Pyloric stenosis and abdominal pain

Many school-age children suffer abdominal pain lasting more than 8 weeks, which is when most doctors will treat this common complaint more seriously.

belly pain2Recent evidence has shown that these children also show a higher risk of later depression and school absenteeism.  It used to be felt that a complex mix of psychological, social, and biological factors influenced abdominal pain.  Evidence has now emerged that early handling of the gastrointestinal tract, either in abdominal surgery, through procedures such as the insertion of a gastric tube, or even less invasive procedures such as nasogastric tube placement or suctioning, may increase the risk of certain children developing later abdominal pain.

Earlier this year (2013) a Mexican medical journal published an article with the telling title, Early life events predispose the onset of childhood functional gastrointestinal disorders.  It reviewed the results of a quite exhaustive survey of the risk factors behind infant abdominal pain, discomfort, malfunction and allergies.  It gleaned its findings from 43 medical articles published by a US medical website during the past 20 years; these reports were found from a search for material on that site dealing with “functional gastrointestinal disorders” (“FGID”), “chronic abdominal pain”, “chronic pain”, “gastrointestinal inflammation”, and “early life events”.

Because of my own pyloric stenosis (“PS”) surgery in infancy and occasional bouts of gastric irritability, and because I have found that there are many complaints about this link (which are dismissed by most doctors) I was very interested in this review.

The Mexican article is valuable in several ways.  Three examples –

  • This review is linked with an article on milk allergies which afflict many children which includes several very useful tables to help the interested reader (whether medical professional or parent) to understand and navigate the complex web of causes and effects behind the simple and commonly used words, “milk allergy”.
    If you or your child has problems with cows’ milk and you would like to know more, follow the link above and read!
  • The review cites a 2011 report on Early Life Events: Infants With Pyloric Stenosis Have a Higher Risk of Developing Chronic Abdominal Pain in Childhood.  100 children who had had PS surgery between 2000 and 2005, were selected for this study, and 91 of their siblings.  It was found that 20% of the PS children had suffered abdominal pain during the previous two months, and 45% of these children had sought medical help for their discomfort.  Only 5.8% of the siblings reported abdominal pain during the same time period.
    It is further remarked that Biological evidence suggests that patients with GI malformations or maldevelopment such as gastroschisis or malrotation have higher rates of gastroesophageal reflux and motility problems as they get older.  These conditions are more major than PS and the surgery to correct them more severe.
  • A third study that is reviewed has found a link between post-natal maternal stress and GI pain and distress.

belly pain1My reading and writing about the possible long-term effects of PS and infant surgery generally continues to underline the same issues –

  1. PS surgery has many more and more frequent long-term after-effects than is generally realised;
  2. The long-term after-effects of PS and infant surgery are not widely known, or are wrongly denied by many doctors and paediatricians;
  3. More research and statistical study is needed in this area;
  4. PS survivors and parents concerned about their abdominal pain and discomfort need to arm themselves with the information that is available before they visit their doctor or pediatrician.
  5. As has been argued in the previous 3 posts, the medical treatment option for treating PS looks even more worthy of consideration. It can only be used in 80% of cases but these seem to be the benefits: it is non-invasive, non-traumatic, doesn’t risk death or shock, doesn’t come with as many complications, results in far fewer long-term problems, and it’s cheaper.
    The main arguments against medical therapy for PS?  It takes longer to achieve results, parents need a little coaching and some patience, 10-20% of babies treated medically need surgery after all, and it doesn’t come with the kudos and cost of surgery!
    What a choice.
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2 thoughts on “Pyloric stenosis and abdominal pain

  1. Wendy

    So informative! My eyebrows shot up at this statement that you made: “It was found that 20% of the PS children had suffered abdominal pain during the previous two months, and 45% of these children had sought medical help for their discomfort.” I also appreciate what you said about the fact that there are a lot more possible long-term effects from PS surgery than are communicated to parents. How I wish medical treatment were a viable option! And what’s the deal with eumydrin being taken off the market. (This was stated in the one of the articles you shared last post.) Something’s afoot. I smell a rat here. In any case, you are bringing valuable information to the public forum. As you said, more research is needed with regard to PS surgery. I’d like to see a study done of the percentage of PSers hospitalized in psyche wards at one time or other in their lives. Maybe–and I mean maybe–this study would not be so relevant now since anesthesia is being used more, at least in America. I would like to see the long-term mental health effects of babies and neonates undergoing surgery–period. Thanks for staying on task and helping us understand the repercussions of early abdominal surgery.

    Reply
  2. Fred Vanderbom Post author

    Thank you Wendy for what is your clearly heartfelt agreement with what I have posted, and be assured of my complete agreement with what you say here.
    I too would dearly love to have my concerns about the long-term effects of PS and infant surgery, trauma and anesthesia answered, but I am so often also reminded of the practically infinite number of questions that still baffle the medical and other sciences – and of the limited funds available for medical research. The list of even very common conditions that modern medicine can treat successfully is slowly growing but still limited. And then there are the many conditions that continue to disable people more severely than PS and its surgery…
    Besides this, I have been frustrated by the fact that so often the research and statistical reports I discover (rather scarce on PS and the effects of infant surgery) reach what seem to be divergent conclusions. I will write about this in my next post.
    Your and my work, writing and networking have discovered that (as you and I comment above) there are many people who suffer long-term effects of infant trauma and who are shunned by most doctors. It is important that we continue to encourage these people and broadcast their stories and our concerns.

    Reply

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