Weak Pyeloric muscle

[Anonymous]

Well, we went for the Upper GI today, and although we still have to wait for the official word from the specialist, which apparently won’t be until at least tuesday, the radiologist said my daughter has a “weak pyeloric muscle” which causes her to vomit all the time. I asked if this meant it was pyeloric stenosis, and he said no, that this weak muscle could be treated with medicine. That’s all i got out of him, as i imagine they’re really not supposed to say too much about it. The other radiologist, i’m assuming the intern, actually doing the procedure, said he didn’t see any reflux, but that the ugi wasn’t the best test to detect reflux anyway.

Does anyone know much about a weak pyeloric (sp?) muscle? I wonder if she goes on those meds, if she can come off of everything else?! Hopefully it is something she will outgrow as well. I’m going to do a little research on it right now.

[Anonymous]

Glad you have an answer. Hopefully this will lead to a big improvement.

[Anonymous]

Hmmmm…..

It sucks that you have to wait until Tuesday for definitive answers. My guess (but this is an uneducated guess) is that the radiologist is referring to reflux meds because the weak Pyloric muscle allows stomach contents and acid to back up and the meds will help reduce the acid. Hopefully I’m wrong and there is some kind of medicine to strengthen the muscle.

How did she do during the procedure?

Keep us posted.

[Anonymous]

I’m so glad you at least have some answers now! That must be such a relief. Hopefully you’ll be able to find something to treat it now.

I may be totally wrong on this, but I believe the medicine that helps the pyloric muscle work better is Reglan. I might be wrong though.

Good luck!

[Anonymous]

i’m thinking he meant she has a weak sphincter muscle, which is what many babies with reflux have. if she had a weak pyloric muscle, her food would be emptying out of her stomach at a faster rate. even though reglan is said to be for delayed gastric emptying, it is also used to strengthen the sphincter valve from the esophagus into the stomache—–though most people on this site haven’t had a lot of good luck with it. a few have gotten help from it, though. for the most part, babies are treated with a PPI to control symptoms until the valve strengthens over time.

[Anonymous]

I agree with Christine. I haven’t really reviewed my anatomy in a while, but from what I remember the pyloric spincter (aka the pyloric muscle) is a band of smooth muscle tissue at the bottom of the stomach, not the same as the LES (lower esophageal sphincter) at the bottom of the esophagus/top of the stomach. A weak pyloric muscle/sphincter would cause the stomach to empty faster, whereas a weak LES would cause reflux. Please keep us posted after you talk to your doc.

[Anonymous]

I was wondering about that too. I’ve heard of almost the opposite happening – the pyloric muscle being tight or a little closed off causing DGE, but haven’t heard of it being weak. Hopefully you can get some more clear answers next week.

[Anonymous]

Thanks everyone–i’ll be sure to keep you all posted as to what the pedi gi says. I’m not exactly sure what the radiologist meant, and he was gone so fast, i couldn’t get any more info. I don’t think they’re really supposed to say much anyway until the treating dr sees the films. What exactly is Reglan, and what are some side effects, and in your opinions, is it worth putting her on it if that’s what the specialist suggests? I know the PPI’s are fairly safe, but I don’t want to give her something that could have adverse side effects.

She did great all the way up to the procefure itself. She went over 5 hours without eating, and wasn’t crying or anything. I had to undress her down to her diaper and they took an xray first of her belly, that was good. But once the radiologist came in and they started moving the big xray machine over her and having her turn side to side, she just lost it. I had to hold her arms and feed her the bottle of barium,but i was crying too. She just looked terrified & was crying the whole time. She calmed down soon after,though. Now she’s constipated, i’m assuming from the barium! We’ve tried everything, she’s had 1 ox of prune juice, several hits of the rectal thermometer, some tummy time, and Maalox. I bought those suppositories for children, but there’s no way that’s fitting in there–apparently there are separate ones for infants which i didn’t find at the store!

Thanks so much for all the info, and I’ll keep everyone posted!

[Anonymous]

Oh, poor sweetie. Will she drink some water? That may help move the barium out. They should have told you that….and I forgot to mention it…sorry. No one at the hospital told me with Myles either. The barium can be very consitpating and giving them some water after the procedure can help. I hope it gets better very soon.

As for Reglan, some babies do fine on it but it can have some scary neurological side effects. I’d probably do some research on it so you can decide if you would comfortable with it.

I hope you hear from the doctor soon. Waiting is awful, isn’t it?

[Anonymous]

Sorry to hear she got so constipated from it. Is she doing better now? Hopefully some extra fluids will help regulate her again. Bryce has a feeding tube, so when we did his upper GI, they put the barium in through his tube, and when he was done, they pulled most of it back out, so he didn’t get the constipation problem. Hope she’s doing better now!

[Anonymous]

Well, I heard from the specialist’s RN yesterday, and she said the UGI showed that everything was normal. I asked her about the “weak pyloric muscle”, and she said that the radiologist said there was a pyloric SPASM (not what he told me, but maybe he looked at it closer & decided that), which is a normal thing, so she’s fine on the inside. That is a relief.

BUT, Dagney still has that gurgling/congestion sound going on, and she seems to be starting to arch again around the afternoon time. In the evening, she was even making that throat clearing sound again, and that king of grunting sound, and seemed uncomfortable. And, of course, she’s still spitting/throwing up after most bottles. She is also getting harder again to put down for the night (falls asleep, I put her down, she wakes up, we start over…) Am I being too picky? Is some of that going to still go on? But if it is happening, doesn’t that mean she’s uncomfy or in pain, and the acid could be hurting her esophagus? I still question whether she really needs to be on the Neocate at all, I was hoping we’d go to the Specialist & they’d even take her off of the Nutramigen, instead they put her on an even more specialized formula!

On a separate note, anyone who has their child on Neocate, how long is it supposed to be before any improvement is seen? I’m not sure that we’ve seen much if any, and it will be a week today that we swiitched her over…

I’m supposed to hear back (again) from the specialist today, since she was off yesterday and the RN was just notifying me of the results. I’m going to again ask to up her prevacid, and see if there’s anything else we can do…

[Anonymous]

I’m glad to hear that everything was normal with the test. It does sound like she might need a higher dose of prevacid. Will your doctor let you increase the dose?

Good luck – I hope you can find a combo that will help her be more comfortable.

[Anonymous]

Good news about the test results.

No, I don’t think you are being too picky. It sounds like she’s still in some pain. I’d definitely push for a higher Prevacid dose.

As for Neocate, I’ve read here that it usually takes at least two weeks to see if a new formula is working or not and that it can take even longer, depending on the age of the infant and how much damage has been done to the GI tract. Here’s a link that may help you.

https://www.infantreflux.org/forum/forum_posts.asp?TID=6013&a mp;KW=misconceptions

Good luck. I hope the doctor lets you increase her dose and that she gets more relief soon.

[Author]

Posts