Radiation exposure in children with inflammatory bowel disease

Abstract

Radiation exposure due to medical imaging has grown exponentially over the past two decades and the awareness has increased in the last few years with a number of articles in scientific publications and lay press. Radiation increases the risk of cancer and is particularly a concern in children. Limiting radiation exposure is most important in children, who are more sensitive to radiation, and specifically in children with a chronic lifelong disease such as inflammatory bowel disease (IBD). Children with IBD and specifically Crohn's disease demonstrate high exposure to ionizing radiation due to medical imaging. The yearly rate of medical imaging radiation exposure may seem small at approximately 3-5 mSv/year, which is only slightly higher than typical background radiation (3 mSv/year). However, this extra yearly radiation exposure to children with a lifelong chronic disease may increase the risk of cancer. Additionally, recent literature suggests that some children with more severe disease are exposed to high radiation doses within the first few years of diagnosis. Imaging modalities that do not utilize radiation, such as MRI and ultrasonography, have demonstrated utility in diagnosing and managing IBD and are particularly important for children. Pediatricians caring for children with chronic diseases should consider radiation exposure and limit exposure when possible. Future quality outcome benchmarks should include limiting exposure to radiation in children with chronic diseases.