Pyloric Valve – An Important Sphincter That Affects Acid Reflux?

The pyloric valve or sphincter is placed right at the bottom end of the stomach. It is basically a strong ring of muscles which are used to control food movement from the stomach and into the intestines or more precisely the duodenum with is the first part of the small intestine.

The pyloric sphincter is meant to control the speed at which the stomach contents are passed into the small intestines.

A common problem for this pyloric valve is for it to be too tight. If this sphincter is too tight or obstructed, it can cause a delay in the stomach emptying as quickly as it should. This can lead to acid reflux (GERD) or LPR (silent reflux).

How Does the Pyloric Sphincter Function?

Basically, the sphincter is a set of muscles around the bottom side of the stomach. They are meant to control the flow of the food from the stomach and into the intestines.

When the sphincter malfunctions (dysfunctions) and is too loose this can lead to things like diarrhea or dumping syndrome. When it’s too tight it can lead to acid reflux which I will cover more in detail below.

What Causes the Pyloric Sphincter to Open & Close?

Basically speaking the body controls this. When the food has been broken down to a certain level then the pylorus will open a little to allow the food to slowly pass through. There are certain things which can affect this.

As an example, if there too much fat in the stomach, then less of the food will be allowed to pass through. The reason for that is because that would cause too many secretions from the pancreas which is used to help break down fat by releasing digestive enzymes and bicarbonate.   

The Pylorus & Acid Reflux

The pylorus is another name for the part of the stomach that connects to the duodenum. As I mentioned when this too tight this can lead to problems with acid reflux or LPR.

When the pyloric valve is too right this leads to a pressure build up in the stomach. This increase in pressure can cause the lower esophageal sphincter (LES) to open. If you didn’t know the LES is the sphincter on the top end of the stomach.

The LES opens when food is passing through and into the stomach and is closed otherwise. Though because of this pressure the LES can relax and open. When it opens this leads to acid refluxing up and into the esophagus and even the throat for some people (LPR).

This is quite interesting because it’s common for the LES to be targeted as the sphincter that leads to reflux and while this is often true it doesn’t mean that the LES is the root cause.

In this case the pressure that is built up due to a tighter pyloric sphincter leads to the buildup in the stomach which in turn opens the LES. So even if you assumed the LES was the problem it may not be the actual root of the problem. This is always something worth considering when trying to work out the root cause of your acid reflux.

How to Diagnose Pyloric Sphincter Problems

The first thing to diagnose the problem would be an endoscopy. This is where the doctor can look directly at the sphincter and it make sure it looks normal. The endoscope can then be pushed through the sphincter to make sure it’s structurally sound. At that point, the next step is to use what’s known as an electrogastrography to check that the sphincter is functioning correctly. If the electrogastrogram shows a problem with the valve then the next step would be a simple procedure, which I will cover below in the next section.

Pyloric Malfunctions – What Can Be Done to Stop Them?

There is a simple pyloric sphincter surgery that is done via endoscopy which is a balloon dilatation. It is a procedure that only takes about 5 minutes and has a very high success rate. Check out this study as an example of that.

If that doesn’t work, there is another option known as a G-POEM with is another form of endoscopic surgery.

Both of these options would provide a permanent fix for the majority of patients.

In terms of side effects for these surgeries the balloon dilation doesn’t have any known side effects and is clearly the best first choice for the majority of people. The G-POEM can cause side effects like developing a symptom like dumping syndrome because of the sphincter becoming to lose as an example.

Pyloric Valve & Acid Reflux – Conclusion

In conclusion we can see that the pyloric sphincter can play an important role in affecting and causing acid reflux and LPR in certain people. This is an area that can sometimes be overlooked because it’s often the LES which is the main focus when trying to solve problems with acid reflux.

Though we must keep in mind that sometimes while the LES may open and relax causing acid reflux this doesn’t necessarily mean that it’s the LES causing the problem directly but it can also be caused due to a malfunctioning pyloric sphincter.

It is something that should be considered and not overlooked when figuring out the root cause of your acid reflux.

A Few Extra Frequently Asked Questions about the Pyloric Sphincter

What Are the Symptoms of Pyloric Stenosis in Adults?

Pyloric stenosis is typically developed in young babies though adults can also have it. The symptoms include vomiting, dehydration, hunger, constipation, and stomach cramps.

How Do You Fix a Pyloric Sphincter?

The best way to fix a pyloric sphincter is via a simple procedure which is a balloon dilatation. This procedure is done via endoscopy and has a high success rate.

What is Pyloric Spasm?

Pyloric spasm is where the pyloric sphincter closed which in turn delays gastric emptying and prevents and slows release of food into the smaller intestines.