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What causes Necrotizing enterocolitis?

Updated: 9/7/2023
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GaleEncyofMedicine

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12y ago

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This is a condition in which parts of intestine undergo necrosis which means death. The condition is more common in premature babies but can occur in full term newborn babies suffering from asphyxia or polycythemia ( blood is thicker than normal). The condition is serious. Some babies may need surgery to remove dead intestinal parts. Xray shows gas within the walls of the intestine.

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15y ago
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10y ago

Necrotizing Entercolitis is a gastrointestinal disease that affects newborn infants mostly. It causes destruction and inflammation of the bowels. Babies affected by this are more likely to be born premature.

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13y ago
Definition

Necrotizing enterocolitis is the death of intestinal tissue. It primarily affects premature infants or sick newborns.

Causes, incidence, and risk factors

Necrotizing enterocolitis occurs when the lining of the intestinal wall dies and the tissue falls off. The cause for this disorder is unknown. However, it is thought that a decrease in blood flow to the bowel keeps the bowel from producing mucus that protects the gastrointestinal tract. Bacteria in the intestine may also be a cause.

This disorder usually develops in an infant that is already ill or premature, and most often develops while the infant is still in the hospital.

Those with a higher risk for this condition include:

  • Premature infants
  • Infants who are fed concentrated formulas
  • Infants in a nursery where an outbreak has occurred
  • Infants who have received blood exchange transfusions
Symptoms

Symptoms may come on slowly or suddenly, and may include:

Signs and testsTreatment

In an infant suspected of having necrotizing enterocolitis, feedings are stopped and gas is relieved from the bowel by inserting a small tube into the stomach. Intravenous fluid replaces formula or breast milk. Antibiotic therapy is started. The infant's condition is monitored with abdominal x-rays, blood tests, and blood gases.

Surgery will be needed if there is a hole in the intestines or peritonitis(inflammation of the abdominal wall). The dead bowel tissue is removed and a colostomy or ileostomy is performed. The bowel is then reconnected several weeks or months later when the infection and inflammation have healed.

Expectations (prognosis)

Necrotizing enterocolitis is a serious disease with a Death Rate approaching 25%. Early, aggressive treatment helps improve the outcome.

ComplicationsCalling your health care provider

If any symptoms of necrotizing enterocolitis develop, especially in an infant that has recently been hospitalized for illness or prematurity, go to the emergency room or call the local emergency number (such as 911).

References

Piazza AJ, Stroll BJ. Digestive System Disorders. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 102.

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11y ago
Definition

Necrotizing enterocolitis is the death of intestinal tissue. It most often affects premature or sick babies.

Causes, incidence, and risk factors

Necrotizing enterocolitis occurs when the lining of the intestinal wall dies and the tissue falls off. The cause for this disorder is unknown. However, it is thought that a decrease in blood flow to the bowel keeps the bowel from producing mucus that protects the gastrointestinal tract. Bacteria in the intestine may also be a cause.

This disorder usually develops in an infant that is already ill or premature, and most often develops while the infant is still in the hospital.

Those with a higher risk for this condition include:

  • Premature infants
  • Infants who are fed concentrated formulas
  • Infants in a nursery where an outbreak has occurred
  • Infants who have received blood exchange transfusions
Symptoms

Symptoms may come on slowly or suddenly, and may include:

Signs and testsTreatment

In an infant suspected of having necrotizing enterocolitis, feedings are stopped and gas is relieved from the bowel by inserting a small tube into the stomach. Intravenous fluid replaces formula or breast milk. Antibiotic therapy is started. The infant's condition is monitored with abdominal x-rays, blood tests, and blood gases.

Surgery will be needed if there is a hole in the intestines or peritonitis(inflammation of the abdominal wall). The dead bowel tissue is removed and a colostomy or ileostomy is performed. The bowel is then reconnected several weeks or months later when the infection and inflammation have healed.

Expectations (prognosis)

Necrotizing enterocolitis is a serious disease with a death rate approaching 25%. Early, aggressive treatment helps improve the outcome.

ComplicationsCalling your health care provider

If any symptoms of necrotizing enterocolitis develop, especially in an infant that has recently been hospitalized for illness or prematurity, go to the emergency room or call the local emergency number (such as 911).

References

Piazza AJ, Stroll BJ. Digestive System Disorders. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 102.

Reviewed By

Review Date: 05/16/2011

Todd Eisner, MD, Private practice specializing in Gastroenterology, Boca Raton, FL. Clinical Instructor, Florida Atlantic University School of Medicine. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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12y ago

Enterobacteriaceae that have been identified in infants with NEC include Salmonella, E. coli, Klebsiella, and Enterobacter

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Related questions

What percentage of necrotizing enterocolitis cases are treated without surgery?

Successful treatment for necrotizing enterocolitis in premature infants occurs in approximately 70% of cases without surgery.


When does Necrotizing enterocolitis begin?

It begins in infants shortly after birth


What is the prognosis for newborns undergoing surgery for necrotizing enterocolitis?

Necrotizing enterocolitis is the most common cause of death in newborns undergoing surgery. The average mortality is 30-40%, even higher in severe cases.


How may necrotizing enterocolitis be prevented?

Preventing necrotizing enterocolitis (NEC) in premature infants involves multiple strategies. Breastfeeding promotion is crucial, as breast milk provides vital nutrients and protective factors for gut health. Implementing careful feeding protocols, gradually introducing enteral feeds, and monitoring for feeding intolerance are essential measures. Maintaining strict hygiene practices in neonatal intensive care units (NICUs) helps minimize the risk of infection. Probiotics have shown potential in reducing NEC incidence, although their use requires careful consideration. Avoiding unnecessary antibiotics and acid-suppressing medications helps maintain a healthy gut microbiome. Minimizing exposure to risk factors such as prematurity and low birth weight also contributes to NEC prevention. Despite preventive efforts, vigilant monitoring and early intervention remain critical in high-risk infants. Also, if anyone is interested in gaining more in-depth knowledge in this field, I would suggest him/her to go for an online course - Pediatrics MD by Prof Piyush Gupta on DigiNerve. This online Pediatrics course is unique as it was designed and is being taught by India's top 100 teachers, who have over 500 years of combined experience and competence. The course encourages concept-based and approach-based learning to cater to all the learning needs of the students while they are pursuing their master's in Pediatrics. The concepts have been supported with benchmark/evidence-based studies. The course's video lectures, and accompanying notes provide clarity in concepts with enhanced understanding.


What does the medical abbreviation nec baby mean?

NEC in this context means necrotizing enterocolitis.


What does the medical abbreviation nec mean?

NEC stands for "necrotizing enterocolitis," which is a serious condition that affects the intestines of premature infants. It is characterized by inflammation and tissue death in the intestinal lining and requires prompt medical attention.


What are symptoms of advanced necrotizing enterocolitis?

Advanced necrotizing enterocolitis (NEC) in premature infants presents with distinctive symptoms indicating severe gastrointestinal distress. Abdominal distension, characterized by visible swelling due to gas accumulation and bowel dilation, is prominent. Bloody or dark stools signal intestinal bleeding, while an increased residual gastric volume and worsening bradycardia indicate compromised digestion and cardiovascular function. Hypotension may develop, jeopardizing organ perfusion, alongside metabolic acidosis evident in blood tests. Respiratory distress and sepsis, with associated fever and lethargy, may emerge as systemic effects worsen. Timely medical intervention is crucial as advanced NEC can swiftly progress, leading to critical complications like bowel perforation, septic shock, and multi-organ failure. Moreover, anyone looking for some source to gain knowledge in this field, should go for this online course - Pediatrics MD on DigiNerve. This course is taught by Dr. Piyush Gupta, who is very well – known and famous author of PG Pediatrics textbooks. It includes well-illustrated video lectures, concise notes, Spotters, Benchmark trials, and self-assessment questions to evaluate our learnings. Also, video lectures are richly illustrated with relevant images, flowcharts, boxes, tables & graphs and Case based discussions supporting every topic are also included in lectures, these elements really help in gaining conceptual clarity and memorizing well. Overall, this course is amazing and extremely helpful, I would suggest every fellow PG resident to go for this course.


What are possible complications of surgery for necrotizing enterocolitis?

wound infections and lack of healing, persistent sepsis and bowel necrosis, and a serious internal bleeding disorder known as disseminated intravascular coagulation.


What conditions render newborns susceptible to necrotizing enterocolitis?

respiratory distress syndrome, congenital heart problems, and episodes of apnea (cessation of breathing). The primary risk factor, however, is prematurity.


Under what circumstances is surgery for necrotizing enterocolitis performed?

The surgical treatment depends on the individual patient's condition. Patients with infection that has caused serious damage to the bowel may have portions of the bowel removed


What is gastric residue?

I believe that is "oily" farts. This commonly happens with a certain diet drug. if you see that gastric residue has increased in preterm neonates at 3 to 10 days after birth suspect necrotizing enterocolitis.


What are early symptoms of necrotizing enterocolitis?

Necrotizing enterocolitis (NEC) is a critical condition, especially among premature infants, characterized by inflammation and tissue death in the intestines. Early symptoms of NEC can vary, often manifesting as feeding intolerance, abdominal distension or bloating, and the presence of bloody stools. Additionally, infants may exhibit temperature instability, such as fever or hypothermia, along with episodes of apnoea or bradycardia. Changes in behaviour, including lethargy or irritability, may also be observed. Prompt recognition and intervention are crucial in managing NEC, as it can rapidly progress and lead to severe complications if left untreated. If anyone is interested Is learning and gaining in-depth knowledge in Pediatrics, I'd recommend looking for this online course- Pediatrics MD by Dr. Piyush Gupta on DigiNerve. It provides in-depth knowledge with enhanced understanding and conceptual clarity through well-illustrated video lectures, digital and printed notes, benchmark trials, and self-assessment questions. Also, clinical case-based discussions are included in each topic, which provides a clinical orientation to us. Apart from that, the indulgent teaching style of the faculty is not only interesting but also makes complexities understandable for the learners. I highly recommend this course to my every fellow Pediatrics MD resident.