The treatment for necrotizing enterocolitis (NEC) varies with the severity of the disease. Three stages (Bell stages) have been defined for NEC.1
- Stage 1, suspected NEC, includes symptoms such as bloody stools, diminished activity (lethargy), excessive sleepiness, an unstable temperature, mild abdominal bloating, and pain when the abdomen is touched.
- Stage 2, confirmed NEC, includes all the symptoms of stage 1 as well as slightly reduced blood platelet levels and a slight excess of lactic acid and no bowel sounds.
- Stage 3, severe NEC, includes the symptoms of stages 1 and 2 plus periods of not breathing, rapid heartbeat, severely reduced blood platelet levels, an increased number of white blood cells, and excess acid.
The treatment for stage 1 patients includes vigorous supportive care, resting the intestine by feeding through an intravenous tube instead of the mouth, and continued diagnostic and monitoring tests to ensure that the disease is not progressing. Treatments for stage 2 patients include continuation of stage 1 treatments and the use of antibiotics. Emergency surgery is needed for stage 3 patients.1
Other treatments2 offered at all stages of NEC include:
- Inserting a tube through the nasal passages into the infant’s stomach to remove air and fluid
- Taking blood samples to look for bacteria Giving antibiotic treatment through an intravenous tube
- Measuring and monitoring the infant’s belly for swelling. If it becomes so swollen that it interferes with breathing, the infant may be given oxygen or put on a ventilator.
Many infants respond to treatment within 72 hours, and physicians may decide to put these infants back on regular feeding. However, if the condition worsens or a hole develops in the intestine or bowel, surgery may be needed.2
- Bell, M. J., Ternberg, J. L., Feigin, R. D., Keating, J. P., Marshall, R., Barton, L., et al. (1978). Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging. Annals of Surgery, 187, 1–7. [top]
- Kids Health. (2011). Necrotizing enterocolitis. Retrieved August 1, 2012, from http://kidshealth.org/parent/medical/digestive/nec.html [top]