How do healthcare providers diagnose necrotizing enterocolitis (NEC)?

The development of symptoms such as the inability to tolerate feeding, bloody stools, or distention of the abdomen could indicate NEC. The condition is usually confirmed by an abdominal X-ray. If the X-ray reveals a “bubbly” appearance in the wall of the intestine or air outside the infant’s intestine (in the peritoneal cavity) the diagnosis is confirmed.1 Other X-ray signs include air in a vein of the liver called the portal vein, swollen intestines, or a lack of gas in the abdomen.

Other useful tests include looking for blood in the infant's stool. If necessary, the healthcare provider can use a chemical that reveals blood not visible to the eye.

In addition, healthcare providers may test the infant's blood to check for infection, which could suggest NEC. They may also use a blood test for lactic acid, which can indicate whether the body is getting enough oxygen or an infection that increases the metabolic rate and production of lactic acid.2

Blood and stool tests, combined with the abdominal X-ray, can help the healthcare provider determine the seriousness of the infant's condition.


  1. Kids Health. (2011). Necrotizing enterocolitis. Retrieved August 1, 2012, from external link
  2. MedLinePlus. (2011). Necrotizing enterocolitis. Retrieved August 1, 2012, from
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