NEC symptoms
The signs and symptoms of necrotizing enterocolitis depend on the severity of the infection. Infants may experience abdominal pain, nausea and vomiting, bloating (abdominal distention), low respiratory rate or periodic breathing (apnea), lethargy (listlessness), and shock (decreased blood pressure).
Necrotizing enterocolitis usually occurs in babies born prematurely. This is because premature babies have body systems that are not fully developed like full-term babies. This can make them more susceptible to NEC because they have less oxygen-carrying blood and have problems with digestion, blood and oxygen flow, and fight-off infections.
In severe cases, a baby’s bowel wall may die. This can result in a hole (perforation) in the intestinal wall that allows bacteria to invade and infect the child’s abdomen.
Your healthcare provider will look for a swollen belly and other NEC symptoms during a physical examination. They also may check your child’s poop for blood that may not be visible to the eye. They will use a fecal test to find out if your child has a bacterial infection that causes blood in their poop.
If you think your baby has NEC, they will start treatment right away to try to cure the infection. This treatment includes antibiotics, fluid resuscitation, and other care. They also will monitor their condition with x-rays and blood tests.
Diagnosis
The diagnosis of necrotizing enterocolitis is made by a team of professionals. This team consists of doctors, nurses, and other healthcare workers who help with the treatment of your baby’s illness.
When your doctor suspects NEC, they will order a series of medical tests that will help them determine the cause and severity of the disease. These include a blood test to check for bacteria, a fecal test to check for evidence of blood in your baby’s poop, and an abdominal X-ray to see if air bubbles (called pneumatosis intestinalis) are present within your child’s intestine.
These X-rays may show multiple small bubbles in the intestine (pneumatosis intestinalis) or free air in the large veins that carry blood to the lungs (portal venous air). This can indicate a damaged intestine, a perforation, or a hole in your child’s bowel.
This type of intestine damage is very common in infants with NEC, and it can cause long-term complications for the child. These include a narrowing of the intestine (intestinal stricture) in 10 to 36% of infants who survive NEC. In severe cases, a hole in the intestine can cause an infection called peritonitis, which can be life-threatening.
Surgery to repair a damaged intestine or perforation is required in some cases of NEC. This surgery is called a colostomy or ileostomy, and it involves removing the dead part of your child’s intestine and reconnecting it later when their bowel has healed.
NEC is an emergency condition that requires immediate medical treatment, because it can be fatal if not treated early. Your doctor will begin treatment to treat the infection and heal your baby’s intestines, and they will continue monitoring your child’s condition with medical tests and X-rays until their symptoms disappear.
