Related Experiment Video
Updated: Jun 20, 2026
Intestinal Epithelial Regeneration in Response to Ionizing Irradiation
Published on: July 27, 2022
Diagnostic ionizing radiation exposure in a population-based sample of children with inflammatory bowel diseases
Lena Palmer1, Hans Herfarth, Carol Q Porter
1Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA. lena_palmer@med.unc.edu
Insights
Many children with inflammatory bowel diseases (IBD) undergo moderate diagnostic radiation exposure, particularly those with Crohn's disease (CD). This high exposure rate necessitates further investigation into potential long-term health risks for pediatric IBD patients.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
- Radiation Oncology
Background:
- Diagnostic radiation exposure in pediatric inflammatory bowel diseases (IBD) is not well-characterized.
- Understanding this exposure is crucial for managing long-term health risks in children with chronic conditions.
Purpose of the Study:
- To quantify diagnostic radiation exposure in a population-based sample of children with IBD.
- To identify factors associated with moderate radiation exposure in this cohort.
Main Methods:
- Utilized a large insurance claims database to identify children with IBD (Crohn's disease [CD] and ulcerative colitis [UC]).
- Assessed radiological study use, medication, and healthcare utilization (hospitalization, ED encounters, surgery).
- Defined moderate radiation exposure as at least one CT scan or three fluoroscopies over 24 months and used logistic regression to identify associated characteristics.
Main Results:
- Identified 965 children with CD and 628 with UC.
- Over 24 months, 34% of CD and 23% of UC patients experienced moderate radiation exposure.
- Moderate exposure in CD was linked to hospitalization, surgery, ED visits, oral steroids, and budesonide, with an inverse association with immunomodulators.
Conclusions:
- A significant percentage of children with IBD receive moderate diagnostic radiation doses.
- The high utilization of radiation-emitting diagnostic tests may pose long-term health risks due to the chronic nature of IBD in pediatric patients.
Objectives:
The degree of diagnostic radiation exposure in children with inflammatory bowel diseases (IBD) is largely unknown. In this study, we describe this exposure in a population-based sample of children with IBD and determine the characteristics associated with moderate radiation exposure.
Methods:
We ascertained radiological study use, demographic characteristics, IBD medication use, and the requirement for hospitalization, emergency department (ED) encounter, or inpatient gastrointestinal surgery among children with IBD within a large insurance claims database. Characteristics associated with moderate radiation exposure (at least one computed tomography (CT) or three fluoroscopies over 2 years) were determined using logistic regression models.
Results:
We identified 965 children with Crohn's disease (CD) and 628 with ulcerative colitis (UC). Over 24 months, 34% of CD subjects and 23% of UC subjects were exposed to moderate diagnostic radiation (odds ratio (OR) 1.71, 95% confidence interval (CI), 1.36 - 2.14). CT accounted for 28% and 25% of all studies in CD and UC subjects, respectively. For CD subjects, moderate radiation exposure was associated with hospitalization (OR 4.89, 95% CI 3.37 - 7.09), surgery (OR 2.93, 95% CI 1.59 - 5.39), ED encounter (OR 2.65, 95% CI 1.93 - 3.64), oral steroids (OR 2.25, 95% CI 1.50 - 3.38), and budesonide (OR 1.80, 95% CI 1.10 - 3.06); an inverse association was seen with immunomodulator use (OR 0.67, 95% CI 0.47 - 0.97). Except for oral steroids and immunomodulators, similar relationships were seen in UC.
Conclusions:
A substantial proportion of children with IBD are exposed to moderate amounts of radiation as a result of diagnostic testing. This high utilization may impart long-term risk, given the chronic nature of the disease.
Related Concept Videos
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the colonic...
01:25Inflammatory Bowel Disease III: Crohn's Disease
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
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...
01:30Inflammatory Bowel Disease II: Crohn's Disease
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...
01:26Inflammatory Bowel Disease I: Introduction
01:20Inflammatory Bowel Disease II: Ulcerative Colitis