Pyloric Stenosis Advice for Parents & Carers

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1 Pyloric Stenosis Advice for Parents & Carers Children s Services The aim of this leaflet is to provide you as carers or parents all the relevant information regarding Pyloric Stenosis and answer some common concerns and questions.

2 What is Pyloric Stenosis? Pyloric Stenosis is a condition which causes forceful or projectile vomiting in babies. It is present from birth but by the time the vomiting becomes projectile most babies are around 6 weeks old. It is more common in boys than girls. What causes it? When babies feed the milk goes down the food pipe (oesophagus) into the stomach, where it is digested. Once digested the milk empties into the bowels through a muscle called the Pyloric Sphincter. In Pyloric Stenosis the muscle is thickened, making the exit narrow and therefore making it difficult for milk to pass through. Pipe (Oesophagus) Thickening Muscle To the bowels Stomach Why does vomiting occur? Vomiting occurs because the stomach tries to force milk through the narrowed exit into the bowels. As it has only a small space to go through the milk comes back up the food pipe and the baby is sick, this usually happens straight after a feed. Over time the stomach becomes more muscular trying to force milk through, this results in the vomiting changing gradually from small vomits or possits to large projectile vomits which can shoot 2-4 feet away, by the time the baby is about 6 weeks old. What are the symptoms? Symptoms at first may include only small vomits after a few feeds, which progress to more frequent vomits of a larger volume and becoming more forceful as your baby reaches about 6 weeks old. As the vomits become more forceful you may find your baby is hungry after vomiting as most of the feed is brought back, and due to the amount of vomiting your baby may not put on weight or may lose weight. You may also find your baby s bowel habits change in that the stools may reduce in size and frequency, and your baby may appear constipated, this is due to the lack of milk passing through your baby s bowel. 2 3

3 How is a Diagnosis Made? The doctors will consider a Pyloric Stenosis based on your baby s symptoms. Once Pyloric Stenosis is considered more tests are required to confirm the diagnosis. A senior doctor will usually perform a test feed. This means feeling your baby s tummy for the enlarged muscle, which is best done when your baby is feeding. As this muscle is not always easy to feel other tests may be necessary such as an ultrasound scan of your baby s tummy, and some blood tests. What is the treatment? The treatment for Pyloric Stenosis is an operation to cut through the thickening muscle to widen the exit from the stomach to the bowel. This operation will cure the problem and most babies recover very quickly. Once your baby has fully recovered, no further intervention should be necessary. Current national guidelines recommend that babies needing any operation should have it in a specialist centre and should be cared for by a Paediatric Surgeon and an Anaesthetist. For this reason your baby will be transferred to a specialist centre for his/her operation, this will usually be Sheffield Children s Hospital. We will arrange transport in an ambulance for your baby and one parent/carer (due to lack of room in the ambulance). Hospital accommodation for parents can usually be arranged with the staff in Sheffield when you arrive. What care is needed before the operation? Dehydration is a common problem for babies with Pyloric Stenosis due to the prolonged and forceful vomiting. The doctors will assess if your baby is dehydrated by his/her condition and the blood tests. When your baby has his/her blood test the doctors will insert a small plastic tube into his/her vein called a cannula, this will enable a drip to be attached and intravenous fluids given to your baby to correct any dehydration. If your baby is dehydrated then it is important this is corrected before the operation is performed and as the operation is not an emergency then it is much safer to wait until your baby s condition is stabilised. The delay will usually be no more than 1-2 days. Once Pyloric Stenosis is confirmed feeds by mouth will usually be stopped to prevent any further vomiting. For the same reason a tube called a naso-gastric tube may also be inserted into your baby s stomach through their nose to drain off any milk left in the stomach, this will help to prepare your baby for surgery. If you are breastfeeding please ask your baby s nurse about facilities for expressing your milk, so you may continue breastfeeding once your baby has recovered. 4 5

4 What happens after the operation? As your baby will be having surgery in Sheffield Children s Hospital, information about the operation and the care he/ she will receive after the operation will be explained by the staff there. However the length of stay is usually only a few days and your baby will usually be discharged home directly from Sheffield. Benefits of having the operation? Once your baby has recovered from the operation and is feeding again normally the vomiting should settle and he/ she should start putting on weight again and make a full recovery. Risks As with any procedure where your baby is given a general anaesthetic, there are risks. However these will be fully explained to you fully prior to the operation. Please do not hesitate to ask any questions if you are unsure of the information provided to you. Alternatives If the condition is left it may eventually resolve by itself but this may take a few months and in the interim the baby can lose much weight and may become seriously ill due to changes in the salt levels. Leaving the condition to resolve by itself is not common practice and surgery is the preferred treatment. Please discuss with a member of medical or nursing team if you require further information regarding this. Contact details If you require any further information or have any questions please see your baby s nurse or doctor, who will be happy to help you. Concerns and queries If you have any concerns/queries about any of the services offered by the Trust, in the first instance, please speak to the person providing the care. For Diana, Princess of Wales Hospital Service (PALS) on or at the PALS office which is situated near the main entrance. For Scunthorpe General Hospital Service (PALS) on or at the PALS office which is situated on C Floor. For Goole and District Hospital Service (PALS) on (01724)

5 Northern Lincolnshire & Goole Hospitals NHS Foundation Trust Diana Princess of Wales Hospital Scartho Road, Grimsby DN33 2BA Tel: Scunthorpe General Hospital Cliff Gardens, Scunthorpe DN15 7BH Tel: Goole & District Hospital Woodland Avenue, Goole DN14 6RX Issue Date: December 2009 Review Date: September 2012 Author: Children s Services NLG-FT 2009 IFP 534