Are We Overradiating Patients with Irritable Bowel Syndrome?

Area of Science:

• Medical imaging
• Radiation oncology
• Gastroenterology

Background:

• Protracted radiation exposure, even at low cumulative effective doses (CED) of 50-100 mSv, may elevate malignancy risk.
• Medical radiation exposure in patients with irritable bowel syndrome (IBS) remains under-examined.
• This study investigated medical radiation exposure patterns in IBS patients at a US tertiary care center.

Purpose of the Study:

• To quantify medical radiation exposure in patients diagnosed with IBS.
• To identify factors associated with high cumulative effective dose (CED) in this population.
• To assess the prevalence of significant radiation exposure levels among IBS patients.

Main Methods:

• Retrospective cohort study of 221 IBS patients from 2009-2018.
• Analysis of medical charts to calculate total and annual cumulative effective dose (CED).
• Multivariable logistic regression to identify predictors of high CED exposure.

Main Results:

• Mean CED was 40.32 mSv; 26.7% of patients exceeded 50 mSv, and 12.2% exceeded 100 mSv.
• CT scans comprised 66.61% of total CED, followed by conventional imaging, nuclear medicine, and fluoroscopy.
• High CED was independently associated with anxiety, chronic pain medication use, and diarrhea-predominant IBS (IBS-D).

Conclusions:

• A significant proportion of IBS patients accumulate high medical radiation doses, with 1 in 4 reaching potentially risky levels (≥50 mSv).
• Comorbid anxiety, chronic pain medication use, and IBS-D are key independent predictors of elevated cumulative effective dose (CED).
• These findings highlight the need for careful radiation dose management in IBS patient care.