Name of the Condition

• Adult Hypertrophic Pyloric Stenosis (HPS)
• Also referred to as gastric outlet obstruction due to pyloric stenosis.

Summary

Adult Hypertrophic Pyloric Stenosis is a rare condition where the pylorus muscles thicken, blocking food from entering the small intestine. Unlike its infant counterpart, this condition can arise later in life and may require different management strategies.

Causes

While the exact cause in adults is often idiopathic, potential contributing factors may include chronic gastritis, peptic ulcers, or previous gastric surgery. Some cases may be linked to persistent inflammation.

Risk Factors

• Previous history of gastric conditions.
• Chronic use of NSAIDs or other medications that irritate the stomach lining.
• Familial history of pyloric conditions, although less common in adults.

Symptoms

• Persistent nausea and vomiting.
• Abdominal pain or bloating.
• Unintended weight loss.
• Difficulty in passing food through the digestive tract.

Diagnosis

• Endoscopy: To visually examine the stomach and pylorus.
• Barium swallow: An X-ray imaging test that shows the passage of barium through the digestive system.
• Ultrasound or CT scan: For identifying thickening of the pyloric region.

Treatment Options

• Surgical intervention (Pyloromyotomy): Surgical cutting of hypertrophied pyloric muscle.
• Balloon dilation: Non-surgical method to widen the pylorus.
• Medications: Proton pump inhibitors to reduce stomach acid production.

Prognosis and Follow-Up

• With appropriate surgical treatment, the prognosis is generally good.
• Regular follow-ups to monitor recovery and check for recurrence of symptoms are essential.

Complications

• Malnutrition leading to further weakness if food passage is severely impaired.
• Electrolyte imbalances due to prolonged vomiting.
• Risk of infection or bleeding from surgical intervention.

Lifestyle & Prevention

• Avoidance of NSAIDs without medical supervision.
• Eating smaller, more frequent meals to manage mild symptoms.
• Immediate treatment of any gastric inflammation or ulcers.

When to Seek Professional Help

• Persistent vomiting lasting several days.
• Signs of dehydration (e.g., dry mouth, dizziness).
• Severe abdominal pain.

Additional Resources

• American Gastroenterological Association (AGA) - (gastro.org)
• Mayo Clinic - Comprehensive guides and articles on gastric health.
• National Institutes of Health (NIH) - Details on gastric conditions.

Tips for Medical Coders

• Ensure distinction between pediatric and adult conditions as they differ significantly in presentation and causes.
• Double-check related symptoms and treatments documented in patient files for accurate ICD coding.
• Be aware of common coding errors, such as confusing pyloric stenosis with other forms of gastric obstruction.