The Consequence and Cause of Pyloric Stenosis of Infancy : Two Personal Stories

The large majority of infant pyloromyotomies are quickly successful and have few or no significant continuing effects. The lay author Rev. Fred Vanderbom, argues on the basis of his own personal and others' experience that for a small number of subjects there are ongoing consequences and pleads for more consideration and research to establish the numbers involved and a suitable response. Constitutional primary hyperacidity is proposed as the cause of this condition which is made more severe by an early insensitivity of an immature neonatal gastrin secretion to the negative feed-back between antral acidity and gastrin. Inappropriate repeated overfeeding of the vomiting baby is a contributory factor. The case for hyperacidity as the cause is argued in the light of the evidence largely accumulated in the last 40 years. A plea is made for the judicious use of acid-blocking drugs in the pre-operative period to reduce alkalosis. It is anticipated that such temporary treatment will in many instances produce a lasting cure.