Detailed Information on Necrotizing Enterocolitis

Necrotizing enterocolitis is the death of intestinal tissue. The illness is most common among premature newborns. Necrotizing enterocolitis (NEC) occurs in approximately 25,000 babies per year. Many newborns who develop necrotizing enterocolitis survive and go on to live healthy lives. But if the infection becomes severe, it can cause serious damage to or holes in the intestinal tissue. NEC typically occurs within the first 2 weeks of life, usually after milk feeding has begun (at first, feedings are usually given through a tube that goes directly to the baby's stomach).

The consequence of necrotizing enterocolitis is not clear. It is believed to occur when the immune and digestive systems do not grow properly. This can happen when a baby is born prematurely or when there are complications during pregnancy or delivery. Bacteria in the intestine may also be a result. In the most severe cases, necrotizing enterocolitis can be fatal. Necrotizing Enterocolitis is equally affected both male and female. Babies with too many red blood cells in the circulation are at an increased risk of developing NEC. This thickens the blood and makes oxygen transport more difficult.

Babies with gastrointestinal infections are at an increased risk of developing NEC. Babies who have had a difficult delivery or lowered oxygen levels are at an enlarged risk for developing NEC. A baby's symptoms depend on how severe the condition is. The primary symptoms vary and may involve feeding intolerance, abdominal distension, bloody stools, apnea, lethargy, temperature instability or hypoperfusion. In newborns who have mild to moderate necrotizing enterocolitis, treatment consists of intravenous (IV) feeding, antibiotics, and removing extra fluids. Intravenous fluids are given to maintain hydration.

About 70% of newborns with necrotizing enterocolitis do not require surgery. If the intestine perforates, then surgery is needed. Surgery may also be required if the condition progressively worsens despite treatment. Pharmacologic therapy includes agents to treat the developing disease and those to provide supportive and symptomatic relief. Different antibiotic regimens can be used; one frequently used regimen includes vancomycin, cefotaxime, and clindamycin or metronidazole. This combination provides broad gram-positive coverage, excellent gram-negative coverage (with the exception of pseudomonads), and anaerobic coverage.

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