Hi all,

I have seen posts on here about a pylorplasty.

A while back, we talked about doing an u/s of Allie's pyloric valve if her DGE had not improved. We are thinking of doing another emptying scan as it seems her DGE is not improving (the weaning of the Reglan is not going so hot).

The doc said that if he had to, he could go in with a scope and enlarge the pyloric valve with a small baloon. Is this a pylorplasty? I googled it and couldn't find much information.

Have any of your kids had this done? I really want to pursue other avenues to help Allie with her DGE - I hate giving her the Reglan.

Thanks,
C

Sounds like they are talking about pyloric balloon dilation. I don't know a lot about this but think they stretch (dilate) the pyloric muscle by inflating a balloon type device.

A pyloroplasty is a surgery where they cut into the pyloric muscle (between the stomach and duodenum) to make a larger opening. It can have some side effects like dumping syndrome (food emptying too fast) and other complications though, so it's likely a last resort.

Maybe someone else can chime in with more info about each.

[quote=Roni]Sounds like they are talking about pyloric balloon dilation. I don't know a lot about this but think they stretch (dilate) the pyloric muscle by inflating a balloon type device.

quote]

Thanks so much Roni. That is what he is talking about. After you gave me the correct terminology, I found this:

http://www.pulsus.com/Gastro/15_11/isra_ed.htm

It looks like something we may be willing to try if we find Allie's emptying is still severe. Her GI doc said it should improve within 3 months and I don't think it has all that much, but the only way we will know is to do another scan. Guess I better schedule it.

C

I am intrigued by this procedure and had never heard of it until your post. I fully intend to ask our docs about it--although we wont see our GI until they are admitted in August because he is on vacation.

Gavin isnt doing well with his DGE either, although he is okay with formula. The food thing is not going that well though. He had avocado last week and 7 and a half hours later at 2 am he puked it all up undigested. He is fine with food that is mostly water like watermelon (and other fruits in terms of DGE but he doesnt tolerate the others for different reasons) but any food with any nutritional benefit really comes out.

We wouldnt consider a pyloraplasty, although it was recommended because of dumping syndrome and all that dumping involves. We wont try reglan either. Erythromycin doesnt work although I am willing to try it again (but where would we fit it in his med schedule!) and domperidone isnt approved here. SOOOOO we are kind of in a stand still when it comes to food and it is frustrating because he doesnt want formula anymore.

I am intrigued by this procedure and had never heard of it until your post. I fully intend to ask our docs about it--although we wont see our GI until they are admitted in August because he is on vacation.

Gavin isnt doing well with his DGE either, although he is okay with formula. The food thing is not going that well though. He had avocado last week and 7 and a half hours later at 2 am he puked it all up undigested. He is fine with food that is mostly water like watermelon (and other fruits in terms of DGE but he doesnt tolerate the others for different reasons) but any food with any nutritional benefit really comes out.

We wouldnt consider a pyloraplasty, although it was recommended because of dumping syndrome and all that dumping involves. We wont try reglan either. Erythromycin doesnt work although I am willing to try it again (but where would we fit it in his med schedule!) and domperidone isnt approved here. SOOOOO we are kind of in a stand still when it comes to food and it is frustrating because he doesnt want formula anymore.

Carla,

I'm sorry Gavin isn't doing well. We took Allie off the Reglan and it was a disaster. So, she's back on it for the time being until we get the new emptying scan done. I talked to her GI doc yesterday who said that if her emptying scan comes back bad again, then he is going to rescope her. He said he would have a surgeon there on stand-by when he did the scope and if the opening in her pyloric valve is small, then he will have the surgeon do the ballon dilation. It is non-invasive and outpatient and DH and I think that we are on board with it b/c we hope that it will mean no more REglan. I talked to her GI doc at length about Reglan and other emptying medicines yesterday and he said out of all of them (including motilum - which we can't get) REglan is his preferred drug. He is going to speak with a neurologist at Children's Hospital (where he practices) and call me back about the side effects w/ Reglan. He thinks that her jerkiness is related to not being on the medicine, and it's pain from the reflux b/c when we put her back on it, she does not do it, eats better, and is just happier in general. So, she's on a reduced dose right now and I don't know what to do about it. This kid has to eat.

Sorry for the book. I will keep you updated with what I learn about this procedure should we elect to do it. I am pretty sure Allie's empyting is not much better (although I think it is a little better) so it is likely we will have the procedure done once we get the results of the second emptying scan.

Wish me luck on getting Allie to sit still for an hour. :)

C

That is very interesting. I will ask our doctor about it as well although we have the same doctor as Gavin. Sarah is getting scoped on the 25th so I will ask him if he will look at her pylorus- I didn't know they could do that.