Abstract:
Evidence to support the hyperacidity theory of pathogenesis. This will consist of titratable acidity of fasting juice both before and after pyloromyotomy. The peak acidity displayed by all babies at 3 weeks of age is analysed with regard to the immature and insensitivity of the negative feed-back between acid and gastrin in the early weeks. Male premature babies secrete more acid than matched females. Since duodenal acidity is a potent stimulant of sphincter contraction pyloric hypertrophy (the tumour) develops and gastric outlet obstruction (GOO) naturally presents at 3-4 weeks principally in the male child. Neonatal hypergastrinaemia facilitates the hypertrophic process. The first born phenomenon is due to a novice mother too frequently feeding her child even when vomiting starts. GOO obstruction by positive feedback involving elevated gastrin levels further increases acid secretion. All the clinical features are explained by this theory. Temporary treatment with acid-blocking drugs pre-operatively rapidly restores a normal acid-base status. In the milder cases temporary prescription of acid-blocking drugs with relative underfeeding may give a long term cure. See Pyloric stenosis of Infancy-the great mystery unravels. I.M.Rogers FRCS all proceeds to Charity (the Safe Water Trust) Available on AMAZON 2019
