Materiały źródłowe

• #1 Pyloric Stenosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK555931/

  Pyloric stenosis, also known as infantile hypertrophic pyloric stenosis (IHPS), is an uncommon condition in infants characterized by abnormal thickening of the pylorus muscles in the stomach leading to gastric outlet obstruction. […] The exact etiology of IHPS is unknown. Some studies have shown that young infants treated with macrolide antibiotics had an increased incidence of IHPS. Postnatal exposure to erythromycin has also been associated with an increased risk for the development of pyloric stenosis. Other risk factors include bottle feeding, preterm birth, cesarean section delivery, and first-born infants (30% to 40% of cases). If the mother was a heavy smoker during pregnancy, the risk of hypertrophic pyloric stenosis could increase by 1.5 to 2.0 fold.

• #2 Pyloric stenosis: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/pyloric-stenosis

  Pyloric stenosis is a rare condition that occurs when the pylorus, a muscular valve that sits at the bottom of the stomach, thickens. This causes the pylorus to narrow. […] Healthcare experts do not know what causes pyloric stenosis but have identified certain risk factors that may increase the likelihood. These include: […] Babies in families with a history of pyloric stenosis may have a higher chance of developing the condition. Research suggests that siblings have a 20-fold increased risk of developing pyloric stenosis. In identical twins, the risk increases 200-fold. […] Male infants are 4 times more likely to have pyloric stenosis than females. […] Pyloric stenosis is more common among firstborn infants, accounting for 30-40% of all cases. Scientists are not sure why this is. […] According to the Centers for Disease Control and Prevention (CDC), pyloric stenosis is more common in white infants and less common in non-Hispanic Asian and non-Hispanic Black infants.

• #3 Pyloric Stenosis (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/pyloric-stenosis.html

  Pyloric stenosis is a condition that can affect the gastrointestinal tract in babies. […] Pyloric stenosis (also called infantile hypertrophic pyloric stenosis) is a type of gastric outlet obstruction, which means a blockage from the stomach to the intestines. […] It’s thought that babies who develop pyloric stenosis are not born with it, but have progressive thickening of the pylorus after birth. […] The cause of this thickening isn’t clear. It might be a combination of several things. For example, use of erythromycin (an antibiotic) in babies in the first 2 weeks of life or antibiotics given to moms at the end of pregnancy or during breastfeeding can be associated with pyloric stenosis.

• #4 Pyloric Stenosis | Causes, Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/p/pyloric-stenosis

  Pyloric stenosis is the narrowing of the lower portion of the stomach (pylorus) that leads into the small intestine. […] There is no clear cause identified for pyloric stenosis, though both genetic and environmental factors are thought to be involved. […] Pyloric stenosis is considered a multifactorial trait, which means that many factors are involved. […] In families where one child has pyloric stenosis, there is an increased risk that a future brother or sister could also have this condition. […] Due to the hereditary factor, several members of a family may have had this problem in infancy.

• #5

  https://www.beaumont.org/conditions/pyloric-stenosis

  Pyloric stenosis is a condition that affects newborns, specifically the muscle between the stomach and small intestine. […] The exact cause of pyloric stenosis is unknown, but it is thought to be caused by a combination of genetic and environmental factors and is a multifactorial trait. […] Multifactorial inheritance is a term for when many different factors contribute to causing a birth defect. Often, multifactorial traits will target one gender more frequently than the other, with males being four times as likely to have pyloric stenosis than females. […] The likelihood of a second child being born with pyloric stenosis depends on the gender of the previous child and the to-be-born baby.

• #6 Pyloric Stenosis (HPS): Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/4524-pyloric-stenosis-hps

  Pyloric stenosis is the thickening and narrowing of your baby’s pylorus, which is the muscular opening between their stomach and their small intestine. […] Scientists don’t know the exact cause of pyloric stenosis. However, genetics and environmental factors may play a role. […] Risk factors for pyloric stenosis include: Family history: About 15% of infants with pyloric stenosis have a biological family history of the condition. […] The condition is more common in white infants, especially those of European descent. […] Babies whose mother smoked during pregnancy are at a higher risk. […] Some babies who needed antibiotics shortly after birth may be at a higher risk. Babies whose mother took certain antibiotics late in pregnancy may also have a higher risk. […] Some studies of babies drinking formula show an increased risk for pyloric stenosis. But it remains unclear if the risk comes from the bottle or the formula. If it comes from the bottle, it may also apply to bottles with breast milk.

• #7 Pyloric Stenosis: Causes, Signs and Symptoms, Diagnosis and Treatment | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/pyloric-stenosis

  Pyloric stenosis is considered a multifactorial trait. Multifactorial inheritance means that many factors are involved in causing a birth defect. The factors are usually both genetic and environmental. […] For example, pyloric stenosis is four times more common in males than females. Once a child has been born with pyloric stenosis, the chance for it to happen again depends on the gender of the child already born with the condition, as well as the gender of the next child.

• #8 Pyloric Stenosis: Symptoms, Diagnosis, Treatment

  https://www.webmd.com/parenting/baby/pyloric-stenosis

  Pyloric stenosis, also known as infantile hypertrophic pyloric stenosis, is a rare condition that makes the valve between a newborn’s stomach and small intestine get thick and swollen. This blocks food from traveling from the baby’s stomach into the intestine. […] Doctors don’t know exactly why the pylorus gets bigger, but it might be partly caused by changes in a gene. It’s often passed down through families. If one or both parents have pyloric stenosis, their baby has up to a 20% greater chance of getting it. […] Other things that can make a baby more likely to have it include: […] Smoking during pregnancy. Babies of mothers who smoke are more than twice as likely to get pyloric stenosis. […] Family history. Studies show pyloric stenosis at higher rates if you have a family history of the condition. […] Pyloric stenosis can’t be prevented, as the causes of the condition are unknown. But genetics and the environment are thought to play a part in it. Babies aren’t born with pyloric stenosis but get the condition after, with symptoms usually showing by 3 to 5 weeks of age.

• #9 Infantile Hypertrophic Pyloric Stenosis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/929829-overview

  Bottle-feeding as compared to breastfeeding was associated with an increased risk for hypertrophic pyloric stenosis in a population-based case-control study of 714 infants after adjustment for sex, race, maternal smoking status (odds ratio [OR] 2.31; 95% confidence interval, 1.81-2.95). […] No single genetic cause has been identified, although multiple studies have demonstrated a strong family concurrence and a higher risk of developing HPS among twins. […] Researchers who identified a cholesterol-related genetic locus associated with risk for infantile hypertrophic pyloric stenosis have also demonstrated that low serum lipids are a risk factor for this disorder. In a genome-wide association study, Feenstra and colleagues found that the single-nucleotide polymorphism (SNP) most strongly associated with risk for HPS was rs12721025 on the long arm of chromosome 11.

• #10 Pyloric stenosis and genetics | EBSCO Research Starters

  https://www.ebsco.com/research-starters/health-and-medicine/pyloric-stenosis-and-genetics

  Pyloric stenosis is multifactorial, suggesting that there is a broad range of genetic and environmental factors that may contribute to the appearance of this birth defect. […] Researchers have identified at least five genes in which mutations may significantly increase the risk of developing this disorder. […] The five genes that are known to be associated with increased susceptibility to the development of pyloric stenosis are known as IHPS1-5, with the gene letters standing for infantile hypertrophic pyloric stenosis. […] Other risk factors include diseases such as diabetes, excessive acid in the duodenum, and some antibiotics.

• #11 Pyloric Stenosis – Children’s Hospital of Orange County

  https://choc.org/programs-services/gastroenterology/pyloric-stenosis/

  Pyloric stenosis is a problem that affects babies between birth and six months of age and causes forceful vomiting that can lead to dehydration. It is the second most common problem requiring surgery in newborns. […] The cause of pyloric stenosis has many factors or causes. The factors are likely both genetic and environmental. Pyloric stenosis is four times more common in males than females. Once a child has been born in a family with pyloric stenosis, the chance for it to happen again depends on the gender of the child already born with the condition, as well as the gender of the next child. […] Pyloric stenosis may be inherited, and several members of a family may have had this problem in infancy.

• #12 Pediatric Pyloric Stenosis – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/pyloric-stenosis

  Pyloric stenosis is a birth defect. This means that your child is born with it. […] This condition may run in some families. Its a multifactorial trait. This means that many things caused it. The factors are often both genetic and environmental. […] Pyloric stenosis is 4 times more common in males than females.

• #13 A Parent’s Guide to Pyloric Stenosis: Symptoms & More – Avisena Women’s & Children’s Specialist Hospital

  https://womenandchildren.avisena.com.my/health-articles/understanding-pyloric-stenosis-symptoms-diagnosis-and-treatment-options/

  Pyloric stenosis is more common in male infants, with a male-to-female ratio of about 4:1. The reasons for this gender difference are not fully understood but may be linked to hormonal or genetic factors. […] First-born infants are more likely to develop pyloric stenosis than their younger siblings. This correlation might be due to a combination of genetic predisposition and environmental factors that affect first-born children differently. […] Infants born prematurely are at an increased risk of developing pyloric stenosis. The underdevelopment of their gastrointestinal system may contribute to the condition. […] Maternal smoking has been linked to an increased risk of pyloric stenosis. Exposure to nicotine and other harmful substances may affect the developing foetus and increase the likelihood of this condition. […] Early introduction of solid foods or changes in feeding practices have been considered potential contributing factors, although the evidence is not conclusive.

• #14 Infantile Hypertrophic Pyloric Stenosis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/929829-overview

  Despite numerous hypotheses, the exact etiology of infantile hypertrophic pyloric stenosis (IHPS) is not fully understood, with both genetic and environmental factors implicated. Environmental factors associated with the development of IHPS include maternal smoking, lower socioeconomic status, delivery via Caesarean section, maternal diabetes mellitus, formula feeding, non-Black race, and neonatal use of macrolides. […] Detailed investigation into the timing of macrolide use revealed that administering oral azithromycin to infants in the first 2 weeks of life increased their risk of developing IHPS by more than 7 fold (P 0.001); when azithromycin was given at ages 15-42 days, the risk of developing hypertrophic pyloric stenosis was more than 2 fold (P =0.028). […] Further studies have reported the association of an increased risk of developing IHPS following the ingestion of erythromycin and azithromycin, especially in the first 14 days of life.

• #15 Hypertrophic Pyloric Stenosis – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/gastrointestinal-disorders-in-neonates-and-infants/hypertrophic-pyloric-stenosis

  Hypertrophic pyloric stenosis is obstruction of the pyloric lumen due to pyloric muscular hypertrophy. […] The exact etiology of hypertrophic pyloric stenosis is uncertain, but a genetic component is likely because siblings and offspring of affected people are at increased risk, particularly monozygotic twins. Maternal smoking during pregnancy also increases risk. Proposed mechanisms include lack of neuronal nitric oxide synthase, abnormal innervation of the muscular layer, and hypergastrinemia. […] Infants exposed to certain macrolide antibiotics (eg, erythromycin) in the first few weeks of life are at significantly increased risk. […] Some studies have noted increased risk in bottle-fed infants compared to breastfed infants, but it is not clear whether this risk is associated with a change in feeding method or with the type of feeding (1, 2).

• #16 Pyloric stenosis: Symptoms, causes, and treatment

  https://www.medicalnewstoday.com/articles/pyloric-stenosis

  Smoking during pregnancy can double the risk of having a baby with pyloric stenosis. […] Ingesting certain types of antibiotics during their first 2 weeks of life can increase an infant’s chance of developing pyloric stenosis. This includes oral azithromycin and erythromycin. […] According to an older 2012 study, bottle-fed babies may be 4.6 times more likely to have pyloric stenosis than those not bottle-fed. However, the researchers could not determine why this might be the case.

• #17 Increased Risk of Pyloric Stenosis with Formula Feeding with Bottles. | InfantRisk Center

  https://infantrisk.com/content/increased-risk-pyloric-stenosis-formula-feeding-bottles

  Pyloric stenosis (PS), also known as infantile hypertrophic pyloric stenosis, is caused by hypertrophy of smooth muscles of the pylorus. […] Its cause is unknown but presents as a palpable mass in right upper quadrant of abdomen. […] A recent study in Denmark suggests that bottle-feeding with formula may be associated with a 4.6 fold increased risk of pyloric stenosis. […] The authors of this study suggest that while the etiology of this increased risk of PS is not clear, it is probably associated with the use of formula. […] The authors theorize that the problem with overfeeding of formula may irritate the pylorus muscle and lead to hypertrophy. […] According to these researchers, breastfeeding may also protect against pyloric stenosis because it contains high levels of vasoactive intestinal peptide, which favors pyloric relaxation. […] Altogether, this data suggests that exclusive breastfeeding in the early months postpartum may dramatically reduce the incidence of pyloric stenosis in newborns.

• #18 Pyloric Stenosis: Causes, Symptoms, and Treatment

  https://patient.info/childrens-health/pyloric-stenosis-leaflet

  Pyloric stenosis affects between 2 and 5 out of 1,000 newborn babies. […] The muscle in the wall of the outlet of the stomach into the small intestine (pylorus) is abnormally thick. This causes the outlet from the stomach to become narrowed (stenosed). It is not known why this occurs though some risk factors have been identified. Use of a particular type of antibiotic shortly after birth has been shown to be a risk factor for developing pyloric stenosis. […] Pyloric stenosis affects between 2 and 5 out of 1,000 babies. Boys are affected more commonly than girls. It can sometimes run in families. It is more common in babies who are bottle fed, who were born by caesarean section or who were born prematurely. It is more common in first-born babies. It is also more common in babies born to women who smoked during pregnancy. […] It is seen most commonly in white babies and less frequently in Black or Asian babies.

• #19 New insights into the pathogenesis of infantile pyloric stenosis – PubMed

  https://pubmed.ncbi.nlm.nih.gov/19760199/

  Infantile hypertrophic pyloric stenosis (IHPS) is the most common surgical cause of vomiting in infants. Despite numerous hypotheses, the aetiopathogenesis of IHPS is not fully understood. Genetic, extrinsic and hormonal factors have been implicated in the pathogenesis of the disease. […] Recently, genetic studies have identified susceptibility loci for IHPS and molecular studies have concluded that smooth muscle cells are not properly innervated in IHPS.

• #20 Pediatric Pyloric Stenosis: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/803489-overview

  A meta-analysis of 9 studies reaffirmed a significant association of postnatal exposure of erythromycin and the development of pyloric stenosis. […] Maternal use of macrolides during the first 2 weeks after birth was also associated with an increased risk of IHPS. […] A study by Cohen Elias et al found that maternal diabetes is associated with the development of IHPS in infants. […] Another study showed that maternal smoking is a risk factor for IHPS. […] Nitric oxide has been demonstrated as a major inhibitory nonadrenergic, noncholinergic neurotransmitter in the GI tract, causing relaxation of smooth muscle of the myenteric plexus upon its release. Impairment of this neuronal nitric oxide synthase (nNOS) synthesis has been implicated in infantile hypertrophic pyloric stenosis, in addition to achalasia, diabetic gastroparesis, and Hirschsprung disease. […] The etiology of infantile hypertrophic pyloric stenosis remains unknown and is probably multifactorial (genetic and environmental factors).

• #21 Hypertrophic pyloric stenosis in adults | Gastroenterología y Hepatología (English Edition)

  https://www.elsevier.es/en-revista-gastroenterologia-hepatologia-english-edition–382-articulo-hypertrophic-pyloric-stenosis-in-adults-S244438241630092X

  Hypertrophic pyloric stenosis in adults is a rare entity, with a wide range of symptoms (although it can be asymptomatic), producing dyspepsia, vomiting or even occlusive symptoms with pneumoperitoneum. Symptoms can appear between the ages of 14 and 85, with an average age of 50 years; it is more common in men, with an incidence of 3:1. The aetiology remains uncertain, but several hypotheses have been proposed, namely: […] Primary causes: No apparent lesion identified: (a) Neuromuscular incoordination due to changes in the Auerbach plexus or vagal hyperactivity. (b) Protracted pylorospasm. (c) Persistence of childhood stenosis. Most authors favour this theory, in which the disease remains latent and is reactivated by secondary factors such as inflammation, oedema, and spasm. Pyloric stenosis in adults and children presents similar anatomical and histopathological abnormalities, which supports this hypothesis. […] Secondary causes: Associated with gastric, pyloric or duodenal lesion, such as gastritis, peptic lesions or tumours.

• #22 Pyloric Stenosis | KidsHealth New Zealand’s Trusted Voice On Children’s Health

  https://www.kidshealth.org.nz/pyloric-stenosis

  Pyloric stenosis (also called infantile hypertrophic pyloric stenosis) is a narrowing of the pylorus – the passage that leads from the stomach to the small intestine. When a baby has pyloric stenosis, the muscles in the pylorus have become too thick to allow milk to pass through it. This usually happens in the first 6 weeks after birth. […] Experts do not know exactly what causes the thickening and enlargement of the muscles in the pylorus. […] Pyloric stenosis affects more boys than girls and tends to run in families.

• #23 Infantile hypertrophic pyloric stenosis – UpToDate

  https://www.uptodate.com/contents/infantile-hypertrophic-pyloric-stenosis

  Infantile hypertrophic pyloric stenosis (IHPS) is a disorder of young infants caused by hypertrophy of the pylorus, which can progress to near-complete obstruction of the gastric outlet, leading to forceful vomiting. […] The incidence of IHPS is associated with: […] The condition occurs in approximately 1 to 3.5 per 1000 live births, although rates and trends vary markedly from region to region. […] Several reports from resource-abundant countries suggest a declining incidence, with variable rates. […] A trend toward earlier diagnosis was illustrated in a study comparing the presentation of a total of 283 infants diagnosed in the decades prior to 1975, 1985, and 1995. […] The earlier diagnosis of IHPS might be explained by advances in diagnostic imaging or by increased awareness of the disorder among clinicians.

• #24 Hypertrophic Pyloric Stenosis | Lurie Children’s

  https://www.luriechildrens.org/en/specialties-conditions/hypertrophic-pyloric-stenosis/

  Hypertrophic pyloric stenosis (HPS) is a narrowing of the lower portion of the stomach that leads into the small intestine. […] Despite extensive clinical and laboratory research, the cause of pyloric stenosis remains unknown. Although a genetic predisposition to HPS is suspected, the exact mode of inheritance is unknown. […] A family history of HPS makes it more likely that an infant will have the disorder. When parents (mother or father) have had HPS, it occurs in 5-20% of their male children but in only 3-7% of their female children. […] Nothing can be done to prevent HPS from occurring.

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