The three differential diagnosis at this time are, pyloric stenosis, intestinal obstruction and lactose intolerance.
Pyloric stenosis is a gastro-intestinal obstruction disorder affecting the pyloric sphincter. It is due to hypertrophy and hyperplasia (Peeters, Benninga, & Hennekam, 2012). The antrum becomes narrow as the pylorus thickens. It leads to gastric distension in response to obstruction. It has genitival predisposition, affecting mostly boys. It is caused by genetically deficient nitric oxidase synthase, and abnormal gastrointestinal innervation.
Lactose intolerance is caused by genetically deficient lactase enzyme deficiency. Progressive loss of the enzyme form the small intestines leads to inability to utilize lactose (Misselwitz et al., 2013). Also, there is increased growth of bacteria in the colon.
Intestinal obstruction is the flow within the gastro-intestinal tract. It can be caused by hernias, intestinal inflammatory conditions, volvulus, or intussusception (Applegate, 2012). It leads to drastic or progressive narrowing of a section of the intestines or causing completely block. Intussusception is the tucking in of a section of the intestines into other section of the intestines. It is the most common cause of intestinal obstruction among infants. There is little influence of genetics in the condition. However, genetically long intestines have been implicated.
Physical examination, computerized tomography, ultrasound, air or barium enema and X-ray are tests that can be used to diagnose intestinal obstruction (Bellot, Francés, & Such, 2013). Lactose intolerance test will be suitable to rule out lactose intolerance (Samad et al., 2012). For pyloric stenosis also serum electrolytes balance test is done.
The three differential diagnosis are lactose intolerance, pyloric stenosis and intestinal obstruction. These conditions have genetically predisposition. Several tests can be used to establish the underlying condition.
1. Applegate, K. E. (2012). Clinically suspected intussusception in children: evidence-based review and self-assessment module. American Journal of Roentgenology. Retrieved from http://www.ajronline.org/doi/full/10.2214/ajr.185.3_supplement.0185S175
2. Bellot, P., Francés, R., & Such, J. (2013). Pathological bacterial translocation in cirrhosis: pathophysiology, diagnosis and clinical implications. Liver International, 33(1), 31–39.
3. Misselwitz, B., Pohl, D., Frühauf, H., Fried, M., Vavricka, S. R., & Fox, M. (2013). Lactose malabsorption and intolerance: pathogenesis, diagnosis and treatment. United European Gastroenterology Journal, 1(3), 151–159.
4. Peeters, B., Benninga, M. A., & Hennekam, R. C. (2012). Infantile hypertrophic pyloric stenosis—genetics and syndromes. Nature Reviews Gastroenterology and Hepatology, 9(11), 646–660.
5. Samad, L., Marven, S., El Bashir, H., Sutcliffe, A. G., Cameron, J. C., Lynn, R., & Taylor, B. (2012). Prospective surveillance study of the management of intussusception in UK and Irish infants. British Journal of Surgery, 99(3), 411–415.
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