Necrotizing Enterocolitis

Written by Gretchen Holm | Published on July 13, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

What Is Necrotizing Enterocolitis?

Necrotizing enterocolitis (NEC) is inflammation and death of intestinal tissue. It may involve just the lining of the intestine or the entire thickness of the intestine. In severe cases, the intestine may even perforate (a hole develops in the wall of the intestine). If this happens, the bacteria normally found only in the intestine can leak into the abdomen and cause widespread infection. This is considered a medical emergency.

NEC is most common in premature infants. It usually develops within two weeks of birth. Up to 80 percent of cases occur in premature babies, according to Children’s Hospital Cleveland Clinic. (CHCC). Around 10 percent of infants who weigh less than 3 pounds and 5 ounces develop NEC, states the Boston Children’s Hospital. (BCH)

NEC is a very dangerous disease that can progress quickly. Immediate medical attention is strongly urged if your baby shows possible symptoms.

What Causes Necrotizing Enterocolitis?

The exact cause of NEC is not clear. However, there are several theories. A lack of oxygen during a difficult delivery may result in your baby developing this condition. Other theories involve issues related to the baby’s prematurity; for instance, incomplete development in the intestines may lead to NEC.

The Texas Pediatric Surgical Associates believe that the lactose present in baby formula may lead to NEC. Because premature babies cannot completely digest this substance, the remainder might allow bacteria to grow, leading to the disease.

Having too many red blood cells and receiving blood transfusions are also risk factors.

This disease may spread between infants. This is suggested by the fact that several cases often occur in the same nursery. If another infant in your baby’s nursery develops the condition, your baby may be at risk.

What Are the Symptoms of Necrotizing Enterocolitis?

Symptoms often include signs of intestinal problems, such as:

  • bloody stool
  • diarrhea
  • poor feeding
  • vomiting

Your baby’s abdomen may be swollen, and in some cases, it may appear reddish or otherwise discolored.

Your baby may also show signs of having an infection. These signs include

  • apnea (breathing pauses)
  • fever
  • lethargy (sluggishness)

How Is Necrotizing Enterocolitis Diagnosed?

A doctor will examine your baby for the symptoms of NEC. He or she will also check whether the baby’s abdomen seems to be painful or tender.

The doctor will then perform an abdominal X-ray. Signs of the disease will typically show up on the X-ray images.

Blood tests may reveal that your baby has a low platelet count or an elevated white blood cell count. Either of these may help the doctor figure out whether your baby is suffering from this condition.

How Is Necrotizing Enterocolitis Treated?

There is no single treatment for necrotizing enterocolitis. The treatment that your doctor suggests will depend on several factors. These include how far the disease has progressed, how old your baby is, and whether your baby is otherwise healthy.

Your doctor will stop any feedings. Your baby will receive his or her nutrition and fluids through an intravenous feeding (IV). Your baby will need antibiotics to help fight the infection.

Because this disease frequently occurs in multiple babies in one nursery, your baby may be isolated. Doctors and other staff may take extra precautions when handling your baby. These measures are intended to help stop the infection from spreading to other babies.

Your baby’s swollen abdomen might make it difficult for him or her to breathe. If this happens, your baby will receive extra oxygen or assistance with breathing.

If the disease is very severe, surgery may be necessary. This involves removing the dead parts of your baby’s intestines.

Throughout the course of the disease, your baby will be monitored closely with X-rays and blood tests. This helps doctors stay on top of the disease and catch any changes quickly.

What Is the Outlook for Necrotizing Enterocolitis?

Necrotizing enterocolitis is always a serious and dangerous disease. Approximately one quarter of babies who develop this disease die of the condition. (NIH, 2011)

Your baby’s individual outlook depends on the severity of the disease, among other factors. The Texas Pediatric Surgical Associates claim that 60 to 80 percent of babies with NEC do not need surgery and manage to recover with the nonsurgical treatments described. (TPSA)

Talk with your baby’s doctors for more specific information regarding your baby’s particular case.

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