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The sphincter located at the outlet of the stomach is called the pylorus. This muscle acts as a separator between the duodenum and the stomach. The acidic contents of the stomach enter the intestines gradually, this “graduality” is regulated by the pylorus of the stomach.

There are cases when the function of a particular organ is disrupted. Due to a neuromuscular disorder, the area of ​​the pylorus muscle is also impaired. It begins to shrink, which leads to digestive problems. This disorder is called pylorospasm. The spasm that occurs in the pit of the stomach is very unpleasant, sometimes comparable to acute colic. The disease occurs most often in children, especially newborns. But sometimes adults are not spared either.

How to detect pylorospasm in newborns?

The first thing you should pay attention to is that the baby spits up a lot. This happens after every meal, regurgitation is abundant, but not more than the amount eaten. At first, the child is outwardly a little irritated, because such spasms are very unpleasant, then he suffers from sleep disturbances, constipation begins, and the baby does not gain weight well.

The symptoms of the disorder are not extensive. It can scare many mothers, especially young ones, because all babies spit up. Both those that are bottle-fed and those that eat breast milk. There is no need to run to the doctor after every such case. Only when regurgitating in the volume of food taken, which is possible even after for a long time Afterwards, you should consult a doctor. Similar cases do not occur on empty space. The most common reasons– difficult childbirth and oligohydramnios during pregnancy.

If a doctor suspects a pyloric disorder, he will either need to refer you for an x-ray or directly to a gastroenterologist. With adults, everything is simpler: they swallow a light bulb (endoscopic examination) and the part of the stomach whose function is impaired is visible on the screen. It's more difficult with children. But diagnosis is a common thing for an experienced doctor. Before the x-ray examination, the child must be hungry. Immediately before the procedure, he receives food with barium suspension. Next, an x-ray is taken.

Pylorospasm is a gastroenterological disease that can be either primary or secondary. It is characterized by the fact that, due to certain etiological factors, a spastic contraction of the abdominal muscles begins in the pyloric region of the stomach. As a result of this, the digestion process is disrupted with all the ensuing consequences.

This disease has no clear restrictions regarding age and gender. However, clinicians note that most often this pathology of the gastrointestinal tract is diagnosed in newborns. If therapeutic measures are not started in a timely manner, pylorospasm in newborns leads to the formation of a functional stomach disorder.

Treatment of pylorospasm in adults and children is carried out using conservative methods, with mandatory adherence to a special diet. If medical measures are started in a timely manner, complications can be avoided.

According to the International Classification of Diseases, Tenth Revision, this disease refers to diseases of the digestive organ. ICD-10 code – K 31.3.

Etiology

Pylorospasm in adults or infants can be of both primary and secondary forms.

The primary etiological factors of this disease include:

• malfunctions nervous system;
• disruptions in the functioning of the autonomic nervous system;
• physical or mental fatigue;
• insufficient amount of vitamin B in the body;
• poisoning with morphine or nicotine.

Secondary etiological factors for the development of pylorospasm in children and adults include:

• with high acidity;
• ulcerative lesions of the gastrointestinal tract;
• adhesive process;
• pyloroduodenitis;
• pathological processes in the biliary tract;
• inflammatory processes in the pelvic area (most often this etiological factor is inherent in women).

In addition, the etiology of such a gastroenterological disease can be any other chronic pathological process in the gastrointestinal tract, which is accompanied by severe pain and spasms during an exacerbation.

Classification

Based on the nature of the etiology, the following are distinguished:

• primary;
• secondary pylorospasm.

According to the nature of the lesion, they distinguish following forms illness:

• absolute – complete covering of the hole with muscles;
• relative - a small hole remains for food to pass through.

The stages of development of the disease are distinguished separately:

• compensated - food passes through the pyloric space;
• uncompensated - the passage of food becomes impossible, which leads to its stagnation and the development of corresponding gastroenterological diseases.

Symptoms

Although clinical picture This disease is unambiguous; independently comparing symptoms and treatment is strongly not recommended, as this can lead to quite serious complications.

In general, the clinical signs of this disease in children and adults are characterized as follows:

• attacks of colicky pain;
• strong spasms are observed in the epigastric region, which is specific sign for this disease;
• , against the background of which there is a sharp weight loss;
• nausea with, which most often brings relief;
• weakness;
• vomit may have a sharp, unpleasant putrefactive odor;
• unpleasant ;
• with the smell of rot, which will indicate stagnation of food in the stomach;
• stool may contain undigested food particles.

It should be noted that the presence of the last three clinical signs may indicate that pyloric stenosis is developing.

Pylorospasm in infants may appear as follows:

• refusal of food;
• constant crying;
• violation of the frequency of bowel movements;

Regardless of how intense the clinical picture is, you should consult a doctor for advice and further treatment.

Diagnostics

Diagnostics and treatment are two interrelated concepts - without carrying out the first, it is impossible to carry out the second correctly. Therefore, first of all, a physical examination of the patient is carried out, with the collection of a general history, clarification of the current clinical picture and lifestyle in general.

To make an accurate diagnosis, the doctor may prescribe the following diagnostic procedures:

• X-ray examination of the stomach with a contrast agent;
• endoscopic examination.

In most cases, laboratory tests are not prescribed, since in this case they are of no diagnostic value. IN in some cases may test stool for occult blood.

Since the clinical picture in some symptoms is similar to other gastroenterological diseases, differential diagnosis may be required. Pylorospasm must be differentiated from the following pathologies of the gastrointestinal tract:

Based on the results of the examination and taking into account the data collected during the initial examination, the doctor determines the exact diagnosis and prescribes a course of therapy.

Treatment

In most cases, treatment of pylorospasm is carried out with conservative treatment methods, which include:

• compliance special diet which implies the exclusion of coarse fiber, spicy and fatty foods;
• bed rest;
• special breathing exercises and physical therapy exercises;
• taking medications that relieve acute symptoms.

As for medications, the doctor may prescribe:

• antispasmodics;
• muscle relaxants;
• sedatives.

In general, provided that treatment is started in a timely manner and all doctor’s instructions are followed in full, complications or relapse of the disease are completely excluded.

If untreated, pylorospasm turns into pyloric stenosis, which is an irreversible pathological process and can only be treated surgically.

Similar materials

Esophageal diverticula are a pathological process that is characterized by deformation of the esophageal wall and protrusion of all its layers in the form of a pouch toward the mediastinum. IN medical literature Esophageal diverticulum also has another name - esophageal diverticulum. In gastroenterology, this particular localization of saccular protrusion accounts for about forty percent of cases. Most often, the pathology is diagnosed in males who have crossed the fifty-year mark. But it is also worth noting that usually such individuals have one or more predisposing factors - gastric ulcer, cholecystitis and others. ICD 10 code – acquired type K22.5, esophageal diverticulum – Q39.6.

Achalasia cardia is a chronic disorder of the esophagus, which is characterized by impaired swallowing. At this moment, relaxation of the lower sphincter is observed. As a result of such a disorder, food particles accumulate directly in the esophagus, causing an expansion of the upper parts of this organ. This disorder is quite common. It affects both sexes almost equally. In addition, cases of detection of the disease in children have been recorded. IN international classification diseases - ICD 10, such pathology has its own code - K 22.0.

Pylorospasm in infants is a pathological spasm of the pylorus of the stomach. This condition appears some time after birth and occurs more often in boys. Food processed in the stomach cannot move further into the upper intestinal sections. As a result, a disturbance in the functioning of the stomach develops. The spasm affects the pyloric (pyloric) part of the stomach, so the pathology is called pyloric spasm.

The causes of the disease are not fully understood by medicine.

It is believed that several factors influence pylorospasm in newborns:

• oxygen deficiency during fetal development;
• injuries during childbirth;
• insufficient production of gastric secretions;
• low amount of gastrointestinal hormones;
• congenital malformations of the stomach;
• allergies to food components;
• lack of B vitamins and minerals;
• maternal infections during pregnancy.

The main sign of pathology is excessive regurgitation after eating. The vomit has a cheesy appearance. Vomiting may be in the form of a fountain. Moreover, the vomit exceeds the volume of food eaten.

The baby is gaining little weight and sleeping poorly. Constipation occurs. The baby's condition becomes dangerous due to exhaustion.

Pylorospasm in children can also be suspected by frequent constipation, scanty urination, and bloody streaks in the vomit.

If pylorospasm affects older children, they complain of abdominal pain, pain in the side, and have decreased appetite.

Pathology is divided into primary and secondary forms depending on the period of occurrence. Primary pylorospasm is typical for infants in the first time after birth.

Secondary pylorospasm in children develops much later against the background of other diseases:

• inflammation of the gastric mucosa;
• peptic ulcer;
• polyps;
• inflammation of the duodenum;
• Crohn's disease;
• cholecystitis;
• adhesions after operations.

The danger of pylorospasm lies in the fact that food remaining in the stomach undergoes rotting and causes general poisoning of the body.

Diagnosis of pylorospasm in children

Frequent vomiting requires seeing a doctor, since the symptom can be a sign of many other pathologies, including more serious ones than pylorospasm.

Causes of vomiting can be:

• overfeeding;
• increased gas formation;
• congenital structure of the esophagus;
• achalasia - a neuromuscular disorder of the esophagus;
• esophageal stenosis;
• atresia;
• intestinal obstruction.

To identify the disease, it is necessary to show the child to a gastroenterologist. Usually in infants, primary pylorospasm is detected in the form of swelling in the gastric area. With the help of palpation, a round formation is felt near the liver. This is the gatekeeper in a state of spasm.

The doctor asks the parents if there are bowel movements, what is the frequency and volume of vomiting, and how the child behaves.

The diagnosis is confirmed by magnetic resonance imaging or computed tomography, as well as fiberoscopy. X-rays show retention of stomach contents by coloring mixtures added to food. Ultrasound examinations of the stomach are used less frequently.

Only after diagnostic measures can the doctor prescribe appropriate treatment.

Treatment for pylorospasm

To treat the pathology, the child is placed in a hospital. If his condition is stable, antispasmodics and muscle relaxants are prescribed, as well as B vitamins and sedatives. A special diet is prescribed.

The following therapeutic measures are indicated for newborns:

1. Alkaline mineral water in the amount of two spoons before eating.
2. Frequent feeding in small portions.
3. Attachment to the breast on demand if the baby is fed mother's milk. For children on artificial nutrition, mixtures with thickeners are prescribed.
4. After eating, the baby should be held upright for 15 minutes.
5. Place it on your stomach more often.

Medications that help:

• antispasmodics;
• H-1-histamine blockers;
• sedatives;
• muscle relaxants;
• vitamin B complexes.

Medicines may also be prescribed to normalize intestinal flora and water-alkaline balance.

Timely treatment and diet completely eliminate the pathology.

Prevention of pathology

It is necessary to take care of preventing the disease even at the stage of pregnancy.

Advice for expectant mothers is simple:

1. Oxygen starvation of the fetus should be excluded.
2. The expectant mother needs to walk often and breathe clean air.
3. Yoga, walking, and water aerobics are useful.
4. Sometimes gynecologists prescribe antihypoxic drugs for preventive purposes.
5. Oxygen cocktails and herbal decoctions that improve blood circulation in organs and tissues are useful.

Babies should be fed small portions and placed on their stomach after meals. It is important not to insist on eating and not to overfeed the baby.

Children after one year should be fed warm pureed food. Baked goods and soda are not allowed. Salty and spicy dishes are excluded. A calm, friendly environment in the family is important, especially during feeding.

It is important to remember that an advanced disease can develop into pyloric stenosis - organic damage to the pylorus muscles - and require surgical intervention.

Pylorospasm light form usually goes away on its own as the child grows and his nervous system develops.

Regular regurgitation in babies in the first year of life usually does not cause panic among parents. If vomiting is frequent and accompanied by copious discharge, there is reason to suspect pyloric spasm in newborns.

Etiology of the disease: symptoms and diagnosis of pylorospasm in newborns

Pylorospasm in newborns is considered a temporary pathology. By the age of one year, babies’ digestive tract has completed its formation, so the symptoms disappear on their own. If the disease causes dehydration and other problems, it is worth getting treatment. Pylorospasm (not to be confused with pyloric stenosis) is accompanied by the following symptoms:

Such symptoms occur due to the incomplete formation of the pyloric part, which is the smallest component of the digestive system (sphincter or muscle ring that connects the stomach to the duodenum). This area prevents food from entering the intestines until it is completely digested in the stomach. If the muscles begin to contract, the contents of the stomach enter the esophagus and are expelled, causing vomiting.

If you observe such symptoms, you should not attempt to make a diagnosis yourself. Additionally, the doctor must prescribe tests: ultrasound of the intestine and contrast X-ray.

Note! Mandatory diagnostics include checking the completed formation of the nervous system. Having ruled out this pathology, other measures can be taken to make a diagnosis.

In such situations, it is advisable to carry out differential diagnosis, which will help distinguish pyloric spasm from pyloric stenosis in an infant.

Causes of pylorospasm in children of the neonatal period

Children say! My son (3 years 10 months) always asks for a brother or sister:
- You and dad were strangers, and then you became friends and you had me... Could you become friends again?

Experts have not yet identified with certainty why pylorospasm occurs in newborns. This phenomenon is associated with the following factors:

From the moment the provoking factor is identified, therapeutic therapy is prescribed.

Pylorospasm and pyloric stenosis: differential diagnosis and differences

Pylorospasm in newborns and pyloric stenosis are diseases that are connected only by the problem of the pylorus. Otherwise, the two pathologies differ.

General characteristics of pylorospasm in infants

Pathology of the gastrointestinal tract in a child under one year of age is manifested by copious regurgitation of undigested food in an amount less than that eaten. Vomiting begins within the first minutes after feeding. The baby is often capricious and does not gain weight well during the first month of life.

Pylorospasm in a newborn is detected by profuse regurgitation in the neonatal period

Distinct Features of Pyloric Stenosis

The first symptoms of the disease in the baby appear several weeks after birth. Vomiting can be characterized as copious discharge that exceeds the amount of milk consumed. The skin is pale, you can see numerous folds on it. The baby is dehydrated. Weight may increase or decrease.

Treatment method for pylorospasm in newborns

The treatment for pyloric spasm in newborns depends on the cause. Most often they are treated with medications, and sometimes surgery is used.

Children say! I’m showing a photo where Alina is one year old:
- Alina, who is this?
- Some bald lalya in my slippers!

Consequences and prevention

The disease can be prevented in newborns during pregnancy. You should avoid any contact with infection, monitor your health, and carefully follow your doctor’s recommendations.

After birth, the baby should not be overfed; lean toward a timed feeding schedule and choose the right formula. Make sure your child does not gain weight. Avoid emotional stress and stress, maintain a favorable environment in your home. Any symptoms of the disease should be stopped immediately, since early pylorospasm in infants is easier to treat. Otherwise, the baby will face dehydration, severe pain, hospital treatment, and possibly surgery.

The condition of the entire body depends on the functioning of our digestive system. It is especially important to understand useful substances in infancy, when the child is rapidly developing. During this period, belching is common, but in some children it occurs very often and is accompanied by vomiting. This condition may be a consequence of pylorospasm.

Pylorospasm in young children: newborns and infants

The pylorus is a muscular organ of the digestive system that constantly contracts, regardless of food intake. It is very sensitive to any disruptions in the rest of the stomach and intestines and reacts strongly to changes in the concentration of digestive juice.

Pylorospasm is a pathological condition in which strong spasmodic contractions of the gastric sphincter occur in the pyloric zone. Most often, this deviation is found in newborns and infants. Due to the spasm, a rapid contraction of the stomach occurs, which tries to overcome the spasmodic pylorus and push food into the intestine.

The sphincter is finally formed in children only by the age of three, and at first the lower parts of the esophagus are not fully developed and because of this, food can long time come out of the stomach. If treatment is not started on time, the disease can progress and become more severe. serious illness, called pyloric stenosis, in which children may develop a hernia of the diaphragm and spasms of the arms after eating.

Video about pylorospasm and pyloric stenosis

Causes

Deviations in the pyloric zone in infants begin to form in the womb due to deviations in the development of the nervous system of the gastrointestinal tract, which leads to narrowing and closure of the sphincter. Relaxing stimuli cease to reach the pyloric receptors in a timely manner.

On initial stages disease, food begins to move in the wrong direction, from the stomach to the esophagus. In newborns, pylorospasm is formed due to disturbances in the functioning of the autonomic system. This can especially often be a consequence of hypoxia suffered during childbirth.

Typically, the formation of the disease occurs due to the following reasons:

• genetic predisposition;
• infectious diseases in the mother;
• pyloric developmental disorders;
• lack of B vitamins;
• use of erythromycin in the first weeks of a child’s life.

Video from the Union of Pediatricians of Russia about the causes of regurgitation in infants

Forms of the disease

There are two forms of pylorospasm:

1. Compensated is a lighter variety. The sphincter muscles are significantly narrowed compared to normal, but food is still able to pass into the lower parts of the intestine. Easiest to treat.
2. Decompensated occurs when the gastric muscles are severely stretched, due to which food cannot enter the duodenum and an even greater expansion of the organ occurs. In this case, the sphincter muscles are tightly closed. Food cannot be fully digested, it stagnates and processes of rotting and decomposition begin to occur in the stomach. Patients exhibit all the signs of toxic poisoning of the body and vomit with a very unpleasant putrefactive odor.

Also, a spasm can be absolute, when the entire passage is closed, and relative, when a small hole remains through which food can pass.

Symptoms of the disease

In young children with pylorospasm, the following symptoms occur:

1. Frequent vomiting due to excessive accumulation of food in the stomach. As a result, this leads to dehydration of the body.
2. Loss of body weight or slower growth due to poor absorption of nutrients that are so necessary at a young age.
3. After eating, the child spits up very often, he has belching and coughing.
4. Swallowing reflex disorder.
5. Having difficulty breathing.
6. Sleep disturbance, tearfulness, irritability.

During endoscopic examination, a reddened and slightly loose gastric mucosa is observed, and a decrease in sphincter tone is detected. In more advanced cases, fibrous plaque forms and erosions appear.

When food frequently enters the esophagus from the stomach, the bronchial mucosa is damaged and children develop symptoms similar to asthma. The child may choke and cough frequently, especially at night. Some may experience laryngospasm, in which the walls of the esophagus narrow significantly and the flow of air into the lungs becomes difficult. This condition is extremely dangerous, as asphyxia can occur and the child will suffocate.

Diagnostics

At the first signs of pylorospasm, you should consult a gastroenterologist. Typically, patients are prescribed the following research methods:

1. X-ray of the stomach with a special contrast liquid. The image reveals stagnation of food and a very slow release of the substance into the intestines. The patient is also given a muscle relaxant, which helps distinguish spasm from stenosis. Under the influence of the drug, the muscles relax and the fluid begins to pass normally into the intestine.
2. Endoscopy of the stomach (EGD, gastroscopy). A special tube is inserted through the larynx into the stomach cavity, at the end of which there is a light bulb and a camera, with the help of which you can see the walls internal organs. The spasmodic pyloric part of the stomach and stagnation of food will be visible on the screen.
3. Computer and magnetic resonance imaging to obtain layer-by-layer images of internal organs.

The doctor also collects anamnesis, finding out the frequency of vomiting and its volume, the time of onset of symptoms, and the presence of bowel disorders. The skin and mucous membranes are examined. The tone of the anterior abdominal wall is studied by palpation. In some cases, an examination by a neurologist is necessary, who will examine the child at the time of the presence of damage to the central nervous system.

Table of differences between pylorospasm and pyloric stenosis

Video about the difference between pyloric stenosis and pylorospasm

Treatment of pylorospasm in infants

Pylorospasm is a very serious disease and cannot be treated on your own. After examining the patient and carrying out diagnostic measures, the doctor will select individual treatment. Surgical intervention may be necessary only in the most serious cases, with a decompensated form of pylorospasm.

Adjusting your diet and daily routine

Most parents are very worried about the constant flow of food from the stomach back into the esophagus. The doctor may recommend feeding the baby small portions. It is necessary to increase the number of meals, but the portions should be smaller.

Some children may be advised to eat special adapted milk formulas, in which 80% is a special protein cow's milk- casein. The prepared solution should be thicker so as not to increase the volume of food supplied. Mixtures rich in coagulants, such as Nutrilon, Samper, Frisovom-1, can also be prescribed.

Be sure to adjust your sleep schedule and get more rest.

How to treat with medications

Your doctor may prescribe the following medications:

• antiemetic medications such as Cerucal;
• antispasmodics to relieve spasms (No-Shpa, Papaverine, Chlorpromazine, Promethazine);
• muscle relaxants to relax smooth muscles (Atropine);
• Cisapride to normalize the functioning of the upper gastric sphincter;
• prokinetic agents to improve peristalsis (Domperidone);
• Plantex to stimulate digestion, reduce gas formation;
• sedatives for calming (Motherwort, Novopassit, Valerian);
• vitamin B1.

Related procedures

Infants are prescribed therapeutic massage, which can be carried out either by a specialist or by parents after instructions from a doctor.

Electrophoresis using antispasmodics such as drotaverine or papaverine hydrochloride is also very effective. They are applied to the epigastrium area and, due to the action of constant electrical impulses, the drugs penetrate into the deeper layers and are delivered to the necessary organs.

In some cases, the doctor may prescribe paraffin applications to the abdominal area.

Disease in children of preschool and school age, as well as in adults

Symptoms of this disease in older patients may generally be similar to those in infants, but there are nuances. Your doctor may prescribe the following medications:

• prokinetics to stimulate gastrointestinal motility (Domperidone);
• adsorbents that eliminate toxic substances (Filtrum, Lignosorb);
• Mottilium and Cisapride to increase pressure on the lower esophageal sphincter and to speed up its cleansing;
• Omez for gastric ulcers.

Pylorospasm in children of preschool and school age

An older child may also develop pylorospasm, but this is a fairly rare occurrence. In adolescents, this disease develops mainly due to the following reasons:

Children often complain of heartburn and breathing problems. Gradual destruction of tooth enamel may also occur due to gastric juice entering the oral cavity. Symptoms worsen when bending the body forward, after eating fiber-rich foods and certain types of medications.

Children are prescribed meals only in a sitting position. Avoid coffee, chocolate, fatty and spicy foods. Meals are split, about six times a day in small portions. The consistency of the food taken should be liquid, the temperature should be warm, but not hot.

Pylorospasm in adults

In older people, this disease can develop due to ulcers, stomach tumors, intestinal polyposis, inflammation of the pelvic organs, adhesions, and disorders of the biliary tract. These pathologies contribute to the narrowing of the pyloric zone, and the sphincter in the lower parts of the esophagus also relaxes. Working in hazardous chemical, pharmaceutical, metallurgical and other enterprises can provoke the formation of pylorospasm.

Also a predisposing factor is the use of the following substances:

• pancreatic hormone glucagon and somatostatin;
• the drug Theophylline, used for bronchial asthma;
• Nifedipine, prescribed for hypertension;
• opium drugs;
• alcohol;
• chocolate;
• nicotine;
• strong coffee.

The first symptoms are very similar to a stomach ulcer. Patients feel severe pain in the stomach, heaviness and frequent vomiting. The patient gradually begins to lose weight, general health worsens, and belching smells of hydrogen sulfide. Increased dryness of the skin, peeling, and diarrhea appear. Some people may develop low blood pressure.

Possible consequences and complications

In general, this disease is highly treatable if it is not in an advanced stage. If pylorospasm is not treated, the following serious consequences may occur:

• severe retardation in height and weight;
• reflux - esophagitis;
• anemia;
• pneumonia;
• entry of undigested food into the respiratory tract;
• abscess pneumonia;
• bronchospasm;
• respiratory arrest;
• death.

Pylorospasm in infants - enough common occurrence and at first it can be confused with a regular eating disorder. Parents need to be careful and consult a doctor promptly to avoid serious complications at the baby's. The prognosis for treatment is generally favorable; in patients of all ages, pylorospasm can be treated if all doctor’s recommendations are correctly followed. It is very important to lead healthy image life, exercise and improve your diet.