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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Treat Pyloric Stenosis?

I am a 34 year old female weighing approximately 240 pounds. I smoked off and on for fifteen years and quit on my own in January 2011 for good. Shortly before I kicked the habit, I began feeling as if I had panic attacks. I went to my physician who prescribed me Buspar for depression / anxiety. I had a reaction to the medicine causing my heart to race, chest to hurt, and arms to tingle. I was advised to stop taking the medication and was not prescribed anything else. All throughout February I had what I thought were panic attacks, but they progressively got worse and lasted longer, always worse at night. I finally went to the Emergency Room on March 12th thinking perhaps it was Asthma, even though I have no cough or wheeze. I thought since we are renovating my mother s house and from years of cigarettes that I had Asthma for sure, but the doctor discovered through X-Rays that I had a large air bubble that had pushed up my left diaphragm causing me trouble breathing. They performed a dilatation where 4 pounds of air was pumped from my stomach and sent me home. I felt so much better and was able to sleep through the night like a baby. Then, four days later, I had trouble breathing again and this time had chest pain as well, so I went to the ER again. They performed a Stress Test, EKG, and MRI scans. They said that my chest was fine, but that I needed to see a Gastro Intestinal doctor as my stomach was bloated. Two days later, I went to the doctor and had an emergency Endoscopy that found I had Pyloric Stenosis (I have no ulcers or scarring and never had it as a child). I had no stomach pain, vomiting or acid reflux, the only GI symptoms I had were nausea, diarrhea, weight loss and bloating. The doctor prescribed Omeprazol & Reglan and had me go back in 2 weeks for a follow up. I felt great for 2 weeks, and at the follow up I was prescribed Paxil to help with IBS symptoms of diarrhea, simithecone to relieve gas and bloating, & Lisinopril for High Blood Pressure (which I did not have before all this). I also caught an ear infection in my right ear during all this and was prescribed Cefdinir, then Allegra and Nasonex to help, and I began having trouble breathing again. X-Rays again showed I had an elevated left diaphragm and air bubbles. I have had blood tests for diabetes and thyroid among other things, CT Scans, another Endoscopy, a colonoscopy, Pulmonary Function tests, Arterial Blood Oxygen tests, Sleep Apnea tests, a Fluoroscopic SNIF test and more X-Rays. I have been told that I have a very small hiatal hernia (too small to operate) and mild asthma (prescribed Pulmicort). I have no other GI tract issues, my heart is fine and my lungs are clear, yet I still have the elevated left diaphragm (which is not paralyzed - it is still functioning in my chest), which has pushed my heart over to the right side of my chest, and pain on my left side now. I stopped taking all meds except the Lisinopril, Gas-X & Pulmicort for Asthma. Some I was told to stop, others I stopped because they seemed to be making the diarrhea, pain and nausea worse. Two nights ago, I tried to lay on my left side to help reduce some of the pain and I immediately felt like I was starving, to the point where I got extremely nauseous and had pain radiating through the left side of my body! I took two bites out of an energy bar, but the feeling was still there. I thought I might be having a heart attack, so I called the doctor and left a message with his answering service. I began to dry heave uncontrollably and then quickly felt better. The doctor said that I should go to the ER if it continued, but it went away, so I did not. So, my current symptoms now are pain in my left side from my stomach / colon to my shoulder that gets worse at night and better in the morning. Sudden nausea with bouts of gas and constipation, PVC heart palpitations, bloating, losing weight quickly and then gaining it back very quickly, loss of appetite then sudden feelings of starving, & discomfort in my chest with physical activities (like sex - I have not been able to do that in 2 months now for fear of making this worse). My question is: What could be causing this and how do I make it stop? Any advice you can give is greatly appreciated! I am allergic to Morphine and Demerol Surgeries: Gall Bladder removed in June 1997, Endometrial Ablation and Tubal Ligation in July 2010. I have had (3) live births (all full term). My last pregnancy in 2005, I had Pregnancy induced hypertension and was on bed rest for one month. My father had a heart attack in his forties and died from a stroke at age 50 - he was a lifetime smoker and had controlled adult onset diabetes and controlled high blood pressure. My mother is still living - she has controlled high blood pressure and at age 58 had a stint put in her heart with a 99% blockage - she is now on blood thinners and doing well.
Mon, 19 Nov 2018
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General Surgeon 's  Response
Hello,

As per my surgical experience, the pyloric stenosis of low grade can be managed conservatively with acute inflammation stage via Ryle's tube insertion, keeping nil by mouth, supportive IV fluids and in-house medical treatment.

The extensive lumen narrowing with obstruction requires immediate surgical intervention via various options as a mere incision or pyloroplasty.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Bhagyesh V. Patel,
General Surgeon
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How To Treat Pyloric Stenosis?

Hello, As per my surgical experience, the pyloric stenosis of low grade can be managed conservatively with acute inflammation stage via Ryle s tube insertion, keeping nil by mouth, supportive IV fluids and in-house medical treatment. The extensive lumen narrowing with obstruction requires immediate surgical intervention via various options as a mere incision or pyloroplasty. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon