Necrotizing EnterocolitisSymptoms, Doctors, Treatments, Advances & More
Learn About Necrotizing Enterocolitis
Necrotizing enterocolitis (NEC) is the death of tissue in the intestine. It occurs most often in premature or sick babies.
NEC occurs when the lining of the intestinal wall dies. This problem nearly always develops in an infant who is ill or premature. It is likely to occur while the infant is still in the hospital.
The exact cause of this disorder is unknown. A drop in blood flow to the bowel can damage the tissue. Bacteria in the intestine may also add to the problem. Also, premature infants have an undeveloped immune response to factors such as bacteria or low blood flow. An imbalance in immune regulation appears to be involved in NEC.
Babies at higher risk for the condition include:
- Premature infants
- Infants who are fed formula rather than human milk. (Human milk contains growth factors, antibodies, and immune cells which may help prevent the problem.)
- Infants in a nursery where an outbreak has occurred
- Infants who have received blood exchange transfusions or have been seriously ill
Symptoms may come on slowly or suddenly, and may include:
- Abdominal bloating
- Blood in the stool
- Diarrhea
- Feeding problems
- Lack of energy
- Unstable body temperature
- Unstable breathing, heart rate, or blood pressure
- Vomiting
Treatment for a baby who may have NEC most often includes:
- Halting enteral (GI tract) feedings
- Relieving gas in the bowel by inserting a tube in the stomach
- Giving intravenous (IV or into a vein) fluids and nutrition
- Giving IV antibiotics
- Monitoring the condition with abdominal x-rays, blood tests, and measurement of blood gases
The infant will need surgery if there is a hole in the intestines or inflammation of the abdominal wall (peritonitis).
In this surgery, the surgeon will:
- Remove dead bowel tissue
- Perform a colostomy or ileostomy
The bowel may be reconnected after several weeks or months when the infection has healed.
University Of Iowa Stead Family Children's Hospital
Steven Mcelroy is a Neonatologist and a Pediatrics provider practicing medicine in Iowa City, Iowa. Dr. Mcelroy is rated as an Elite provider by MediFind in the treatment of Necrotizing Enterocolitis. He is also highly rated in 4 other conditions, according to our data. His clinical expertise encompasses Necrotizing Enterocolitis, Premature Infant, Viral Gastroenteritis, and Patent Ductus Arteriosus.
Suburban Geriatrics Inc
Robert Pearlstein is a primary care provider, practicing in Geriatrics and Internal Medicine in Plymouth Meeting, Pennsylvania. Dr. Pearlstein is rated as a Distinguished provider by MediFind in the treatment of Necrotizing Enterocolitis. He is also highly rated in 180 other conditions, according to our data. His clinical expertise encompasses Dementia, Alzheimer's Disease, Painful Swallowing, Gastrostomy, and Endoscopy. Dr. Pearlstein is board certified in .
Rubenstein Child Health Building
David Hackam is a General Surgeon practicing medicine in Baltimore, Maryland. Dr. Hackam is rated as an Elite provider by MediFind in the treatment of Necrotizing Enterocolitis. He is also highly rated in 4 other conditions, according to our data. His clinical expertise encompasses Necrotizing Enterocolitis, Necrosis, Short Bowel Syndrome, Pancreaticoduodenectomy, and Hepato-Pancreato-Biliary Surgery. Dr. Hackam is board certified in American Board Of Surgery. Dr. Hackam is currently accepting new patients.
NEC is a serious disease. Up to 40% of infants with NEC die from it. Early, aggressive treatment can help improve the outcome.
Complications may include:
- Peritonitis
- Sepsis
- Intestinal perforation
- Intestinal stricture
- Liver problems from prolonged inability to tolerate enteral feeds and need for parenteral (IV) nutrition
- Short bowel syndrome if a large amount of intestine is lost
Get emergency medical care if any symptoms of necrotizing enterocolitis develop. Infants who are hospitalized for illness or prematurity are at higher risk for NEC. They are watched closely for this problem before they are sent home.
Summary: The primary objective of this study is to demonstrate that mucous fistula refeeding between enterostomy creation and enterostomy closure reduces the time to full enteral feeds after enterostomy closure compared to standard of care.
Summary: Study Hypothesis/Question In infants born very preterm, advancing enteral feeds after 24 hours from birth (limited trophic feeds) versus after 72 hours (extended trophic feeds) reduces the risk of all-cause late onset sepsis (LOS) without increasing the risk of other adverse outcomes. Study Design Type This is a multi-center, open-label, parallel-group, individual randomized controlled trial compa...
Published Date: April 06, 2025
Published By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
de la Cruz D, Neu J. Neonatal necrotizing enterocolitis. In: Martin RJ, Fanaroff AA, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 12th ed. Philadelphia, PA: Elsevier; 2025:chap 89.
Greenberg JM, Narendran V, Brady JM, Nathan AT, Haberman BB. Neonatal morbidities of prenatal and perinatal origin. In: Lockwood CJ, Copel JA, Dugoff L, et al, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 73.
Maqbool A, Liacouras CA. Normal development, structure, and function of the stomach and intestines. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 374.