Necrotizing Enterocolitis (NEC) is an inflammation that occurs in the intestines (typically the colon) and can be life-threatening if not treated immediately. Necrotizing Enterocolitis can affect only the mucosa or all layers of the intestine. The damage it causes to the intestinal tissues can lead to perforation of the intestine and the leakage of normally present bacteria in the intestines, resulting in an infection. Such an infection progresses rapidly and is considered a medical emergency.
Necrotizing Enterocolitis most commonly affects premature infants, accounting for 60% to 80% of cases. It is the most common gastrointestinal emergency in the neonatal intensive care unit. It typically develops 3 to 12 days after birth.
Causes of Necrotizing Enterocolitis (NEC)
The exact cause of Necrotizing Enterocolitis is unknown. When the intestines weaken due to reduced oxygen or blood supply, the bacteria present in the ingested food can cause damage to the tissues, leading to a severe infection or even death. Contrary to popular belief, breast milk does not cause or prevent Necrotizing Enterocolitis. Prematurity is the most common underlying factor.
Symptoms of Necrotizing Enterocolitis (NEC)
Symptoms of Necrotizing Enterocolitis typically develop within the first 2 weeks and may include:
- Abdominal distension
- Poor tolerance to feedings
- Frequent vomiting (often greenish in color)
- Bloody stools
- Redness or abnormal color of the abdomen
- Lethargy (lack of energy)
- Fever
- Apnea (pauses in breathing)
Diagnosis of Necrotizing Enterocolitis (NEC)
The diagnosis of Necrotizing Enterocolitis is made by evaluating the infant based on the aforementioned symptoms (typically abdominal distension and tenderness). Abdominal X-ray may show a bubbly appearance in the intestines and signs of air or gas in the large vessels of the liver. Air may be present inside the abdomen and outside the intestines. A needle may be inserted into the abdominal cavity (usually to obtain a sample) to check for the presence of intestinal fluid, which indicates a perforation in the intestines.
Treatment of Necrotizing Enterocolitis (NEC)
The treatment of Necrotizing Enterocolitis depends on the baby’s age, overall health, tolerance to specific medications, and the severity of the disease. It may involve the following steps:
- Administration of antibiotics to combat infection
- Controlling bowel movements
- Stopping oral feedings and providing nutrition through intravenous (IV) means
- Regular X-rays to monitor the progression of Necrotizing Enterocolitis
- Removal of air and fluid from the baby’s stomach and intestines through a tube inserted through the nose or mouth
- Regular blood tests to monitor for possible infections
- Potential respiratory support (depending on the severity)
In severe cases of Necrotizing Enterocolitis, surgery may be required to remove the diseased portion of the intestine.
Prognosis of Necrotizing Enterocolitis (NEC)
Complications such as scarring or narrowing of the intestine (obstruction) or the inability of the intestine to properly absorb nutrients (malabsorption) may arise.
Consult your baby’s doctor for specific prognosis regarding your baby.
