Pyloric Stenosis

Since we came to Boise on December 1st Isaac has started spitting up. All of our boys have actually spit up quite a bit when they were babies, but this is different. He has done it about once a day and it is very forceful – kind of a projectile spit up. At first we thought that it was just because he was kind of stuffy, but it has continued for a while now. Michael mentioned once that he was the right age for symptoms to start showing for some medical condition, but honestly I didn’t really think much of that comment because every once in a while Michael learns about medical problems and then wonders if he or one of our family members may have them.

So, after this went on for a while, we were starting to wonder if it might be something more than just his reaction to being really stuffy or something. We were at Cass and Marci Smith’s house for dinner last week (Cass is a pediatric GI doctor), and Michael and Cass talked that night about the condition Michael had mentioned earlier, Pyloric Stenosis. Cass said he thought we should keep an eye on him and keep that in mind. I took Isaac in and had him weighed yesterday morning. He was weighed a couple days before we came out here, and he had lost about 7 ounces since then, and babies his age are generally supposed to gain about an ounce a day, our pediatrician told me. I called our pediatrician in Milwaukee, and he also thought that it was possible that Isaac could be showing signs of Pyloric Stenosis, and that we should have him seen by a doctor here. (I guess this shows me that Michael is really becoming a real doctor and I should pay more attention to his ideas about medical problems).

So, I took him into the emergency room yesterday (our insurance will only cover emergency room visits when we are out of state, so we couldn’t just find a pediatrician here to see him). We were there all day, and Debbie was nice enough to watch the other boys for me while I went (since Michael was on an airplane all day). In the emergency room, they weighed Isaac, took his history, and decided to have an ultrasound done to see if he had this Pyloric Stenosis. I had read a little about the condition on the internet before taking him in. Basically, it is when the muscle of the pylorus (the tube that empties into the stomach) gets too thick, and makes it so that the milk does not enter the stomach like it should. This condition is much more common in boys than in girls, and the symptoms are projectile vomiting, the baby loosing (or at least not gaining) weight, and the baby often appearing otherwise healthy (unless it progresses to where the baby is not keeping anything down, and then the baby can come dehydrated and lethargic). So, they did an ultrasound of his stomach and measured the thickness of the pyloric muscle. They told me that his pylorus looked elongated and was measuring between 2.5 and 3 mm thick, which is thicker than normal. But they said that it would measure 3.5 mm if it were true Pyloric Stenosis, which would require a surgical procedure to fix.

So, the doctor said that we would just watch him and see how he does. Isaac was seen by an ER doctor and a pediatric surgeon, and they told me that this problem will either go away after a few weeks when he may just grow out of it, or that it may develop into true Pyloric Stenosis and require the surgery if the spitting up were to continue and get worse. I talked to the surgeon this morning, and he did say that the majority of babies with this problem will develop true Pyloric Stenosis before they are 2 months old, so hopefully if Isaac doesn’t worsen in the next couple weeks, he will just get over it and we won’t have to worry about it any more. He hasn’t spit up like that for a day now, so I am hoping that it will just go away and we won’t have to do anything more for it. Poor little guy he’s already had enough surgeries for a 7-week old baby, he doesn’t need one more.