Necrotizing Enterocolitis

Is your newborn passing blood in stool and also suffering from Diarrhea? The problem could be an acute intestinal disease, known as Necrotizing Enterocolitis (NEC). Read and know all about the causes, symptoms, diagnosis and treatment of this disorder.

Necrotizing Enterocolitis Definition

It is the most frequent gastrointestinal crisis that occurs in neonates. This bacterial infection severely damages the intestinal tissues and generally occurs in newborns resulting in neonatal morbidity and death. Sick babies or premature newborns are prone to this syndrome.

Necrotizing Enterocolitis ICD9 Code

The ICD9 code for this condition is 777.5.

Necrotizing Enterocolitis Incidence

NEC generally develops among premature infants. It occurs in 1 out of every 2000 to 4000 newborns in the US and is considered to be one of the most common intestinal ailments among infants.

Necrotizing Enterocolitis Causes

NEC occurs in newborns when the inside layer of the wall diminishes and the adjoining tissues falls off. The exact cause of this syndrome is still unknown. According to medical professionals, however, the intestinal tissues of the premature babies become weak due to lessened supply of oxygen. Hence, when feeding initiates, the increased pressure of passing the food via the intestine allows bacteria to rupture the wall of intestine tissues.

Inability of the digestive and immune systems to function properly may give rise to NEC. It is inevitable when a baby is born quite early or there are difficulties during pregnancy.

Common Necrotizing Enterocolitis sufferers

NEC is an acute gastrointestinal disorder which can lead to death. The category of patients affected by this syndrome includes:

  • Premature babies who have problems with blood and oxygen circulation are more prone to NEC
  • Babies who have experienced delivery problems. They are at an increased risk to NEC due to reduced oxygen in the gastrointestinal circulation.
  • Newborns with gastrointestinal infections are more prone to NEC
  • High risk babies who are fed by tube have more chances of developing this disease.

Necrotizing Enterocolitis Symptoms

The symptoms of NEC may appear slowly or unexpectedly, depending on the on the severity of the disease. Each and every child affected by NEC displays the symptoms in the initial 2 weeks. The symptoms, exhibited by the majority of sufferers, may include:

  • Diarrhea
  • Abdominal distention
  • Lethargy
  • Vomiting
  • Constipation
  • Unstable body temperature
  • Abnormal heart beat and breathing
  • Inactivity
  • Blood in stool
  • Feeding intolerance
  • Swollen red belly
  • Fever and chills

Necrotizing Enterocolitis Diagnosis

The diagnosis of NEC is dependent on the symptoms manifested in sufferers. If NEC is suspected, few tests are recommended by doctors to patients, which include:

  • Stool for occult blood test (guaiac)
  • Thrombocytopenia (low platelet count)
  • Abdominal x-ray
  • Elevated white blood cell count in a CBC (Complete Blood Count)
  • Lactic acidosis

Necrotizing Enterocolitis Treatment

Newborns with NEC are given special medical treatment for their disease. The treatment determined by your child’s doctor may depend on:

  • Extent of the disease
  • Overall health of the baby
  • Ability to tolerate different procedures, therapies, medications etc.

The treatment of NEC is based on removing the dead bowel and killing the infection at the same time healing the inflammation. This can be done with the aid of:

  • Nasogastric feeding
  • Antibiotic injections
  • Extra artificial oxygen or mechanically helped breathing if the abdomen becomes swollen which disrupts breathing.
  • Complete stoppage of feeding.
  • Intravenous liquids, for fluid replacement and nutrition.
  • Regular X-rays to administer the growth and development of this syndrome.
  • Isolation techniques, to prevent infection from propagating.

Few severe cases of NEC may include:

  • Positioning of a drain right in the abdominal cavity to washout the dirty fluid.
  • Surgery, to remove the affected bowel or intestine

Necrotizing Enterocolitis Prognosis

NEC is a severe disorder which has a death rate of nearly 25%. Treatment at an early stage helps to enhance the outcome of the disease.

Necrotizing Enterocolitis Complications

NEC is a life-threatening syndrome. If immediate treatment and precautions are not taken, this disorder may give rise to a number of complications including:

  • Intestinal stricture
  • Intestinal perforation
  • Peritonitis
  • Sepsis

Necrotizing Enterocolitis Risk Factors

The high-risk group for NEC includes:

  • Newborns in nursery where outbreak has taken place.
  • Premature newborns
  • Infants who have experienced blood transfusion
  • Newborns who are given concentrated formulas

Necrotizing Enterocolitis Prevention

Prevention of NEC is difficult as the exact cause of this syndrome is not known. According to medical researchers, breast milk may minimize the occurrence of NEC. One of the recommended measures for prevention is to start feeding a baby in large quantity.

Necrotizing Enterocolitis can result into death unless properly treated in time. Hence, if any member of your family displays the signs of this syndrome (especially a newborn who has been hospitalized for illness or pre-maturity), consult your family physician immediately.

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