From the Research
Pyloric stenosis in adult males typically presents with symptoms such as postprandial nausea, vomiting, early satiety, and epigastric pain. These symptoms are consistent with the findings of a study published in the Journal of community hospital internal medicine perspectives 1. The study highlights that adult idiopathic hypertrophic pyloric stenosis (AIHPS) is a rare but well-defined entity in adults, with the most common symptoms being postprandial nausea, vomiting, early satiety, and epigastric pain.
Some key points to consider in the diagnosis and management of pyloric stenosis in adult males include:
- Persistent vomiting, particularly after meals, which may contain undigested food but typically no bile
- Upper abdominal pain or discomfort
- Feeling of fullness after eating small amounts of food
- Unintentional weight loss due to poor nutrient absorption
- Dehydration, causing symptoms like dry mouth, decreased urination, and fatigue
- Early satiety (feeling full quickly), nausea, and bloating
The condition occurs when the pylorus (the outlet between the stomach and small intestine) narrows, preventing proper stomach emptying. This narrowing in adults typically results from peptic ulcer disease, scarring from previous surgeries, or rarely from tumors. Diagnosis usually requires upper endoscopy or imaging studies, and treatment often involves endoscopic balloon dilation or surgery to widen the narrowed passage. Proton pump inhibitors like omeprazole (20-40mg daily) may help manage associated acid reflux symptoms but don't treat the underlying stenosis, as noted in a case report published in BMJ case reports 2.
It's worth noting that the clinical presentation of pyloric stenosis can vary, and some patients may not exhibit the classic symptoms. A study published in The Israel Medical Association journal 3 found that the clinical presentation of hypertrophic pyloric stenosis has not actually changed despite the easier accessibility of GI imaging studies, but the use of imaging and laboratory studies may have shortened the time for diagnosis and reduced the postoperative stay. However, the most recent and highest quality study 1 suggests that postprandial nausea, vomiting, early satiety, and epigastric pain are the most common symptoms of pyloric stenosis in adult males.