Necrotizing Enterocolitis Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Necrotizing Enterocolitis (NEC) is a digestive disorder that often occurs in premature babies who receive formula milk. This disease is characterized by damage to intestinal cells that is quite severe so that intestinal leakage can occur.
NEC is more often experienced by babies with a birth weight of less than 1500 grams. The death rate from NEC is quite high. About 50% of babies with a birth weight of less than 2000 grams who experience NEC end up dying.
Symptom
Most cases of NEC are experienced by premature babies in the first few weeks of life. The symptoms experienced are:
- Nausea and vomiting
- Diarrhea
- Stomach looks bloated and bloated
- Abdominal skin can look reddish
- Defecation mixed with fresh blood
In contrast to other diarrhea which can also occur in infants, digestive disorders due to NEC are usually accompanied by a very severe decline in health conditions in infants. The baby will appear very weak and inactive, blood pressure drops dramatically, and the baby can even experience sudden respiratory arrest.
Reason
Under normal conditions, the human intestine has a number of good bacteria. Most of the good bacteria come from the bifidobacteria group. One of the benefits of the presence of these bacteria is to protect the intestine against germ infections from outside.
When germs enter the digestive tract (for example from contaminated food or drink) and have the potential to damage intestinal cells, good bacteria will try to fight these germs so that intestinal infections can be prevented before they occur.
In premature birth, the baby’s intestines have not matured properly and there are not many good bacteria. Good bacteria will slowly increase in number if the baby gets exclusive breastfeeding. Conversely, if the premature baby gets formula milk contaminated with germs, the germs will enter the digestive tract, can infect the intestines and eventually damage intestinal cells.
The germs that most often cause NEC are Escherichia coli, Klebsiella pneumonia, Proteus mirabilis, Staphylococcus aureus, Enterococcus, Clostridium perfringens, and Pseudomonas aeruginosa.
Diagnosis
The diagnosis of NEC is generally considered by doctors in premature infants who receive formula milk and experience complaints of severe digestive disorders. The main examinations in cases of Necrotizing Enterocolitis are as follows:
- X-ray examination of the abdomen (abdomen). In the case of NEC, you will see a lot of air in the abdominal cavity which should not be there under normal conditions.
- Routine blood tests (hemoglobin, leukocytes, platelets) periodically. This examination is generally carried out every 6 hours as part of monitoring the baby’s condition. If there is bleeding, hemoglobin (red blood cells) and platelets (platelets) will decrease in number. Leukocytes are generally also in lower levels than normal.
- Blood culture. In this examination, a sample of the baby’s blood is taken and cultured in a cup. The goal is to see if there are bacteria that cause NEC.
Treatment
Babies who experience NEC must be treated in a hospital with complete facilities. If the condition is severe, it is not uncommon for treatment to be carried out in an intensive care room. The main treatments that will be carried out by the team of doctors are:
- Temporarily stop all feedings
- Installing a tube from the nose to the stomach ( nasogastric tube / NGT) to help expel excess air in the digestive tract.
- Give broad-spectrum antibiotics (broad spectrum means that these antibiotics have the ability to kill various types of bacteria).
- Give fluids and calories through an IV.
- If there is a decrease in condition until breathing stops, it is necessary to install a breathing apparatus in the form of a ventilator to help keep the baby’s breathing regular.
- If the damage to the intestine is so severe that a part of the intestine dies or leaks, then surgery generally needs to be done.
Prevention
To prevent NEC, as much as possible give only exclusive breastfeeding to premature babies. In addition, consult with your doctor about the possibility of giving probiotics for the digestive tract of infants, especially premature babies.