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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 medical emergency.
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.
The symptoms of NEC often include the following:
Your baby may also show symptoms of an infection, such as:
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.
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.
There are numerous different ways to treat NEC. Your child’s specific treatment plan will depend on several factors, including:
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.
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 intestine removed.
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.
Written by: Gretchen Holm
Medically reviewed on: Jan 21, 2016: Steve Kim, MD
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