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Journal of Current Pediatric Research | Volume: 23
March 14-15, 2019 | London, UK
International Conference on
Pediatrics & Neonatal Healthcare
P
yloric Stenosis of Infancy (PS) was first clearly documented
300 years ago. Since then the curious clinical features have
been repeatedly defined and pyloromyotomy remains the
best treatment. There has been a progressive increase in the
frequency of published articles about PS in the last century.
Few speculate on the cause and none attempts to explain the
pathogenesis by trying to explain the symptoms and signs.
The Primary Hyperacidity theory as here described explains all
the clinical symptoms and signs and is a credible and testable
explanation for the condition. When acidity is measured by
titration methods PS babies are hyperacid. When puppy dogs
are made hyperacid by Penta gastrin injections, they develop
PS. PS babies after pyloromyotomy when gastric hold-up is
abolished, continue to be hyperacid. In later life they suffer
from hyperacidity problems. Acidity entering the duodenum is
a potent cause for pyloric sphincter contraction. The repeatedly
contracting sphincter hypertrophies and the enlarged sphincter
blocks stomach emptying. Continuing attempts to feed the PS
baby produce even more acidity, more hypertrophy and so on.
There is good evidence that the negative feed-back between
gastrin and acid secretion takes a few weeks to develop after
birth. Thus, both gastrin and acid secretion peaks at around 3-4
weeks until negative feedback is established. In this way, the
presentation at 3-4 weeks makes sense. Similarly, with acidity
now controlled and the pyloric lumen getting larger with time,
self-cure in the milder cases is not uncommon. Another major
driver is the frequency and volume of feeds. 3-hourly fed babies
are more commonly affected and an anxious first-time mother
is more liable to feed her vomiting baby. Medical treatment is
more successful when associated with reduced feeds.
Speaker Biography
Ian Munro Rogers was born on March 1, 1944 in Glasgow, Scotland. He did his Bachelor
of Medicine, Bachelor of Surgery from Glasgow U. in 1967. He has membership fellow
at Royal College Surgeons Edinburgh, Royal College Physicians Glasgow, Royal College
Physicians and Surgeons Glasgow. He was Consultant in General Surgery, South
Tyneside Hospital, 1978-2004; Surgical Tutor to the Royal College of Surgeons, England,
1990 - 1996. He was the Hon. Lecturer in Surgery at Newcastle University, 1991. He
was a Director of Surgical Services at South Tyneside, May 1995 – March 1998 and
President of the North of England Surgical Society 2000 - 2001. He is retired Consultant
Surgeon in General Surgery with an interest in vascular surgery, Ingham Infirmary,
South Shields and South Tyneside Health Care Trust 1978 –2003. He was retired from
the NHS in October 2003 and presently undertake medico-legal work. He was a Guest
Examiner at Royal College of Physicians and Surgeons, Glasgow 2005, Intercollegiate
Assessor of Surgical Examiners 2006. He was a Visiting Prof. Surgery, AIMST University,
Kedah, Malaysia 2007-2009/2011; he has a long-term interest in the cause of Pyloric
stenosis of Infancy with particular reference to the Primary Hyperacidity Theory.
e:
irogers2000@hotmail.comIan Munro Rogers
Royal College of Physicians and Surgeons of Glasgow, UK
Pyloric Stenosis of infancy-The great mystery unravels
Notes:
Ian Munro Rogers
, Curr Pediatr Res, Volume 23
DOI: 10.4066/0971-9032-C1-010