What is necrotizing enterocolitis?

Necrotizing enterocolitis is a devastating disease of premature infants. It strikes acutely and without warning. The typical infant with necrotizing enterocolitis is a relatively stable premature baby who suddenly develops feeding intolerance, abdominal pain and abdominal distention, and, in severe cases, is either dying or dead from overwhelming sepsis within 24 hours. If these tiny patients undergo surgery, extensive death of the small and large intestines is encountered. Current treatment is effective in only about one-half of patients, and it involves the use of broad-spectrum antibiotics and resection (removal) of the dead intestine.

Our lack of understanding of the precise pathogenesis of necrotizing enterocolitis is highlighted by the fact that overall survival has not improved significantly in the past 30 years, when the disease was first described.

Why is necrotizing enterocolitis an important priority?

• Necrotizing enterocolitis is the most common cause of death in premature infants.
• Between 10 and 12 percent of premature infants born prior to 36 weeks are stricken with necrotizing enterocolitis.
• Necrotizing enterocolitis affects one in 500 live births.
• There is currently no real cure, and doctors do not yet know the cause.

What are the global public health impacts of necrotizing enterocolitis?

• Premature births are increasing all over the world. This means that necrotizing enterocolitis, which is more common in premature infants, is also on the rise.
• The cost to patients and to society, including lifelong medical care and loss of productivity, is between $1 billion and $2 billion per year in the U.S. alone.

What else does necrotizing enterocolitis affect?

• Those who survive necrotizing enterocolitis may suffer from cognitive, motor and lung impairment; these are areas of active investigation in the Hackam Lab.