Necrotizing Enterocolitis

Necrotizing enterocolitis, or NEC, is a serious disorder affecting a baby's gastrointestinal tract, which consists of the mouth, stomach, small intestine, large intestine and anus. Although the exact cause of NEC is unknown, it may be associated with an infection.

Damage caused by NEC to the intestines may create a hole in the intestines, allowing bacteria normally present in the intestines to leak out into the abdomen and cause infection. Even with treatment, this can cause serious complications. In more severe cases, it may be necessary to surgically remove part of the intestine. In the most severe cases, NEC can be fatal.

The vast majority of NEC cases are found in very premature infants. Even so, the condition only affects a small percentage of premature infants. Although NEC is rare, because of their increased risk premature infants are monitored closely during feedings.

Symptoms of necrotizing enterocolitis may include:

  • Abdominal distension or swelling in almost all cases (although most infants with abdominal distension don't have NEC)
  • Signs of infection such as sluggishness and apnea, a condition in which the baby doesn't breathe properly
  • An unstable temperature
  • Bloody stools
  • Poor feeding
  • Feeding intolerance
  • Bile-colored, or green, gastric residuals or vomiting

If the doctor suspects that your baby has necrotizing enterocolitis, an abdominal X-ray will be taken to look for signs of the condition.

Treatment of necrotizing enterocolitis depends on the severity of the baby's condition. The treatment plan may include medical treatments or surgery.

Medical Treatment

Medical treatments may include:

  • Stopping all regular feedings and using an intravenous (IV) catheter to provide nutrients to the baby
  • Placing a nasogastric tube extending from the baby's nose into the stomach to suction air and fluids from the baby's stomach and intestine
  • Antibiotic therapy to treat possible infections
  • Checking stools for blood
  • Frequent blood tests to look for signs of infection and imbalances in the body's chemistry
  • Oxygen or mechanically assisted breathing if abdominal swelling interferes with breathing
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Reviewed by health care specialists at UCSF Benioff Children's Hospital.

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