Inflammatory bowel disease refers to two chronic (or recurring) conditions called “Crohn’s disease” and “ulcerative colitis,” which cause redness and swelling (inflammation) in parts of the intestinal tract. Like asthma, IBD symptoms in children occur in bouts — periodically flaring up for sometimes weeks or months.
What’s the Difference Between IBS and IBD?
Often confused with irritable bowel syndrome (IBS), IBD is a condition that can cause the intestines to narrow and restrict food from moving through the bowel. IBS is a functional disorder, which means the digestive system looks perfectly normal, but it doesn’t work exactly like it should. IBD and IBS have many similar symptoms, but IBS doesn’t cause blood in the stool (bowel movements or poop) like IBD can.
Crohn’s vs. Ulcerative Colitis in Children
Crohn’s disease and ulcerative colitis are both inflammatory bowel diseases that cause inflammation to different parts of the digestive system. Crohn’s can occur anywhere along the intestinal tract, but it’s commonly found in the last segment of the small intestine (ileum) and the large intestine (colon). Ulcerative colitis mostly affects the colon.
Crohn’s impacts the entire thickness of the intestine and can affect more than one section of the intestinal tract. In contrast, ulcerative colitis occurs only within the inner lining of the organ and is found only in one spot.
What Causes IBD in Children?
The exact cause of IBD in children is unknown. However, experts agree that the environment, genetics, and/or diet may have something to do with it. Scientists believe that an overactive immune system may trigger inflammation in response to an offending agent, like a virus or certain foods. Researchers are actively studying IBD to get to the bottom of possible causes, and hopefully help relieve IBD symptoms in children and adults.
An abdominal X-ray is a safe and painless test that uses a small amount of radiation to make an image of a person's abdomen (belly). During the examination, an X-ray machine sends a beam of radiation through the abdomen, and an image is recorded on special film or a computer. This image shows the stomach, liver, spleen, small and large intestines, and diaphragm.
The X-ray image is black and white. Dense body parts that block the passage of the X-ray beam through the body, such as bones, appear white on the X-ray image. Softer body tissues, such as the skin and muscles, allow the X-ray beams to pass through them and appear darker. Gas in the stomach and intestines appears black.
An X-ray technician takes the X-rays. One or two pictures of the abdomen are usually taken to get a view of the area from different angles.
Why It's Done
An abdominal X-ray may help to find the cause of abdominal pain or vomiting. It can sometimes detect kidney stones, an obstruction (blockage), a perforation (hole) in the intestines, or an abdominal mass such as a tumor.
The image also can reveal small metal objects (such as coins) that might have been swallowed. Not all swallowed foreign bodies are seen on X-rays. Abdominal X-rays can also help confirm that medical tubes have been placed in the right locations in organs such as the stomach or intestines.
An abdominal X-ray doesn't require special preparation. Your child may be asked to remove clothing and jewelry and change into a hospital gown because buttons, zippers, clasps, or jewelry might interfere with the image.
If you suspect that your daughter is pregnant, it's important to tell the X-ray technician or her doctor. Abdominal X-rays are usually avoided during pregnancy because there's a small chance the radiation may harm the developing baby. But if the X-ray is necessary, precautions can be taken to protect the fetus.
Also be sure to inform the technician or the doctor if your child has had an X-ray exam using barium contrast material (such as for a barium enema or an upper GI study) or has taken antidiarrheal or stomach-upset medicine containing bismuth subsalicylate in the last 5 days, as these can affect the quality of the images.
Although the procedure may take about 15 minutes, actual exposure to radiation is usually less than a second.
Your child will be asked to enter a special room that will most likely contain a table and a large X-ray machine hanging from the ceiling. Parents are usually able to accompany their child to provide reassurance. If you stay in the room while the X-ray is being done, you'll be asked to wear a lead apron to protect certain parts of your body. Your child's reproductive organs will also be protected as much as possible with a lead shield.
If your child is in the hospital and can't easily be brought to the radiology department, a portable X-ray machine can be brought to the bedside. Portable X-rays are sometimes used in emergency departments, intensive care units (ICUs), and operating rooms.
An abdominal X-ray is usually performed in standing and lying positions. The technician will position your child, then step behind a wall or into an adjoining room to operate the machine. Older kids will be asked to hold their breath and stay still for 2-3 seconds while the X-ray is taken; infants may require gentle restraint. Keeping still is important to prevent blurring of the X-ray image.
What to Expect
Your child won't feel anything as the X-ray is taken. The X-ray room may feel cool due to air conditioning used to maintain the equipment.
The position required for the X-ray may feel uncomfortable, but it needs to be held for only a few seconds. If your child is in pain and can't stay in the required position, the technician might be able to find another position that's easier on your child. Babies often cry in the X-ray room, especially if they're restrained, but this won't interfere with the procedure.
After the X-ray is taken, you and your child will be asked to wait a few minutes while the image is processed. If it is blurred or unclear, the X-ray may need to be redone.
Getting the Results
The X-ray will be looked at by a radiologist (a doctor who's specially trained in reading and interpreting X-ray images). The radiologist will send a report to your doctor, who will discuss the results with you and explain what they mean.
In an emergency, the results of an X-ray can be available quickly. Otherwise, results are usually ready in 1-2 days. In most cases, results can't be given directly to the patient or family at the time of the test.
In general, X-rays are very safe. Although there's some minor risk to the body with any exposure to radiation, the amount of radiation used in an abdominal X-ray is small and not considered dangerous. It's important to know that radiologists use the minimum amount of radiation required to get the best results.
Developing babies are more sensitive to radiation and are at greater risk for harm, so if your daughter is pregnant, make sure to inform her doctor and the X-ray technician.
Helping Your Child
You can help your young child prepare for an abdominal X-ray by explaining the test in simple terms before the procedure. It may help to explain that getting an X-ray is like posing for a picture.
You can describe the room and the equipment that will be used, and you can reassure your child that you'll be right there for support. For older kids, be sure to explain the importance of staying still while the X-ray is taken so it won't have to be repeated.
If You Have Questions
If you have questions about why the abdominal X-ray is needed, speak with your doctor. You can also talk to the X-ray technician before the procedure.