Blog post by Michael Dolinger, MD MBA
Managing Inflammatory Bowel Disease (IBD) in children is uniquely challenging. With conditions like Crohn’s disease and ulcerative colitis often starting at a young age, children face lifelong care plans to manage inflammation and prevent complications. Traditionally, this has meant repeated invasive tests, like endoscopies, to keep an eye on the disease. But now, a new tool is rising in popularity: Intestinal Ultrasound (IUS). This non-invasive method is revolutionizing the way pediatric gastroenterologists monitor IBD, offering real-time, radiation-free insights into bowel inflammation.
If your child has IBD, here’s why IUS could be the key to a better care experience.
What is Intestinal Ultrasound (IUS)?
Intestinal Ultrasound (IUS) is a cross-sectional imaging tool that allows doctors to visualize inflammation in the intestines. Unlike traditional methods like MRIs or CT scans, IUS is non-radiating and easy to perform right at the bedside during routine clinic visits. For children, this is a huge advantage because it avoids the need for sedation, fasting, or uncomfortable bowel preparations—requirements that come with more invasive procedures like colonoscopies.
IUS provides real-time data, meaning doctors can quickly assess how well a child is responding to treatment or whether a flare-up is imminent. This makes it easier to adjust therapies on the spot, improving the chances of keeping the disease in check before it worsens.
Why IUS is a Game-Changer for Kids with IBD
Managing IBD in kids is a balancing act—monitoring disease progression while minimizing discomfort and invasive procedures. Here’s how IUS is improving the care process:
- Non-Invasive and Radiation-Free: IUS offers a non-invasive way to monitor disease without the exposure to radiation that comes with other imaging methods like CT scans. This makes it safer for repeated use, which is essential for long-term disease management in children.
- Real-Time Insights: With IUS, doctors can see what’s happening in the intestines in real-time. Whether it’s assessing bowel wall thickness or detecting inflammation, the procedure allows doctors to make on-the-spot treatment decisions, offering immediate feedback on whether current therapies are working.
- No Special Prep: Children won’t need to fast or undergo uncomfortable bowel preparations before the scan. Plus, there’s no need for sedation, which makes the experience less stressful for both kids and their parents.
How IUS is Used in Pediatric IBD Care
The Pediatric Committee of the International Bowel Ultrasound Group (IBUS) has developed guidelines specifically for using IUS in pediatric IBD cases. Here's a general approach:
- Baseline Assessment: IUS is often performed when a child is first diagnosed with IBD or during an initial colonoscopy. This allows the healthcare team to establish a baseline with a reference gold-standard test of the child’s bowel condition.
- Monitoring Treatment: After starting or adjusting treatments (like biologic therapies), IUS can be used to see if the treatment is working. Changes in bowel wall thickness and blood flow can be detected as early as 4-8 weeks after starting therapy, allowing doctors to tweak treatments if necessary.
- Regular Check-ups: Doctors recommend performing IUS every 3-6 months during routine clinic visits. This makes it easier to keep tabs on how the disease is progressing without invasive tests.
Patient-Friendly and Family-Approved
What makes IUS so special is how well it fits into the lives of children and their families. Endoscopies, while necessary at times, are often dreaded due to the preparation and recovery involved. In contrast, IUS offers a quick, painless, and stress-free way to check in on disease activity. Parents and children alike can feel more comfortable knowing that this tool provides critical insights without the discomfort of other procedures.
The Science Behind IUS: How It Works
IUS works by using sound waves to create images of the intestines. These sound waves bounce off the tissues and organs, allowing doctors to assess key indicators like bowel wall thickness (BWT), blood flow (hyperemia), and the presence of complications like strictures or fistulas.
In children with IBD, bowel wall thickening is a common marker of inflammation. IUS can measure this thickness and detect changes over time, helping to assess whether treatments are reducing the inflammation. Hyperemia (increased blood flow) is another important indicator of active disease, which can be easily seen using color Doppler during the ultrasound.
What Does the Future Hold for IUS?
While IUS is already making waves in pediatric IBD care, its full potential is just beginning to be realized. Experts are working on standardizing IUS training for pediatric gastroenterologists, ensuring that more doctors are equipped to use this tool effectively. As the technology becomes more widely available, more children with IBD will benefit from this non-invasive, real-time monitoring option.
In the meantime, if your child has IBD, consider talking to your pediatric gastroenterologist about IUS. It could make a world of difference in managing the disease—offering peace of mind without the stress and discomfort of invasive procedures.
**Our open access series are blog posts highlighting intestinal ultrasound research that is freely available for public consumption. These blog posts summarize the key points from the latest intestinal ultrasound open access original research, editorials, guides, and consensus statements. The original link to download the article for free in full can be found by clicking here. Otherwise, the summary above should provide some of the valuable information you may be looking for.
