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Infantile hypertrophic pyloric stenosis causes severe vomiting, leading to dehydration and metabolic alkalosis; it can be treated by surgical pyloromyotomy. A failure of pyloric relaxation has been postulated as the cause. Recent research has shown that nitric oxide, the synthesis of which requires the enzyme nitric oxide synthase (NOS), is an important mediator of gut relaxation in animals. A team from Brussels reports that NOS deficiency may be the cause of pyloric stenosis.
The team's studies compared pyloric muscle from nine infants with pyloric stenosis and seven unaffected infants and children. In the infants with pyloric stenosis, but not in the controls, the nerve fibers of the circular smooth muscle of the pylorus showed greatly dim…