Role for Diversion Immediate diversion should be strongly considered for all patients presenting with sepsis and severe HAEC, especially in newborns when this is the initial presentation. [ncbi.nlm.nih.gov]

Acute FPIES presents with repetitive, profuse vomiting that typically starts one to four hours after a triggering food is eaten. Some infants can become floppy, pale, cold and develop diarrhoea. [allergy.org.au]

In the present study, five of the seven infants in the EHM cohort developed NEC on Day 6 or Day 7 of life, during the early modal distribution of NEC. [liebertpub.com]

Older infants can present with solid food FPIES, typically when an infant starts eating rice, oats, barley and other similar foods. This generally occurs after 4 months of age. [acaai.org]

Incidence and timing of presentation of necrotizing enterocolitis in preterm infants. Pediatrics 2012; 129: e298-304 4 Goulet O, Baglin-Gobet S, Talbotec C. et al. [thieme-connect.com]

• Trisomy 21

  21 compared to a 25% incidence in those without Trisomy 21.(24, 25) Similar risk of HAEC may exist in patients who concomitantly have intestinal neuronal dysplasia and trisomy 21(26). [ncbi.nlm.nih.gov]

• Candidiasis

  (March 2023) Cause[edit] Among the causal agents of acute enterocolitis are:[citation needed] bacteria: Salmonella, Shigella, Escherichia coli (E. coli), Campylobacter etc. viruses: enteroviruses, rotaviruses, Norovirus, adenoviruses fungi: candidiasis [en.wikipedia.org]

• Feeding Difficulties

  Limiting the range of foods can lead to nutritional deficiencies, poor growth, food refusal and feeding difficulties. [allergy.org.au]

• Nausea

  Common clinical manifestations of enterocolitis are frequent diarrheal defecations, with or without nausea, vomiting, abdominal pain, fever, chills, alteration of general condition. [en.wikipedia.org]

  Vier Tage nach Erhalt des zweiten Zyklus Docetaxel stellte sich die Patientin mit Bauchschmerzen, Nausea, Emesis und Obstipation bestehend seit 3 Tagen vor. [karger.com]

• Failure to Thrive

  Early on, infants tend to have poor growth and might be diagnosed with failure to thrive. Older infants can present with solid food FPIES, typically when an infant starts eating rice, oats, barley and other similar foods. [acaai.org]

  […] to thrive, including dilatations, washouts, laxatives or anti-motility medications. [ncbi.nlm.nih.gov]

• Fecal Incontinence

  One concern that has been raised regarding this procedure is the risk of incontinence in adulthood. [ncbi.nlm.nih.gov]

• Explosive Diarrhea

  HAEC: abdominal distension in 99% of cases, explosive diarrhea in 82%, vomiting in 61%, fever in 40%, lethargy, in 32%, rectal bleeding in 6%, and shock in 6%.(29) In addition to these “classic” diagnostic criteria many patients will present with less [ncbi.nlm.nih.gov]

• Heart Disease

  In addition to feeding practices, NEC has variously been attributed to intolerance of bovine milk protein, chorioamnionitis, intrauterine asphyxia, hypovolemia, congenital heart disease, abnormal intestinal development, medications, infections, blood [liebertpub.com]

  While certainly not needed in most cases, diversion should be considered for those HD patients with severe congenital heart disease, due to their compromised physiology and impaired tolerance to insult.(4) Probiotics Probiotics have been used to prevent [ncbi.nlm.nih.gov]

• Dermatitis

  These organisms have been evaluated for treatment of infectious diarrhea, antibiotic associated diarrhea, atopic dermatitis, necrotizing enterocolitis, Helicobacter pylori infection, Crohn’s disease, and ulcerative colitis.(31-33) Shen et al. reported [ncbi.nlm.nih.gov]

• Perianal Excoriation

  excoriation.(2) Due to lack of clearly defined diagnostic criteria for HAEC, the reported incidence of HAEC has wide variation in the literature. [ncbi.nlm.nih.gov]

• Excoriation

  […] explosive diarrhea in 82%, vomiting in 61%, fever in 40%, lethargy, in 32%, rectal bleeding in 6%, and shock in 6%.(29) In addition to these “classic” diagnostic criteria many patients will present with less specific symptoms such as loose stool or perianal excoriation [ncbi.nlm.nih.gov]

• Candida

  In addition to bacterial overgrowth, it is thought that alterations in bacterial composition (54) and certain pathogens (C. diff., Candida sp., Rotavirus) may increase risk of HAEC.(55, 56) To avoid morbidity from septicemia it is not only imperative [ncbi.nlm.nih.gov]

  (79%) 158 (79%) 1 UVC 296 (67%) 122 (61%) 0.180 PDA 91 (21%) 46 (23%) 0.467  PDA treated with indomethacin 75 (17%) 29 (15%) 0.489 Sepsis  Clinical, culture negative 93 (21%) 51 (26%) 0.220  Bacterial, culture positive 40 (9%) 5 (3%) 0.004  Fungal (Candida [liebertpub.com]

• Helicobacter Pylori

  Twenty-first century[edit] In 2005, Barry Marshall and Robin Warren of Australia were awarded the Nobel Prize in Physiology or Medicine for their discovery of Helicobacter pylori (1982/1983) and its role in peptic ulcer disease. [en.wikipedia.org]

  These organisms have been evaluated for treatment of infectious diarrhea, antibiotic associated diarrhea, atopic dermatitis, necrotizing enterocolitis, Helicobacter pylori infection, Crohn’s disease, and ulcerative colitis.(31-33) Shen et al. reported [ncbi.nlm.nih.gov]

Diagnosis[edit] Types[edit] Specific types of enterocolitis include:[2][3] necrotizing enterocolitis (most common in premature infants) pseudomembranous enterocolitis (also called "Pseudomembranous colitis") Treatment[edit] Treatment depends on aetiology [en.wikipedia.org]

If you suspect that your child has symptoms of FPIES, see an allergist for diagnosis and treatment. [acaai.org]

Once appropriate treatment for IBD was started, the patients responded. [ncbi.nlm.nih.gov]

Stemmler HJ, Kenngotte S, Diepolder H, Heinemann V: Gastrointestinal toxicity associated with weekly docetaxel treatment. Ann Oncol 2002;13:978–981. [karger.com]

Outlook / Prognosis What is the prognosis (outlook) for people who have necrotizing enterocolitis? An estimated 8 in 10 babies with NEC survive. Some of these babies will have long-term health problems from NEC. [my.clevelandclinic.org]

A bimodal distribution of the age of onset suggests separate etiologies for early and late NEC. [liebertpub.com]

The chapter also details approaches to diagnose HAEC as well as to exclude other etiologies. [ncbi.nlm.nih.gov]

Epidemiology of necrotizing enterocolitis. Clin Perinatol. 1994;21:205-18. 5. Llanos AR, Moss ME, Pinzón MC, Dye T, Sinkin RA, Kendig JW. Epidemiology of neonatal necrotizing enterocolitis; a population-based study. [revistabiomedica.org]

Necrotizing enterocolitis: Recent scientific advances in pathophysiology and prevention. Semin Perinatol. 2008:32;70-82. 12. Spritzer R, Koolen AM, Baerts W, Fetter WP, Lafeber HN, Sauer PJ. [revistabiomedica.org]

Prophylactic Washouts In addition to pre-operative prevention, rectal washout is also effective for prevention of postoperative HAEC. Irrigations are performed with 10 to 20 ml/kg aliquots one to two times daily. [ncbi.nlm.nih.gov]

Prevention How can I prevent necrotizing enterocolitis? If you are at risk for preterm birth, you may get corticosteroid injections. This medication boosts the health of the developing fetus. It may lower its chances of lung and intestinal problems. [my.clevelandclinic.org]

Currently the only management option for prevention of FPIES reactions is to avoid the trigger food/s. FPIES reactions are managed by giving fluids to maintain hydration. [allergy.org.au]

Multiple strains probiotics appear to be the most effective probiotics in the prevention of necrotizing enterocolitis and mortality: An updated meta-analysis. PLoS One 2017; 9; 12: e0171579 13 Guthmann F, Arlettaz Mieth R, Bucher HU. et al. [thieme-connect.com]

A range of probiotic supplements, as single‐ or multiple‐strain preparations, are available commercially and have been used to prevent and treat infectious or inflammatory gastrointestinal conditions in adults. [cochranelibrary.com]