The difference between GERD and Pyloric Stenosis

Four of my blogs during the past six weeks have dealt with the sadness and/or anger of far too many parents the world over because the diagnosis of their baby’s malady was by any standard less than respectful and thorough.

I have observed in several blogs that all the parents and medical professionals concerned with this issue could improve their consultation process in particular ways, possibly in many ways.

During the past week I heard a radio program about the number of parents who take their sick children to the local hospital’s Emergency Department.  Some went there with urgent and serious conditions but we were told that many went with minor ailments of infancy that could easily have been taken care of in other ways: by checking the web or a book at home, consulting a family member, or calling on their local pharmacist or the local health clinic.

What completely amazed me however, was the comment of the health professional and educator being interviewed that in Australia and most other developed countries most hospitals do not use an evidence-based diagnosis procedure!  That is: a list of the symptoms, questions, and tests that need to be worked through to arrive at as accurate and prompt a diagnosis as possible. And that most health workers do not have one either.

Every medical worker is like everyone of us: we all have strong and weak areas.  Not every family doctor is a whiz at diagnosis or sports medicine, not every surgeon is a good communicator, not every nurse has a good manner with children, and not every hospital CEO is a born negotiator.  We all need to recognise and remember that.

This is all the more reason to ask why every hospital “emergency room” (ER) must not have a formal set of diagnostic procedures!  My body and its working and defects is very, very complex, and thus diagnosing a problem can sometimes be very difficult.  If we could expect every ER to have somebody on duty at all times who is able to cover many cases and who is strong in diagnosis . . . “and pigs will fly!”  Surely every doctor and hospital must have a list of the symptoms, questions, and tests that need to be worked through to arrive at an accurate and prompt diagnosis.

Let me illustrate with a simple example.

Many parents who take their new baby to their doctor or ER because of constant vomiting tell us they were assured the problem is probably gastro-esophageal reflux disease (GERD) or reflux.  Their family history of pyloric stenosis (PS) or their list of symptoms pointing to this was summarily brushed off: “All babies sick up!  New mothers are anxious!”  Just read the recent posts or some of the web-based comments.

In recent blogs I have listed the symptoms of PS.  The following small table makes it easy for parents and all concerned to recognise the clear differences between PS and GERD –

I have seen many tables like this on the web, dealing with many different conditions and symptoms.  They help the general public, and surely such simple information (or fuller versions of them) would also greatly raise the standard of good medical diagnosis.

4 thoughts on “The difference between GERD and Pyloric Stenosis

  1. Brianna

    I wish I had seen your blog prior to my son’s surgery for pyloric stenosis. My concerns were brushed off, and my son was being treated for GER until he was dehydrated and vomiting in our last peditrician’s office.

  2. Fred Vanderbom Post author

    Thanks for your kind endorsement, Brianna. I get a lot of feedback like yours! There’s a lot of carefully researched information here – but to find something just when you need it… though I’m sometimes embarrassed how many links there are to my posts when I Google.
    Even when we have a good grasp of the story, it can be a huge challenge for already emotional parents to stand up to some of the less sensitive, busy or strong-minded medical people. Again and again parents who have been through this say: Do your homework and then follow your feelings, take somebody with you, get a second opinion, refuse to leave until you’re taken seriously.

    1. Maureen

      My son is 4 months old. He has had problems with projectile vomiting since he was about 4 weeks old. The pediatrician keeps telling us that it is reflux. 2 months ago we switched him to nutramigen formula; after no change they had me start thickening his formula with rice cereal. After very little change they started him on zantak twice a day and still not much better. At 2 months old he weighed 12.2 lbs. Today at almost 4 months he is 12.5 lbs. I am calling the pediatrician office on Monday to get a referral for a gastroenterologist.

  3. Fred Vanderbom Post author

    Thanks for sharing your frustrating journey here, Maureen. From what you have written, it is certainly time to see a gastroenterologist; try to find one who also has pediatric interest.
    As your son has been gaining some little weight over his 4 months, it’s fairly unlikely he has pyloric stenosis, although he could have a mild case which could be treated medically. If you are not completely clear about the symptoms of PS (and many GPs and even pediatricians aren’t) search this site for the category of “Diagnosis” (see top right) and/or the tags “GERD”, “reflux” and “symptoms” (tags may be found at the end of each post).
    Please let us here know how you go… best wishes.


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