Adult Pyloric Stenosis

Infant pyloric stenosis (“PS”) is not well-known in the general community.  Even fewer (in fact, far less) people know anything about the adult form of 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. And the symptoms are in general the same: vomiting that is often severe and possibly (especially in infants) life-threatening.

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.

belly-ache-02Adult 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 and thicken the stomach and pylorus, ultimately narrowing and blocking the stomach outlet.  These ulcers can also give rise to cancer.

The 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, whether in its infant or adult form, is also the same: the narrowing of the stomach’s exit ring muscle, causing vomiting and starvation.

Diagr Stomach ulcers1.jpegThe 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 narrowing or blockage occurs inside the pylorus or at the antrum, the tapered (narrowing) part of the stomach closest to the pylorus.

Adult PSers suffer from a range of symptoms including vomiting, reflux, lack of appetite, and inability to maintain body weight.  Their general practice doctors and GI specialists will recommend and try various treatments, starting with drugs and repeated stretching to widen the pylorus, and all-too-often continuing to one or more of a short list of surgical remedies, all of which are more severe and often less effective than the pyloromyotomy which is the usual surgery of choice for infants.

Doctor worried01Unhappily adult PS is more complex in its causes, symptoms, and available treatments.  And all the treatment options are far from assured of success and may have unwanted and significant physical side-effects, far more often so than the great majority of infant PS survivors report.

However, infant PSers also run a risk of a list of abdominal and other 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 not-too-distant past.

For readers who use Facebook, I can recommend its “closed” Pyloric Stenosis Support Group which includes at least 30 members who have experienced and have posted (in great variety) about their adult form of PS.  (A “closed” Facebook Group can be found but not be opened and read by non-Group members.)

Interested readers are also invited to email the undersigned (via the Contact tab at the top of the screen) for a sheet of adult PSers’ various posts reporting on their experience with adult PS and its treatment.

– Fred Vanderbom

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Author: Fred Vanderbom

A stable upbringing in a Christian home, a long and happy marriage and family life, a lifetime of productive and steady work in close touch with many people - and with the God our world can know through Jesus Christ, many good and shaping experiences - I believe I've been very privileged. By some blogging and other work in retirement I am enjoying being able to offer some of what I've learnt for those interested. Your comments are always welcome.

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