Pathophysiology and current management of necrotizing enterocolitis

Himabindu Kasivajjula, Akhil Maheshwari

Research output: Contribution to journalReview articlepeer-review

Abstract

Necrotizing enterocolitis (NEC), an inflammatory bowel necrosis of preterm infants, is the most common gastrointestinal emergency and a major cause of morbidity and mortality in these infants. In this article, the authors review the pathophysiology and clinical presentation of NEC and provide a critical appraisal of the evidence supporting various prophylactic and therapeutic strategies. A literature search was performed using the databases PubMed, EMBASE, and Scopus. Current pathophysiological models of NEC suggest that the disease occurs when mucosal injury in the preterm intestine results in translocation of luminal bacteria across the epithelial barrier, triggering an exaggerated and damaging local inflammatory response. Medical management of NEC is largely supportive and likely does not modify the etiopathogenesis of this disease. Antenatal steroids, human milk feedings, adoption of standardized feeding regimens, and probiotics hold promise for prevention of NEC. Future research should focus on early recognition that occurs well before the onset of intestinal necrosis, and prevention of this disease.

Original languageEnglish (US)
Pages (from-to)489-497
Number of pages9
JournalIndian journal of pediatrics
Volume81
Issue number5
DOIs
StatePublished - May 2014
Externally publishedYes

Keywords

  • NEC
  • Pathophysiology
  • Treatment

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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