Necrotizing enterocolitis (NEC) is a serious intestinal illness in babies that results in the death of intestinal tissues. NEC can lead to holes or areas of narrowing (strictures) in the intestines and is a cause of short bowel syndrome (SBS). In SBS, a child lacks enough small intestine to absorb all the nutrition their growing body needs.
Symptoms & Causes
What causes necrotizing enterocolitis?
The cause of necrotizing enterocolitis (NEC) is unknown. Premature babies or sick newborns are at the greatest risk for NEC, which occurs in about 10 percent of babies weighing less than 3 pounds, 5 ounces.
Diagnosis & Treatments
How is necrotizing enterocolitis diagnosed?
Your doctor will examine your baby for the following symptoms:
Abdominal distention (bloating or swelling)
Feedings that stay in the stomach
Bile-colored (green) fluid in stomach
Bloody bowel movements
Signs of infection such as apnea (stopping breathing), low heart rate, and lethargy (sluggishness)
We may then suggest an X-ray to look for air in the intestines or the large veins of the liver. In some cases, your doctor may insert a needle into your baby's abdominal cavity to look for intestinal fluid, which is often a sign of NEC.
How is necrotizing enterocolitis treated?
Treatment for NEC may include the following:
Stopping feedings
Inserting a nasogastric (NG) tube (nose into stomach) to keep the stomach empty
Intravenous fluids (IV) for nutrition and fluid replacement
Antibiotics for infection
Frequent X-rays to monitor the progress of the disease
Extra oxygen or mechanically assisted breathing
Isolation procedures (such as protective gowns and gloves) to keep any infection from spreading
In more severe cases, babies with NEC may require:
Surgery to remove diseased intestine or bowel
Connecting part of the intestine or bowel to an ostomy (opening on the abdomen)
How we care for necrotizing enterocolitis
At Boston Children's Hospital, we treat children with NEC in our Center for Advanced Intestinal Rehabilitation (CAIR), which includes a team of experts with decades of experience in caring for children with intestinal problems and their families. Our specialists include:
Physicians trained in surgery, gastroenterology, and nutrition
