NEC: Necrotizing Enterocolitis (Patient Information)

NEC is a disease that is seen primarily in premature infants, but may occasionally be seen in full-term infants and older children. A child has NEC when they have had damage to the lining of the intestines (bowel). NEC usually occurs within the first month of life.
What causes NEC?
The actual cause of NEC is unknown. However, several conditions are associated with NEC. These conditions include prematurity, stress, decreased blood flow to the bowel, low blood pressure, and asphyxia (not enough oxygen for the baby before, during, or after birth). Sometimes, there are no warnings of NEC and the infant becomes very sick in a short period of time.

What are the symptoms of NEC?
The symptoms of NEC can include some or all of the following, depending on the seriousness of the disease:
  1. An enlarged abdomen due to gas and decreased movement of the bowel (ileus).
  2. Leftover food or milk in the stomach from the previous feeding.
  3. Vomiting.
  4. Blood in the stool (bowel movement). The blood may or may not be visible.
  5. Low blood pressure.
  6. Abnormal clotting of the blood.
  7. Temperature changes.
How is NEC diagnosed?
The physician can diagnose NEC by some or all of the following:
  1. The infant's history of symptoms and the results of a physical exam.
  2. The infant's blood will be checked for abnormalities, particularly abnormal clotting and/or infection.
  3. The infant's stools will be watched and may be tested for blood.
  4. The infant will have an abdominal x-ray to check for abnormal air.
What is the treatment?
  1. The infant will probably not be orally fed for approximately seven days.
  2. The infant will have an IV instead of oral feedings.
  3. An orogastric tube (OG) will be placed into the infant's stomach to drain secretions and release gas.
  4. The infant will be given IV antibiotics to prevent or treat infection in the bowel and the rest of the body.
  5. Blood transfusions may be necessary.
  6. Surgery may be necessary if the damage to the bowel lining is severe. If surgery is required an ileostomy or colostomy may be necessary to allow the damaged bowel to heal
Future Expectations:
Occasionally, an infant can get a stricture or narrowing of the bowel due to scarring from the disease or surgery. If the stricture causes obstruction of the bowel, further surgery may be necessary.