Category Archives: Abdominal pain

How Japan handles infant Pyloric Stenosis

Most readers of this blog are more than interested in Pyloric Stenosis (“PS”), either because they or one or more of their children had infant PS as a baby.

PS is the most common form of bowel blockage to affect newborns in their first 4 or so months.  In most developed countries, all but the mildest cases are treated surgically. The surgical technique is a long-standing and firm favourite among surgeons: once mastered it is quick, simple, almost bloodless, and usually immediately effective. Parents who had been traumatised by their baby’s uncontrollable and violent vomiting and then by having to surrender their little one to be anesthetised and then cut open receive their little one back alive and with the promise: All done, you have a new baby, sick no more, home soon, and nothing to worry about in the future!  No wonder surgeons just love the Ramstedt procedure!

But if you look up “pyloric stenosis” on any of the larger social forum websites, you learn more.

  • The parent trauma resulting from PS and infant surgery can be deep and long-lasting,
  • this can affect the child also, and
  • the surgery is not always free of long-term problems, in both the immediate and long terms.

Such problems are probably far from the rule, and most Py babies seem not to look back. However, there are no substantial studies on this subject, and the ongoing effects of infant surgery on parents and sometimes the whole family, let alone the patient, can certainly be significant.

During my 20 years of researching the many issues related to PS, I have been surprised to learn that in some developed countries far from the Anglo-European world, surgery is the exception rather than the rule for PS babies.

The reports relating this are few but persistent.  For many decades now, academics and medical practitioners in countries including Japan, Taiwan, and Turkey have reported on regarding PS  surgery as a last resort.

ranitidine01Their policy is to treat most infant PS medically as the first option. The drugs involved are atropine sulphate and Ranitidine, drugs that reduce gastric acidity production. Very small or fragile babies, and those that do not respond to medical treatment within a stated time, are referred to a surgeon.

The outcomes are comparable by almost every standard: morbidity, mortality, and short-term problems. The hospital stay is longer, but the total cost is lower. Parents are happier and less traumatised.

Now a  2018 Japanese study has reported a small trial of adding a second drug, nitroglycerin or glyceryl trinitrate (GTN), in those cases that do not respond to atropine sulphate.  GTN is widely known as an explosive but is also often used to treat heart conditions.  Using both drugs meant success in treating all the PS infants in the study.

It is well worthwhile clicking on the link in the previous paragraph to read the full article, published by Open Source publisher Science Direct.

This is a story worth recording also! Most medical reports are published by large for-profit companies that first charge researchers for publishing their work and then the readers for access to the reports and discussions.  Open Access publishers believe that new research and discoveries should be published online without cost to the authors and should be freely available to anybody interested.

Posting this great news makes me soooo happy!

I am one of many millions who have gone for years hating our scars from infant surgery. PS survivors know that without this damage most of us might not be alive today!

But what if we knew that our parents had had a choice between a few days or weeks of supervised medical treatment – and disfiguring surgery?  And that they chose surgery without considering how we their child might be affected by that in years to come? We PS babies had no say in our treatment – but our parents were our advocates!  And parents who learn that infant surgery not only saves lives but can come with adhesions, collateral GI damage, and/or long-term psychological effects… who would not give medical treatment a try first?

This free medical article from Japan explains how treating infant PS medically is their first option – and it’s all that’s needed for up to 90% of PS babies to survive. This case reports details 2 cases when old-established medical treatment failed but was successful when combined with skin patches of another drug!

But… can our surgeons wean themselves off their favourite surgery?

Is there a link between infant PS and later abdominal trouble?

Most General Practitioners (GPs) will reject any link out of hand.  Some GPs have even been known to ask their patient (or client) what “PS” (pyloric stenosis) is.

We can be sure that every medical textbook and training includes at least a page or part of a lecture on PS, which is the most common reason for non-elective surgery on infants in their first months and years.  But who can blame a medical student for not remembering everything they are told and read over six or more packed years?

However, the almost universal denial of a link between PS and later abdominal trouble is more than a nuisance.  It may be “textbook” but it misleads and misinforms the parents of a PS baby and most will continue with this false assurance until they discover the truth – usually only after much frustration.  As for PS survivors, they are the immediate and personal subjects of the widespread ignorance and misinformation about the possible long-term gastric and other problems that can come with PS and/or its surgery.

113This kind of trouble does not seem to afflict the majority of PS survivors, and may only affect a small minority.  But considering PS affects between 2 and 5 in every 1,000 babies, that is still a lot of people!  I have on file hundreds of stories just from those who have told something of their story on Facebook’s several PS Group pages – and elsewhere!  There are several other social forum sites carrying the stories of worried or unhappy PSers.

The pattern is typically like this:

  • The “survivors” endure some years of increasingly nagging (though not mortal) discomfort, pain and frustration with real but unidentified gastric and/or other abdominal symptoms (tightness, pain, bloating, irritable bowels, dietary misbehaviour, vomiting, etc.
  • Their doctors seem loathe to acknowledge these symptoms, giving their patients medication or dietary advice.
  • There is outright rejection of PS possibly having long-term consequences – the high acidity of PS, damage to the gastric passage and even the lungs (from ingested vomit), post-surgical adhesions, and trauma after old-style infant surgery and hospitalization are just some of the hazards which should be considered.  All of these possible conditions have been documented and reported in medical literature.
  • It seems that often the “survivor” discovers the link between their malady and their PS past only when they stumble onto an online forum where they find they are not alone.

Sadly, because PS-related problems are low on the medical world’s radar for several reasons, there is virtually no interest in researching them.  Hence the medical juggernaut rolls on in rejection and ignorance.  However, there have been a few small studies and (from what I have found) just one very large study that have confirmed that infant PS is not always free of long-term consequences.

If the reader is interested to trawl through enough pages of stories on this blog and on the screens of the largest three of Facebook’s PS Groups, they will also find reports that several GI specialists have (usually after many, many consultations) admitted to a connection, agreed on tests, and arrived at better advice treatment.

In 2014 a pediatric surgeon friend and I published a small book, in which he explained what many still regard as the elusive cause of PS and I outlined my personal experience of this condition.

Pain01Lay reading of medical journals and even a basic understanding of how our gut and PS work tell us there certainly can be a link.  More specifically, the high acid that causes PS continues with the patient, raising the risk of related issues including reflux, irritable bowels, esophageal damage, and gastric ulcers and cancer.  Reduced gastric emptying could well be caused by damage to the vagus nerve or adhesions from the operation constricting the working of the stomach and gall bladder, whilst the throat / voice problems are likely caused by erosion / scarring of the esophagus caused by reflux, high acid, or lack of care with the breathing tube during surgery.

Of course anyone with any such symptoms would need a proper diagnosis but it’s not hard for even lay people to understand the links.  With countless numbers from my Facebook networks, I plead with the medical profession, parents, patients and the family and friends of PS survivors to recognise and help spread the awareness of this quite common condition and its possible ramifications.

And if what you the reader has learnt here “rings a bell” … I sincerely hope that you have been greatly encouraged to pursue your problem and get it sorted out.

Networking after pyloric stenosis (2): blockages and pain

The previous post looked at some of the benefits of the internet age enabling us to network with people worldwide about issues of common interest.  I gave links to some of the websites I have found very useful for people with infant pyloric stenosis (“PS”), whether they be parents or survivors now in their adult years.

This post starts a series in which we listen to what people from all over have shared about the hassles they have experienced before and more often after PS surgery.  True, we can be grateful that the problems mentioned seem to occur to only a minority, and there is probably a “silent majority” who find they can easily put their PS nightmare behind them and “move on”, never or hardly ever thinking about it again.

However, that does not make the problems about which so many take the trouble to write any less real and troublesome.  The medical world’s ignorance about PS is widespread and reprehensible, as the many online forums and this blog have often demonstrated and stated – but in 17 years of following this subject area I have never yet seen a single research report on the frequent and serious grievances about shoddy diagnosis of this rather common condition!

The fact that ongoing problems occur as often as they do after PS flies in the face of the bland assurance of too many of those doctors who know anything much about PS: the common mantra is that “PS is quickly and easily fixed, with only rare post-operative problems and no long-term hazards”.  Ahem, what was that again?

Adhesions can form without an obvious cause, but usually result from damage to tissue and organs caused by surgery, such as those shown in this diagram caused by an appendectomy.

Adhesions can form without an obvious cause, but usually result from damage to tissue and organs caused by surgery, such as those shown in this diagram caused by an appendectomy.

In this and the following posts I pass on some of the comments from six PS survivor networks on Facebook.  This selection of comments is about adhesions and related conditions following PS surgery.  This blog has devoted several posts to the post-operative adhesions which can cause bowel blockages and pain: readers can find these posts by using the Categories box near the top right of this page.

KD was born in 1949 and wrote:
I am a 64 year old survivor.  Have over the past 2 years had a lot of problems with partial small bowel obstructions that are apparently caused by adhesions very probably from my PS surgery all those years ago.  I am also lactose intolerant and have IBS, and often have pains at the top of my scar!  I have bowel adhesions caused by scar tissue my surgeons say from that P S op all those years ago… in between i am ok, plus years of having pain at the scar site,
Electric Heating pads, hot baths and lots of either swimming or exercise are really good to keep things moving.  Strong pain killers are a whole other issue, and you have problems from them too, so I try and avoid them but sometimes u have to.  Every time you have abdominal surgery you run the risks of more adhesions so be careful about that too.  I get small bowel obstructions with my scar tissue, not nice.
I had it done at 12 weeks.  Huge vertical with big dots horizontally…  It is amazing to see how far surgery has advanced.  Have been embarrassed by my scar all my life and never wore a bikini.  I have suffered so many digestive problems.
now I have partial bowel obstructions caused by adhesions which surgeons say probably came from my ps op all those years ago, as I haven’t had any other abdo surgery.  I still feel pain at the top of the scar from time to time.  Weird!!

TF, 1977
I had surgery for this in 1977.  I have a ton of scar tissue and adhesions everywhere because of it.  Also my small intestines are stuck to my abdominal wall because of all this.  Been painful for the last year, so I’m going to have to have surgery soon to fix all this.  Just have been going through all the tests to be sure that is the problem and ruling anything else out.

LH, 1980
I have an almost 5 inch scar that has is bulky and is such a mass that it has attached itself to my diaphragm.  I am going to a general surgeon in a couple of weeks to get it checked out and possibly reduced a bit.
I was just diagnosed anemic and put on iron pills after lots of testing and a colonoscopy.  It’s great to know that the iron might be a part of the ps stuff.
Mine bothers me when I exercise because I breathe heavily, so my diaphragm moves a lot then it stretches the scar tissue and tears.  Once I have been exercising for a while as long as I keep it up regularly it doesn’t shrink again and I’m good.  But if I stop it shrinks and hurts like hell when I start up exercising again.
How do I know it’s attached?  I was just told by a doctor years ago… I explained the pain and after an ultrasound they confirmed it.

JM, 1986
I get bad pains like a stitch but worse.

PM, 1969
I am having some tenderness at the surgery site and acid issues.  Wondering about scar tissue?  Just had an endoscopy to try and figure things out.  Anyone else have issues many years later?

AB, 1992
I have acid reflux and gastritis as well, they are side effects from the surgery.
I had PS as well and surgery when I was a month old.  I’ve always had pain with my scar too.  It gets hard at time and sinks in very nasty.  I’ve had ultrasound scans, even cat scans, mri scans and xrays.  My doctor told me that my scar didn’t heal properly internally and as a result I have scar fibers extending to my ribs and even to my liver.  All the doctors say that I have nothing to worry about because in time they will tear on their own.
I have a hard time bouncing back [after a stomach bug attack].  Leaves me weak for weeks… sometimes months.  My doctor says it’s because my stomach went through such a major change when I was a baby.

RR, 1987
I had pyloric stenosis surgery at 10 days old.  I went to the E.R yesterday because I was having bad pain in my rib / back like someone had punched me a few times.  I was given an ultrasound scan but nothing was found.  I was told it could be a muscle strain or scar tissue issue from my surgery… Never did I think of my surgery from that long ago: I had always overlooked it.

Next time:  poor diagnostic work

Pyloric stenosis can leave post-op problems

If you are the parent of a pyloric stenosis (“PS”) baby you were probably assured that the surgery to remedy this ugly condition is quick, simple and effective, and that the surgery would not leave your baby with any long-term problems.

babies many1Many of us who have had that surgery might agree, at least on a personal basis: PS affects about 4 in every 1,000 in the countries where this blog is read, and let’s face it, if there are millions of PS survivors who have significant ongoing health or wellbeing problems, we’d all know about it!

Nowadays, many websites that give information about PS are more careful in the assurances they give: typically they tell us, Almost all babies who have this operation recover well, and, pyloromyotomy is a successful operation and there are usually no long-term consequences, other than an incision scar. (from the BUPA health insurance site; underlining mine)

So what can go wrong as a result of the surgery, immediately and in later life?

I have already posted about the several parts of the answer to this big question, and my September 2011 post is one of the most read at this blogsite.  Please use the Categories search box to find what you are after.

Here I want to give a brief overview of this subject, with links to some of the more detailed informative posts at this site.

Complications from the surgery

Problems resulting from the actual surgery are a well-known risk, and every surgeon and anesthetist will run through a list of warnings about this with the baby’s parent(s).

  • The anesthetic is probably the most feared risk area but today it very rarely causes major problems or takes a life, although it seems minor problems are fairly common.  Anesthetising a baby is a very special and exacting skill.  Other fairly common warnings on the list of complications are –
  • A breach of the inner lining of the pyloric passage during surgery (when it is immediately repaired); when very sometimes it is unnoticed during the surgery, it is a very serious matter.
  • Incomplete pyloromyotomy also occurs in a small percentage of surgeries: the enlarged muscle is insufficiently cut or can regrow which usually means a second operation.
  • Infection and bleeding in the wound are an ever-present danger, much reduced from the past, but still a hazard.
  • Wound rupture and hernia formation were more common when surgeons worked (as too many still do) through an incision in delicate baby tissue that was already weakened by malnutrition.  The result is more hospital care and usually more disfiguring scarring.

Disturbance of gastric function – infancy

Unhappy and vengeful bowels are an understandable and very common result of fiddling with a baby’s internal body system.  It can take the form of continued (but not life-threatening) vomiting, reflux or GERD (gastro-esophageal reflux disease), irritable or unstable bowels, and unusually fast or slow metabolism (food processing).

1946-01 FLVLike many babies after a pyloromyotomy, I was insatiable and a picture of health a few months later – hardly a problem unless it develops to obesity as some find to their distress.  Other survivors become fussy eaters which is far more trying for concerned parents.

Several small studies have shown that gastric function is indeed affected by PS surgery, but that this troubles only a small percentage to a significant degree.  It is something most doctors don’t want to hear about – it is hard to diagnose the cause and therefore to treat.

Disturbance of gastric function – adulthood

As already mentioned, these effects can and all-too-often do continue into adult life.  In adulthood it becomes even harder to link these problems with infant surgery, and also to recognize their cause and treat them.

But “anecdotally” I note (from 17 years of reading people’s stories via the internet) that there seem to be a great number of people who report abdominal problems after infant PS surgery, many of them able to trace their problems right through their years.  The percentage of PS survivors affected may be relatively small, but this is still a huge number of very troubled people.  I only wish I could let you read some of their accounts, but most are freely available to read on Facebook and web forum sites.

Adhesions are a related but distinct subject with which I dealt (again) in my previous post.  Adhesions are usually (but not always) recognized only in adulthood, but unlike most other gastric problems they are easily linked with infant or later abdominal surgery.

PPTSD, psychology and emotions

The way in which conditions of infancy such as PS were dealt with until fairly recent years has scarred many who only now are recognizing and speaking up about this.

This is arguably a “sleeping issue”: the long-term effects of doing surgery on infants under age 2 years without the necessary pain management and involving lengthy periods of maternal separation is still incalculable.  Who can tell how much of today’s anger, violence, depression and dysfunction in public and private life is caused by subconscious and unrecognised memories and undiagnosed traumatic stress disorder?  We all know how unresolved stress can affect repatriated military personnel but discount or ignore how countless babies may have been affected in their later years by crude surgical and hospital processes.

Most medical doctors decline engaging with this subject, but the links on the right of this blog reflect only some of (1) those who report long-term problems after PS surgery, and (2) the well-informed and reputable psychologists and therapists who have recognized and begun to work in this area in recent years. The 2 pages of personal reports and discussion on one of the Patient UK forums are a good place to start; I have often thought it useful to contribute to this and similar sites.

It was my growing understanding of psychology and our inner self that has motivated me to read and write here – and several others elsewhere.

Pyloric stenosis and chronic abdominal pain

This past week another medical report appeared on my screen about surgery for infant pyloric stenosis (PS) possibly having long-term effects.

kid stomach pain3So many of those affected by PS, either themselves or in a child, have to put up with their doctors’ constant denials of this possibility or they hear false and self-serving assurances that PS and its surgical treatment have no after effects.  It is heartening therefore that at long last there seems to be a fairly steady trickle (and sorry, that’s all it is) of research reports on this subject, all of which affirm that, yes, there can indeed be ongoing consequences.  Most of these studies are small and narrowly focussed, but at least they speak with one voice.

How valuable would it be for parents and the medical community too if some medical researchers gathered and published the statistics on (say) the long-term effects of operating on PS babies compared with treating suitable cases medically and/or on a “watch and wait” basis!  I’m afraid there is a deafening silence on this: I have not seen even one such study in all my reading which covers all that I can access of a century of medical writing about PS.

Yet this must be an area in which surely all parents of PS babies would dearly love to have some answers before they sign for a surgical “fix” which they fear and loathe but which is almost always presented as the only available course.

But almost always it is not.  Only about 20% of PS babies are diagnosed before 3 weeks of age, and especially after this age it is usually safe and effective (in about 80% of cases) to try medical therapy and to regard surgery as a last resort.  But the medical world loves PS surgery: it strokes the surgeon’s ego, hospitals want to get patients off and away as soon as possible, and the medical industry is understandably petrified of not following “best practice” as defined by “what we’ve always been taught and done”.

The 2011-written article that was posted on-line this week (but only in Abstract) comes from two Chicago researchers (S Bonilla and M Saps) and bears a long but very clear title: Early Life Events: Infants with Pyloric Stenosis Have a Higher Risk of Developing Chronic Abdominal Pain in Childhood.  Do click on the Abstract: it is well worth reading.  This study is from the same people as the Mexican study I reviewed in a post almost 3 months ago.

Pain01Several things are worth highlighting –

  • This study is large enough to be significant.  Some statistical reports I have read are based on a very small number of subjects, but 100 people with a PS background and compared with 91 controls is a solid sample.  The results are also very clear and thus significant.
  • I was interested that the writers had already “hypothesized” that PS surgery would have long-term effects and the results of their work showed this to be so convincingly.  In the light of this I would be most interested to understand why so many pediatric specialists are still reported as spruiking the fable that PS babies can forget about trouble after their surgery.
  • Also telling is the claim that We have described a new model to study early life events in infants.  The writers mention that PS and its surgical treatment include risk factors which may well result in continuing abdominal and gastric problems.  The internet has much angst and many complaints about this, and this blog has quoted and discussed this subject several times.  The researchers state that they must underscore[s] the importance of early life events in the development of chronic abdominal pain in children.

I am very pleased that the link between PS, infant abdominal surgery and functional gastrointestinal disorders (FGIDs) has been established beyond reasonable doubt, both by academic work and personal experience.  This will be reassuring for many who suffer with various abdominal complaints, and will I trust make doctors more sympathetic, even if effective remedies and treatment are still elusive.

Sadly, there is a continuing silence in the medical community about the link between the infant surgery as it was often done 30 and more years ago and post-traumatic stress disorder (PTSD).  There is just as much reason to hypothesize about that linkage.  Wouldn’t it be honest and healing to look into that subject?

When infant surgery causes ongoing trouble (2) – the gut

The previous post looked at how different people have found relief from the trauma or PTSD that may be an ongoing problem after early abdominal surgery they had.  We look here at another group whose infant surgery for conditions including pyloric stenosis (“PS”) gives them a lot of grief.

Several of the online forums (such as Facebook, MedHelp, Patient UK and Topix) have a “page” for those of us who had abdominal surgery in infancy.  Anyone who checks out these forum pages will be struck by the fact that gut or gastro-intestinal (“GI”) problems are all-too-common among us “survivors”, and that most doctors have very little time for these complaints.

constipationThis kind of GI disorder carries the acronym FGID, or Functional Gastro-Intestinal Disorder.  (“Functional” implies that this kind of disease is not organic (caused by a physical disorder or malfunction) but nevertheless real (affecting the body’s functioning).  Googling for either will yield a long list of useful material.

In a previous post I wrote about this at some length.  Here I want to revisit the subject more briefly, not repeating what I wrote in the earlier article but hopefully shedding some added light.

What kind of GI disorders do people report after infant surgery?

  • GERD – gastro-esophageal reflux disease and RSD – Reflex Sympathetic Dystrophy (including painful, distasteful and/or smelly burps)
  • Nausea after eating
  • Bloating (feeling full)
  • “Dumping Syndrome” – pyloric muscle sometimes stays open when it should not
  • Continued vomiting (intermittent or after certain foods or situations or in stress) or gag reflex
  • Phobia at vomiting
  • Inability to to burp or vomit, often causing discomfort
  • Muscle twitches, spasm or stabbing pain in the scar region and stabbing or tearing sensation during exercise (Chronic Regional Pain Syndrome) – may be intermittent and/or sometimes intense
  • Confused “on-off” switch – to quote one sufferer: “for both hungry and full, can go days without feeling hungry, and have puked from eating too much, yet still felt hungry afterward”
  • Food intolerances
  • Difficulty gaining or losing weight
  • Irregular bowel movements

The list is not short!  It will be clear that some of these symptoms are not hard to relate to the actual surgery or the condition that led to the surgery.

What kind of remedies (if any) are offered?

As this blog has often mentioned, many GPs and MDs shrug off these complaints and frustrate their patients by not engaging with them or their complaint.  They are not able (or willing) to take the time and trouble to help.

belly pain1From the web I have gleaned some “diagnoses” and suggestions about how to find help –

1                    There may be an interaction of physical and emotional responses here, perhaps to the infant surgery and perhaps to other related or more recent triggers or circumstances.  In other words, these symptoms may be psycho-somatic: real but not caused by a malfunction in the body alone.  A short presentation I found helpful is FGID Information – click on the link to look it up!

2                    Lactose intolerance, a GI disease such as Crohn’s, and/or an allergy to gluten are another area of possibility.  Diagnostic tests are necessary to establish this.

3                    Antispasmodic drug may be effective in reducing twitches and scar pain.

4                    Many items of the list of symptoms can also be caused by adhesions.  To learn more about this very common and sometimes very troublesome result of infant surgery Google for this word or click on it in the “Categories” or “Search” boxes on the right of this screen.

OLYMPUS DIGITAL CAMERA5                    When children complain of the above symptoms, parents must monitor their weight gain and physical growth, and if this is impaired (static or falling) for any length of time, medical advice and possibly treatment for ‘growth impairment’ (idiopathic, “from unknown causes”) must be sought.  Pyloric stenosis (“PS”) often causes dehydration and malnutrition in babies too young to weather their effects, and studies have noted lasting damage to the developing brain.  Similar life-affecting mental, physical, learning and social damage can be caused by the inadequate intake of nutrition while the child is growing up.

This post underlines what I have so often stated here: that infant surgery for conditions such as PS is certainly not without all-too-frequent long-term effects.  The complaints discussed here are not only distressing for most sufferers – but would frequently have been avoidable also.

Medical treatment alternatives should almost always be investigated, and in the case of infant PS used far, far, far more often than it is in “Western” countries.

In my next post I plan to explore some more the trauma (PTSD) that can can result from pre-1990s infant surgery.   While PTSD is not as commonly reported as FGID it is just as distressing and troubling, and is another powerful argument why surgery for infant PS should even today be avoided if possible.

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.