Necrotizing Enterocolitis Health Article

Definition

Necrotizing enterocolitis (NEC) is a serious bacterial infection in the intestine, primarily affecting sick or premature newborn infants. It can cause the death (necrosis) of intestinal tissue and progress to blood poisoning (septicemia).

Description

Necrotizing enterocolitis is a serious infection that can produce complications in the intestine itself such as ulcers, perforations or holes in the intestinal wall, and tissue necrosis. It can also progress to life-threatening septicemia. Necrotizing enterocolitis most commonly affects the ileum, the lower portion of the small intestine. It is less common in the colon and upper small bowel.

Demographics

It is estimated that narcotizing enterocolitis affects 2 percent of all newborns, but it is more frequently seen in very low birth weight infants, affecting as many as 13.3 percent of these babies. It has a high mortality rate, especially among very low birth weight babies. Some 20 to 40 percent of these infants die. It does not appear that male or females are more susceptible to this condition, and no one race or nationality has a higher incidence.

Causes and symptoms

The cause of necrotizing enterocolitis is not clear. It is believed that the infection usually develops after the bowel wall has already been weakened or damaged by a lack of oxygen, predisposing it to bacterial invasion. Bacteria grow rapidly in the bowel, causing a deep infection that can kill bowel tissue and spread to the bloodstream.

Necrotizing enterocolitis almost always occurs in the first month of life. Infants who require tube feedings may have an increased risk for the disorder. A number of other conditions also make newborns susceptible, including respiratory distress syndrome, congenital heart problems, and episodes of apnea (cessation of breathing). The primary risk factor, however, is prematurity. Not only is the immature digestive tract less able to protect itself, but premature infants are subjected to many stresses on the body in their attempt to survive.

Early symptoms of necrotizing enterocolitis include an intolerance to formula, distended and tender abdomen, vomiting, and blood (visible or not) in the stool. One of the earliest signs may also be the need for mechanical support of the infant's breathing. If the infection spreads to the bloodstream, infants may develop lethargy, fluctuations in body temperature, and may periodically stop breathing.