Is Necrotizing Enterocolitis (NEC)?
Necrotizing enterocolitis (NEC) is a disease that develops when
the tissue in the inner lining of the small or large intestine becomes damaged and
begins to die. This causes the intestine to become inflamed. The condition usually
affects only the inner lining of the intestine, but the entire thickness of the
intestine may become impacted eventually.
In severe cases of NEC, a hole may form in the wall of the
intestine. If this occurs, the bacteria normally found inside the intestine can
leak into the abdomen and cause widespread infection. This is considered a
NEC can develop in any newborn within two weeks after birth.
However, it’s most common in premature infants, accounting for 60
to 80 percent of cases. Around 10
percent of babies who weigh less than 3 pounds, 5 ounces develop NEC.
NEC is a serious disease that can progress very quickly. It’s
important to get treatment right away if your baby is showing symptoms of NEC.
Are the Symptoms of Necrotizing Enterocolitis?
The symptoms of NEC often include the following:
- swelling or bloating of the abdomen
- discoloration of the abdomen
- bloody stool
- poor feeding
Your baby may also show symptoms of an infection, such as:
- apnea, or disrupted breathing
- a fever
Causes Necrotizing Enterocolitis?
The exact cause of NEC isn’t known. However, it’s believed that a
lack of oxygen during a difficult delivery may be a contributing factor. When
there’s reduced oxygen or blood flow to the intestine, it can become weak. A
weakened state makes it easier for bacteria from the food entering the
intestine to cause damage to the intestinal tissues. This can lead to the development
of an infection or NEC.
Other risk factors include having too many red blood cells and having
another gastrointestinal condition. Your baby is also at an increased risk for
NEC if they were born prematurely. Premature babies often have underdeveloped
body systems. This may cause them to have difficulty with digestion, fighting
infection, and blood and oxygen circulation.
Is Necrotizing Enterocolitis Diagnosed?
A doctor can diagnose NEC by doing a physical examination and running
various tests. During the exam, the doctor will gently touch your baby’s
abdomen to check for swelling, pain, and tenderness. They’ll then perform an
abdominal X-ray. The X-ray will provide detailed images of the intestine,
allowing the doctor to look for signs of inflammation and damage more easily. Your
baby’s stool can also be tested to look for the presence of blood. This is
called a stool guaiac test.
Your baby’s doctor may also order certain blood tests to measure your
baby’s platelet levels and white blood cell counts. Platelets make it possible
for the blood to clot. White blood cells help fight infection. Low platelet levels
or a high white blood cell count can be a sign of NEC.
Your baby’s doctor may need to insert a needle into the baby’s
abdominal cavity to check for fluid in the intestine. The presence of
intestinal fluid usually means there’s a hole in the intestine.
Is Necrotizing Enterocolitis Treated?
There are numerous different ways to treat NEC. Your child’s
specific treatment plan will depend on several factors, including:
- the severity of the disease
- the age of your child
- the overall health of your child
In most cases, however, your doctor will tell you to stop breast-feeding.
Your baby will receive their fluids and nutrients intravenously, or through an
IV. Your baby will likely need antibiotics to help fight the infection. If your
baby is having difficulty breathing due to a swollen abdomen, they’ll receive
extra oxygen or breathing assistance.
Surgery may be necessary in severe cases of NEC. The procedure
involves the removal of the damaged sections of the intestines.
Throughout the course of treatment, your baby will be monitored
closely. Your baby’s doctor will perform X-rays and blood tests regularly to
make sure the disease doesn’t get worse.
Is the Outlook for Children with Necrotizing Enterocolitis?
Necrotizing enterocolitis can be a life-threatening disease, but
most babies completely recover once they receive treatment. In rare cases, the
bowel may become damaged and narrowed, leading to intestinal
blockage. It’s also possible for malabsorption
to occur. This is a condition in which the intestine is unable to absorb
nutrients. It’s more likely to develop in babies who had a section of their
Your child’s specific outlook depends on their overall health and
the severity of the disease, among other factors. Speak with your doctor for
more specific information regarding your baby’s particular case.