The Painful Passage of Food
Identifying and Treating Pyloric Valve Problems Can Restore Pleasure in Eating
Originally published in Boomers & Beyond, October 1, 2013
How is your pyloric valve today? Maybe a better question is “What is a pyloric valve?” Maybe an even better question is “Do you get sharp pains after eating?”
The pyloric valve is a sphincter that controls the opening between your stomach and your small intestine. It is situated about 2 inches above your belly button. You would never think of it when it’s working right, but when it isn’t functioning correctly, you will experience pain.
Quick Anatomy Lesson: What the Pyloric Valve Does
The main purpose of the pyloric valve is to control the flow of material from your stomach into your duodenum, the top section of your small intestine where most of the nutrients are extracted from food matter. Under normal conditions, the valve opens slightly a few times a minute to allow a small amount of material into the duodenum. It has a secondary function of preventing bile reflux, which is bile flowing from your intestines into your stomach.
Of course, the pyloric valve doesn’t work correctly for many people. Either it ‘spasms’ and doesn’t open or it doesn’t close completely and allows bile to pass into the stomach and, potentially, into your esophagus. Both conditions can create a lot of discomfort and serious medical problems.
As a side note, we see quite a few patients with pyloric valve problems. In most cases, they have no idea why they are in pain. Once we identify the problem, we can help them get on track to healthy, pain-free living again.
Problems with the Pyloric Valve
When the pyloric valve spasms, it constricts and becomes inflamed. Then, when you eat, you experience sharp pain as food tries to pass through the valve. It hurts…a lot. It may even lead to nausea and violent vomiting as your stomach tries to clear itself. Typical symptoms of a spastic pyloric valve are bloating and a sharp and extended pain following eating.
On the other hand, if the valve doesn’t close properly, bile from the intestines can flow into the stomach. This is less common than a constricted valve. According to the Mayo Clinic web site, “Bile reflux can be difficult to distinguish from acid reflux. The signs and symptoms are similar, and the two conditions may occur at the same time.” When bile gets into your stomach and esophagus, it can lead to a variety of serious issues, from damage to your stomach and esophageal lining, to bleeding ulcers, to Barrett’s Esophagus.
Diagnosing Pyloric Valve Problems
Given that these pyloric valve problems are well known, you would think that they would be simple to identify. They aren’t. Each of the symptoms can be mistaken for other less-significant problems. Furthermore, the discomfort may go away on its own after an hour or two—until you eat again, that is.
The common way to identify problems with the pyloric valve is to undergo upper endoscopy. A gastroenterologist feeds a tube with a camera down your throat and has a look around. This is a messy, costly, and uncomfortable process. A second, less expensive and more comfortable way to diagnose problems with the pyloric valve is thermal imaging.
When the valve is constricted and inflamed, or when bile is entering the stomach and attacking the stomach lining, blood flow is increased to the region. The increased blood flow raises the temperature corresponding to the area of distress, and infrared cameras can capture the image of the heat (which is why it’s called ‘thermal imaging’).
Dr. Gregory Melvin, a board-certified thermography reading doctor, notes that “Most conditions are detectable with infrared imaging. When the pyloric valve is under distress, it creates a specific and unique thermal image, making it fairly obvious.”
Using Thermal Imaging to Diagnose Pyloric Valve Problems
Let’s say Bob gets a lot of pain after eating. He has tried to avoid first one type of food and then another, but he still gets pain. He has even tried various anti-gas and antacid medications, but they don’t help either. Bob finally goes to his doctor and explains the symptoms. His doctor isn’t sure what’s happening but recommends what Bob is already doing. Without better information, neither Bob nor his doctor can determine what’s happening and, therefore, what to do about it.
Bob is tired of the pain. He goes to a clinical thermal imaging center. After the intake survey, he disrobes to the waist, and the technician takes a series of infrared images. Those images are sent to the certified thermography reading doctors for analysis. The images show a marked hot area that blossoms around the pyloric valve and extends into the stomach.
The reading doctor’s report comes back to Bob in a few days. Bob has a constricted pyloric valve. Bob shares the report with his doctor. Now that they know what the problem is, they can decide what to do about.
For the first time in months, Bob feels hopeful that finally he will be able to eat without pain.
Treating a Constricted Pyloric Valve
A loose pyloric valve can be complicated to treat, but in many cases, a constricted valve can be treated at home using fairly simple techniques. Because the pyloric valve is a muscle, massaging the muscle firmly can help. Try this if you suspect, or know, you have a constricted valve and are experiencing pain.
To massage the pyloric valve, use a large, hard, blunt object. Your fist will work, but a better choice is a 3-pound dumbbell encased in a rubber shell. Most sports stores sell them.
Hold the dumbbell in one hand with the end of the dumbbell against your abdomen, about two inches above your belly button and two inches to the right. Press down with the other hand. Then, knead the area slowly and firmly, left to right. Dr. Melvin explains that “You are going to put pressure on the valve to break its reflex so that it relaxes.”
This will be uncomfortable at first, maybe even painful. After a couple of minutes, the valve should relax, and you will feel relief.
For longer term relief, repeat this massage every night after eating for two weeks and then every other night until you are not experiencing pain. Then continue every third night for another week. Thermal imaging can be used to monitor the effects of the massage treatment.
You could get surgery for this condition, in which a stint is placed in the valve. You can also take strong muscle relaxation medication. In most cases, though, the massage technique will work. What massaging does is get the valve to relax so that it can function properly. And when it is working correctly, you will eat without pain.