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The truth about projectile vomiting: What exactly makes it so painful for babies?
Projectile vomiting is a common cause of anxiety for many parents, especially when their baby vomits violently after a feeding. This condition is usually caused by narrowing of the stomach outlet, medically known as pyloric stenosis. The condition is not common, affecting about one or two babies per thousand, and is four times more common in boys than in girls. Why does this worrying situation occur and what are the hidden reasons behind it?
Signs and symptoms
Symptoms of pyloric stenosis usually appear in the first few weeks to six months of life, with increasing vomiting.
Some infants may eat poorly and lose weight, while others may maintain normal weight gain. Dehydration is also a problem and may cause your baby to cry without tears and not urinate for hours or even days.This type of vomiting is often described as "non-bilious" and "projection vomiting" because it is much more forceful than normal reflex vomiting.
Causes
The exact cause of pyloric stenosis is unknown, but some studies suggest it may be related to hyperacidosis in newborns.
Also, in rare cases, this stenosis may be inherited in an autodominant manner.
Pathophysiology
Obstruction of the gastric outlet prevents gastric contents from flowing smoothly into the duodenum, and food and gastric secretions can only be discharged through vomiting. This condition causes vomiting without bile. Due to the loss of gastric acid, the chloride ion level in the body decreases, which in turn affects the kidney's bicarbonate excretion function and ultimately leads to metabolic alkalosis.
One study showed that elevated levels of adrenaline (aldosterone) can cause the kidneys to over-retain sodium and increase potassium excretion.
Diagnosis
Diagnosis of pyloric stenosis is generally made through a careful history and physical examination, combined with imaging studies. Doctors usually palpate the abdomen to check for the presence or detection of masses called "olives" during a physical examination.
Most cases of pyloric stenosis are diagnosed with an ultrasound examination, which identifies the thickened pylorus and the inability of stomach contents to pass through it.
Treatment methods
The only effective treatment for pyloric stenosis is usually surgery, most often to repair the sun's cavity (Ramstedt procedure).
EpidemiologyThis surgery is usually done through a small incision, or laparoscopically, depending on the surgeon's experience and preference.
Although relatively uncommon, pyloric stenosis is more common in certain ethnic groups, particularly people of Scandinavian descent. Specifically, the incidence rate is higher in Caucasians than in other races, and the incidence rate in male babies is four times higher than that in female babies.
When faced with a baby's projectile vomiting, parents should remain calm, be sensitive, and quickly seek medical help for prompt diagnosis and treatment. However, what impact will this situation have on the baby's future?
