General characteristics

Pyloric stenosis is the name given to the condition where the pyloric sphincter tightens and narrows.

The pyloric sphincter is a ring of smooth muscle located at the bottom end of the stomach that opens to allow foods and liquids to pass from the stomach into the duodenum (the first part of the small intestine). Ordinarily the pyloric sphincter is closed allowing stomach and intestinal contents to remain separated until it relaxes and opens to allow partially digested foods from the stomach to pass on into the small intestine. In pyloric stenosis (stenosis=narrowing) the muscle of the pyloric sphincter overgrows and thickens, tightening the passageway and therefore interfering with the normal emptying of the stomach contents. The stomach takes much longer to empty and can cause bloating and discomfort in the infant as food sits in the stomach for some time.

Pyloric stenosis usually affects babies under the age of 6 months and is more common in baby boys than girls. It often presents itself when the baby is around 6 weeks old and symptoms often begin with the parent noticing that the amount of vomit after feeds is excessive (looks like an entire feed has come back up) or is projectile. The baby often wants to feed immediately after vomiting and if the condition is left untreated it can progress onto dehydration and weight loss as under nourishment can occur. Vomiting after feeding is quite normal in babies, the difference in pyloric stenosis is that vomiting tends to occur after every or nearly every feed and can be quite copious in amount. Sometimes the baby will be restless and show discomfort before vomiting. Nappy contents (both fluid and solid) may also decrease as little food is being digested.

The cause in babies is mostly unknown but thought to be hereditary although the antibiotic erythromycin is thought to increase the risk. In adults it may result from scarring of the pyloric sphincter from a stomach ulcer, abdominal surgery or (very rarely) tumour growth. Some have suggested a link between an irritation or allergy like reaction to certain foods (or perhaps in the mothers milk in breastfed babies) that begins as a simple irritation of the pyloric area, then progresses on to chronic spasm in the pylorus which in time leads onto a thickening of the overactive sphincter.

Conventional treatment in babies is usually with surgery to cut the tightened muscle and relieve the blockage.

Useful herbs

Chamomile tea can be taken to try and relax the sphincter. For babies, make a cup of chamomile tea using a teaspoon of dried chamomile and give a teaspoonful of the liquid 3 times a day.

Dill, fennel and caraway seeds as well as other digestive antispasmodics like wild yam may help to relieve the spasms.