Pyloric stenosis: its infant and adult forms

This blogsite has mentioned several times that pyloric stenosis (“PS”) afflicts adults as well as infants.

Pain01Recently I devoted a post to the adult form, passing on the stories of several people who had related these on one of the Facebook PS Groups’ pages.  By using the “Categories” box at the top right of this site, interested readers can locate several posts that deal with adult PS.

The stories of adult PSers vary even more than those about the infant form of the condition.  However, the basic cause is the same: high gastric acidity.

In the infant disease, the high gastric acid level over-stimulates the pylorus (the circular muscle valve at the stomach’s exit, causing it to thicken, toughen and choke the muscle’s ability to relax and pass food. Peptic ulcer3

Adult PS is also caused by high acidity and often a virus, Helicobacter pylori. The acid erodes the stomach lining and creates conditions which enable the virus to trigger the eruption of gastric ulcers, which then scar the stomach and pylorus, ultimately narrowing and blocking the stomach outlet.  These ulcers can also give rise to cancer.

These differences do not affect the name of the condition: “pyloric stenosis” means “narrowing” of the pylorus (which means “gate”).  The term “hypertrophic” means “enlargement” and is only used of the infant form.  The effect of PS is also the same: the blockage of the narrow exit valve, starvation and vomiting.

The difference in the development of the two forms of PS explains why the relatively simple “fixes” for infant PS (medication or surgery to relax the pyloric ring) do not relieve the adult form of the condition.  The PS baby’s problem is the thickening of the pyloric passage’s muscular outer, whereas the adult’s blockage occurs inside the pylorus or at the antrum, the tapered part of the stomach closest to the pylorus.

Scared_DoctorThe main post mentioned above reflects the range of symptoms that adult PSers may suffer and the various treatments which are offered by GI specialists: unhappily adult PS is more complex in its causes, symptoms and available treatment.  All treatment options are far from assured of success and they tend to have unwanted and significant physical side-effects, far more often so than the great majority of infant PS survivors report.

Infant PSers have a much higher risk of a list of abdominal complaints after their early surgery and in later life.  One of the risks is of developing gastric ulcers – and the other form of PS.  Deja-vu!

But today, thanks to effective antibiotic treatment, H. pylori infection is usually quite easily dealt with, and so gastric ulcers are now much less common than they were in my younger years.

The next post will continue the stories of adults with PS.

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One thought on “Pyloric stenosis: its infant and adult forms

  1. Wendy

    Fantastic information. I always learn something new when I read your posts even though you may have covered a topic before. I shudder to think of what adult PS must feel like. Gastric ulcers, oh no! But it sounds like sometimes, problems can be cured with antibiotics thankfully. I’ve been working intensely on my memoir about infant surgery for the past week. The book actually begins with a scene in which I am one year old and lying on an examination table. My mother asks my pediatrician if PS will affect me negatively in later life. He answers that “it shouldn’t, but we’ll keep an eye out for it.” It was an honest answer because as you say infant PSers have a “higher risk” of abdominal complaints as kids and adults than non-peers. And at least he wasn’t pooh-poohing her concern. He was honestly stating that he, and medical science, didn’t know. I just wish he didn’t answer her where I could hear. His comment kept me worrying (subconsciously) for about five decades. Thankfully, I didn’t develop a gastric ulcer from chronic anxiety. Thanks, Fred, and as always, looking forward to the next post.

    Reply

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