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
I.M.Rogers is a retired surgeon with a long-standing interest in the cause. He made the earliest discovery of neonatal hypergastrinaemia and also was ,as far as I know, to document hyperacidity in the pyloric stenosis(PS) baby. He first proposed an inherited primary hyperacidity as the cause and subsequently refined this theory in the light of evidence showing insensitivity of the negative feed-back between acid and gastrin in the early weeks. He is the author of The Consequences and Cause of PS of Infancy with a survivor of PS-Dr. Fred. Vanderbom available on AMAZON ISBN 978-3-659-52125—6 and has just finished another book Pyloric stenosis of Infancy-the Great Mystery unravels- again published by Amazon all profits to the Safe Water Trust.Available 2019. He is also the author of many paers on the subject of cause.