Necrotizing enterocolitis (NEC) is an acute life threatening illness of intestine in new born and premature babies. The disease is characterized by necrosis of the tissues of inner lining of intestine which eventually leads to perforation in at least one third cases. If perforation occurs, the bacteria present in intestine will enter into the abdomen leading to serious infection. NEC is more common in premature babies and infants with low birth weight.
This enigmatic intestinal illness is a challenge for doctors because its definite etiology is not yet known. The typical mild symptoms of disease include feeding intolerance and abdominal distention.Serious symptoms include blood in stool, fever, breathing difficulty, diarrhea and vomiting. Necrotizing enterocolitis is considered as emergency which needs to be treated immediately. Treatment consists of administration of antibiotics, intravenous fluids, and surgery in severe cases. Prognosis of the disease is encouraging after treatment.
Causes And Risk Factors Of Necrotizing Enterocolitis
Necrotizing enterocolitis is a disease of small as well as large intestine. The exact cause of NEC still eludes medical researchers. The disease was described for the first time by Paltauf in 1888. However, the term necrotizing enterocolitis was used for the first time by Schmid and Quaiser in 1953.
Although there is no single definite cause of necrotizing enterocolitis; several risk factors are thought to increase the risk of developing NEC. One of the key factors is lack of oxygen at the time of difficult delivery of the infant. Reduced level of oxygen and blood flow to the intestine can weaken the intestinal wall. Weak wall makes it easier for the bacteria to penetrate in the intestine wall eventually leading to NEC.
Other risk factors include:
- Premature babies
- Low birth weight. Birth weight lower than 1500 gm.
- Dehydration and severe electrolyte imbalance.
- Babies who are tube feeding.
- Exposure to cocaine during pregnancy.
Signs And Symptoms Of Necrotizing Enterocolitis
The symptoms of necrotizing enterocolitis manifest within first two weeks and include:
- Distension of the abdomen
- Tenderness and redness of the abdomen
- Poor tolerance to feeding
- Vomiting frequently.
- Stool traced with blood.
- Blue discoloration of abdomen
- Lack of energy
- Breathing difficulty
- Low heart and pulse rate.
Diagnosis And Treatment Of Necrotizing Enterocolitis
Following steps will help in diagnosis of necrotizing enterocolitis:
- Physical examination by the pediatrician.
- X-ray of the abdominal.
- Stool test for presence of blood in stool.
- Blood tests to determine white blood cell count and platelet count.
The treatment of necrotizing enterocolitis depends on many factors such as the age, overall health severity of the condition. Treatment consists of following:
- Administration of antibiotics to fight the bacterial infection.
- Intravenous administration of fluids.
- Breathing assistance and extra supply of oxygen if the baby experiences difficulty in breathing.
- Stopping feeding and putting a nasogastric tube inside the stomach to keep it empty.
- Monitoring the patient with X-ray regularly.
In severe cases surgery may be necessary to remove the diseased part of bowel.