A pyloric spasm is a brief, involuntary spasm of the pyloric sphincter muscle, which is part of the digestive system. The pyloric sphincter is a ring-shaped muscle that’s located in the upper part of the stomach. It’s made up of smooth muscle fibers. This muscle acts as a valve that allows food to pass through the stomach on its way out through the pylorus into the small intestine. A pyloric spasm occurs when the muscle becomes overstretched and cannot relax.
Pyloric spasm causes abdominal pain and bloating. You may also experience nausea and vomiting.
What causes pyloric spasm?
Pyloric spasms are most commonly caused by:
- Acid reflux (heartburn): When the esophagus (the tube that connects the throat to the stomach) is exposed to stomach acid, it can irritate the esophagus and pyloric sphincter muscle.
- Certain medications: Taking certain drugs, such as NSAIDs (nonsteroidal anti-inflammatory drugs) or antidepressants, can cause a pyloric spasm.
- Gastroesophageal reflux disease (GERD): Gastroesophageal reflux disease (GERD) affects the esophagus and the lower part of the stomach. If the acid in the stomach flows backward into the esophagus, it causes irritation to the esophagus and the muscles in the lower part of the stomach.
- Obesity: Being overweight increases the risk of pyloric spasms.
- Lactose intolerance: A lack of the enzyme lactase in the small intestine can cause gas and bloating.
How is pyloric spasm diagnosed?
Your doctor will take a thorough medical history. A physical exam will be conducted to check for any other symptoms. Your doctor may also order a barium swallow test to check the movement of the esophagus and stomach as well as the pyloric muscle.
To perform the test, you’ll swallow a liquid diet containing barium sulfate. Barium sulfate has a metallic color that shows up on X-rays.
Your doctor will then take X-rays of your upper gastrointestinal tract. These X-rays will show the movement of the esophagus and the pyloric muscle.
How is pyloric spasm treated?
You may be treated for pyloric spasms with:
- Medications to reduce stomach acid
Medications to relax the pyloric sphincter muscle
Your doctor may recommend a surgical procedure to treat pyloric spasms. This procedure usually involves the following steps:
- Your doctor will make a small incision in the abdomen.
- They’ll insert a thin tube called a nasogastric tube through the incision. This tube will allow them to suction the stomach.
- They’ll remove any excess tissue and connect the tube to a drain that will be removed later.
- They’ll apply a rubber band around the stomach to stop the stomach from pushing up against the esophagus.
- They may inject a local anesthetic into the stomach to numb the area.
What are the complications of pyloric spasm?
Pyloric spasms usually don’t cause serious complications. However, your doctor may have to repeat the procedure if the spasm recurs.
What is the long-term outlook?
Pyloric spasms usually go away on their own. If they don’t go away on their own, your doctor may suggest lifestyle changes to help ease the symptoms. These changes may include the following:
- Avoiding foods that trigger a pyloric spasm or that can cause gas.
- Eating smaller meals.
- Eating slowly.
- Eating with a straw.
- Removing foods from your diet that may irritate the esophagus.
- Drinking more water.
- Taking over-the-counter pain medications.
- Taking over-the-counter antacids.
Your doctor may also want to monitor you for other causes of pyloric spasms. If you’re having symptoms of GERD or a peptic ulcer, for example, you may need to make lifestyle changes or take medications to help prevent a pyloric spasm.
Living with pyloric spasms
If you have pyloric spasms, you may experience bloating and pain after eating. You may also feel bloated after you lie down for a long period of time. This condition is called postprandial distress syndrome (PDS).
PDS can affect anyone, but it’s more common in people who have GERD or take NSAIDs. If you’re experiencing PDS, you may find that the symptoms are worse after eating certain foods. Try to avoid these foods for at least a few hours after meals.
Try to avoid foods that may trigger pyloric spasms, such as:
- Spicy foods
- Dairy products
- Citrus fruits
- Fried foods
In addition, you may want to keep a food journal to record any symptoms you have. This journal can help you and your doctor pinpoint any food triggers.
If you have PDS, you may also want to try relaxation techniques. These techniques may help reduce symptoms of PDS.
Some relaxation techniques that may help include:
- Deep breathing exercises to increase oxygen flow to the brain
You may also want to talk to your doctor about:
- Dietary changes
- Antacids or other medications
- Herbal remedies
- Proton pump inhibitors (PPIs)
What’s the link between pyloric spasm and GERD?
Pyloric spasms can be caused by acid reflux. Acid reflux is a common symptom of GERD. The acid in the stomach can flow back up into the esophagus. This causes the sphincter muscle on the esophagus to relax, which allows acid to flow backward into the esophagus.
What is the link between pyloric spasm and overweight?
Being overweight can increase the risk of pyloric spasms.
Pyloric spasms can also be caused by a lack of the enzyme lactase in the small intestine. Lactose is a sugar found in milk. People who don’t have enough lactase in their intestines may have a problem digesting lactose. This may cause bloating and gas.
What is the link between pyloric spasm and anxiety?
If you have anxiety, you may find that you feel pain or discomfort in your abdomen. This may be due to a pyloric spasm.
Is it normal to have pyloric spasms?
Pyloric spasms aren’t common. However, they can occur with other symptoms of GERD or a peptic ulcer.
Symptoms of pyloric spasms
Pyloric spasms usually only occur when you lie down. They may also occur after eating certain foods.
Symptoms may include:
- Abdominal pain or discomfort
These symptoms may be triggered by:
These symptoms can also be caused by a peptic ulcer.
When to see your doctor?
It’s important to see your doctor if you have any of these symptoms:
- Frequent pyloric spasms
- Pain that gets worse with eating
- Abdominal distention
These symptoms may be a symptom of a peptic ulcer or a peptic cancer.
Your doctor may recommend a gastroenterology consultation if you have symptoms of GERD.
They may also recommend a gastroenterology consultation if you:
- Have symptoms of GERD
- Have symptoms of a peptic ulcer or peptic cancer
- Have pyloric spasms or heartburn after eating
- Have difficulty swallowing
- Have heartburn
- Have a loss of appetite
What do you do if you think pyloric spasm is related to GERD or a peptic ulcer?
If you think you have pyloric spasms, talk with your doctor. They can help rule out other causes of your symptoms. They may also refer you to a gastroenterologist. This is a doctor who specializes in digestive problems, including esophageal problems.
In some cases, you may need to have a pyloric spasm surgery. This is called a fundoplication.
Procedures for pyloric spasm
Pyloric spasm surgery is done in the hospital. You may receive sedatives, which may help you relax. An anesthesiologist will monitor your vital signs during the surgery.
During the procedure, your doctor will remove the part of the stomach that’s spasming. They’ll also insert a tube into the esophagus that’s used to drain the fluid that’s causing the spasm.
If you take NSAIDs, your doctor may have you stop taking them before surgery. They may also have you take proton pump inhibitors (PPIs) for three weeks before surgery.
Another common procedure for pyloric spasm surgery is a fundoplication. This is a procedure that joins the stomach to the esophagus. This surgery helps prevent acid reflux and pyloric spasms.
What are the risks of pyloric spasm surgery?
Pyloric spasm surgery isn’t usually dangerous. However, your doctor will do this procedure to prevent pyloric spasms. This is called a prophylactic fundoplication. Prophylactic means it’s done in the future to prevent reflux.
Before surgery, you’ll need to stop taking your NSAIDs and PPIs for at least three weeks. You may also need to avoid nonsteroidal anti-inflammatory drugs (NSAIDs) for a few weeks before and after surgery.
If you smoke, you may have a higher risk of complications during or after surgery, such as bleeding.
A pyloric spasm is a brief, involuntary spasm of the pyloric sphincter muscle in the stomach. This muscle is located in the upper part of the stomach and is made up of smooth muscle fibers.
Pyloric spasms can be triggered by:
- Acid reflux (heartburn): When the esophagus (the tube that connects the throat to the stomach) is exposed to stomach acid, it can irritate the esophagus and the pyloric sphincter muscle.
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