Necrotizing enterocolitis

A Kulkarni1, R Vigneswaran

  • 1Indraprastha Apollo Hospital, New Delhi. akulkarni58@rediffmail.com

Insights

Necrotizing enterocolitis (NEC) is increasingly recognized in India among survivors of intensive care for low birth-weight infants. Further understanding of NEC is crucial for prevention and management strategies in this growing population.

Area of Science:

  • Neonatalogy
  • Pediatric Gastroenterology
  • Public Health

Background:

  • Improved survival rates for low birth-weight infants in India's neonatal intensive care units are noted.
  • Increased survival is linked to the growing acceptance and affordability of advanced infant care.
  • There is a rising concern that Necrotizing enterocolitis (NEC) may significantly increase future morbidity and mortality.

Purpose of the Study:

  • To highlight the growing concern of Necrotizing enterocolitis (NEC) in India.
  • To emphasize the need for better understanding of NEC's pathophysiology and pathogenesis.
  • To underscore the importance of developing optimal prevention and management principles for NEC.

Main Methods:

  • This study is a review of current trends and concerns regarding NEC in India.
  • It synthesizes observations on the increasing incidence of NEC among survivors of intensive care.
  • It identifies the need for further research into the causes and mechanisms of NEC.

Main Results:

  • Necrotizing enterocolitis (NEC) is frequently observed in early survivors of intensive care for low birth-weight infants in India.
  • NEC is the most common acquired gastrointestinal emergency in newborns, with universally poor outcomes.
  • The rising survival rates of preterm infants predict a potential increase in NEC cases.

Conclusions:

  • Necrotizing enterocolitis (NEC) poses a significant future threat to the morbidity and mortality of preterm infants in India.
  • A deeper understanding of NEC's development is essential for effective clinical intervention.
  • Developing optimal strategies for NEC prevention and management is a critical public health priority.

Related Concept Videos

Inflammatory Bowel Disease I: Ulcerative Colitis01:27

Inflammatory Bowel Disease I: Ulcerative Colitis

Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory Bowel Disease II: Crohn's Disease01:30

Inflammatory Bowel Disease II: Crohn's Disease

Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
Bacterial Gastroenteritis01:18

Bacterial Gastroenteritis

Bacterial gastroenteritis, characterized by diarrhea, abdominal cramps, and vomiting, is often caused by ingestion of contaminated food or water and is frequently associated with pathogenic Escherichia coli strains. These microbes exploit two principal mechanisms to inflict disease.Shiga toxin–producing E. coli, also referred to as STEC—notably O157:H7—release Shiga toxins that target ribosomes, blocking protein synthesis. The B subunit of the toxin binds the host glycolipid receptor...
Amebiasis01:28

Amebiasis

Entamoeba histolytica, a protozoan parasite, is responsible for intestinal and extraintestinal amebiasis. Though a significant proportion of infections remain asymptomatic, approximately 50 million individuals annually are estimated to present with clinical disease, resulting in up to 100,000 deaths globally. The disease burden is disproportionately high in regions with lower socioeconomic status, such as parts of India, Africa, Mexico, and Latin America.Etiology and TransmissionThe infective...
Intestinal Obstruction II: Pathophysiology01:07

Intestinal Obstruction II: Pathophysiology

Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...
Inflammatory Bowel Disease II: Ulcerative Colitis01:20

Inflammatory Bowel Disease II: Ulcerative Colitis

Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...