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Packard/Stanford study suggests two causes for bowel disease in infants
Date:4/26/2009

STANFORD, Calif. New research from Lucile Packard Children's Hospital and the Stanford University School of Medicine is helping physicians unravel the cause of a deadly and mysterious bowel disease that strikes medically fragile newborn babies. The findings could lead to a better understanding of the disease and its medical management, and also shed light on the causes of sepsis, a major killer of children and young adults.

The bowel disorder, necrotizing enterocolitis, or NEC, is seen mainly among premature infants, affecting about one in every 2,000 births. A similar constellation of symptoms, also labeled NEC, is also seen in children born with congenital heart defects. The disease causes massive intestinal inflammation and impairs nutrient uptake. Complications can include perforation of the intestine and widespread infection of the abdominal cavity or blood sepsis as well as lasting consequences such as the need for bowel transplant or chronic intravenous feeding.

The findings, which will appear in the May issue of the journal Pediatrics, suggest that the diagnosis of NEC in premature infants versus those with heart disease may actually encompass two distinct disease processes with different origins.

"If we start accepting that we are looking at two different diseases, further research may be able to elucidate some differences in the disease process and help us tailor management," said senior study author Sanjeev Dutta, MD, assistant professor of surgery and pediatrics at Packard Children's and the School of Medicine. Right now, because physicians have such a poor understanding of what causes the disease, they can't tell which infants will be hardest hit, Dutta said. "At present, we're managing all cases the same way without addressing the concept that the child with heart disease may have a different underlying cause of NEC than the child with prematurity alone. We're giving support, but not really curing the disease."
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Contact: Erin Digitale
digitale@stanford.edu
650-724-9175
Stanford University Medical Center
Source:Eurekalert

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