Factors associated with radiation exposure in patients with inflammatory bowel disease Z. LEVI*, A. FRASER  , R. KRONGRAD*, R. HAZAZI*, O. BENJAMINOV*, J. MEYEROVITCH à , O. B. TAL à , A. CHOEN à , Y. NIV* & G. FRASER* *Division of Gastroenterology, Rabin Medical Center, Beilinson Hospital, Petah Tikva and University of Tel-Aviv, Israel;  Department of Social Medicine, University of Bristol, Bristol, UK; àResearch Department, Clalit Health Services, Tel-Aviv, Israel Correspondence to: Dr Z. Levi, Division of Gastroenterology, Rabin Medical Center, Beilinson Hospital, Petah Tikva and University of Tel-Aviv, 49100, Israel. E-mail: zohar_levi@012.net.il Publication data Submitted 23 May 2009 First decision 15 June 2009 Resubmitted 30 August 2009 Accepted 3 September 2009 Epub Accepted Article 7 September 2009 SUMMARY Background Inflammatory bowel disease (IBD) patients undergo multiple radiological evaluations. Aim To estimate total and abdominal radiation exposure from diagnostic X-ray investigations in IBD patients and the associated risk factors. Methods Patients with Crohn’s disease (CD) or ulcerative colitis (UC) treated in the IBD clinic were recruited. Clinical data were extracted from patient files and radiological data were obtained from the central HMO com- puter data base. Results A total of 199 CD and 125 UC patients were included. The mean cumu- lative estimated doses (CED) for CD and UC were 21.1 Æ 19.5 and 15.1 Æ 20.4 millisieverts (mSv) respectively (P < 0.001). Twenty-three patients (7.1%) had an estimated CED of ‡50 mSv. In multivariate anal- yses, predictors of increased CED were: surgery (OR 5.68, 95% CI: 2.73–11.8, P < 0.001), CD (OR 2.56, 95% CI: 1.29–5.07, P = 0.007), prednisone use (OR 2.0, 95% CI: 1.11–3.67, P = 0.02), first year of dis- ease (OR 6.4, 95% CI: 1.3–32, P = 0.02) and age in the upper quartile (OR 3.26, 95% CI: 1.68–6.3, P = 0.001). Conclusions Diagnosis of CD, IBD-related surgery, prednisone use, first year of diag- nosis and age on the upper quartile are independent predictors of increased exposure in IBD patients. Alternative investigations which do not require radiation exposure should be considered for patients at risk for increased radiation exposure. Aliment Pharmacol Ther 30, 1128–1136 Alimentary Pharmacology & Therapeutics 1128 ª 2009 Blackwell Publishing Ltd doi:10.1111/j.1365-2036.2009.04140.x