospital in a few days. The baby will be healthy and start gaining weight normally.
- Risks: As with any surgery, there are some risks, but the risks of pyloromyotomy are very low . When performed by an experienced pediatric surgical team, the risk of complications is less than 1%. Two possible risks are:
1. The delicate membrane on the inside of the pylorus is cut during surgery.
2. Vomiting continues even after surgery.
These are very rare things, but they can be managed.
How to take care of the baby after surgery?
After the surgery, the baby will be kept in the recovery room for a few hours and then transferred to the ward. Keep these things in mind when caring for your baby.
Bandages and Stitches
Small, waterproof bandages (sterile strips) are used to cover the small surgical wounds. There are no visible stitches on the skin, the dissolvable stitches are under the skin. You don't need to do anything special for this. However, always check the wound for redness, pus, and fever . If you notice any of these, inform the doctor immediately.
Pain Control
Since this is a very small incision surgery, the baby will not feel much pain. Usually, something like Paracetamol is given for pain. Always give painkillers as directed by your doctor and only in the prescribed dosage . If your baby continues to cry in pain, tell your doctor .
Diet
Your baby will probably be very hungry after the surgery. You can usually start breastfeeding again within a few hours. You may vomit a little at first, which is normal. However, follow your doctor's instructions about how much and when to breastfeed after the surgery. Don't give a large amount at once.
If your baby is in severe pain after surgery, has a fever, or has any symptoms that make you suspicious, call the doctor immediately.
Take-Home Message
- If your baby under 3 months old vomits violently, as if he is about to vomit, after drinking milk, don't ignore it, thinking it's normal.
- This may be due to Pyloric Stenosis, which is a thickening of the muscle at the entrance to the stomach, blocking the food passage.
- This is not your fault. This is a rare but treatable condition that can occur in babies.
- This condition can be completely cured with a simple surgery called pyloromyotomy. This is a very safe surgery.
- If you notice these symptoms, don't panic, but see a pediatrician as soon as possible for advice. The sooner you get treatment, the sooner your baby will recover.
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