What is an MR enterography (MRE)?

If your child has Crohn's disease or ulcerative colitis, their healthcare team may recommend a scan called an MR enterography, often shortened to MRE.

The name can sound complicated, especially if your child has never had this type of scan before. You might wonder why it is needed, whether it will hurt, or whether your child will need an injection or sedation.

An MRE is a specialised MRI scan that takes detailed pictures of the small intestine and surrounding tissues. It can help doctors identify inflammation and other changes associated with Crohn's disease without using ionising radiation.

Here's what parents need to know about why an MRE is used, how to prepare your child and what happens during the scan.

🔍 Why might a child with IBD need an MRE?

Crohn's disease can affect different parts of the digestive tract, including areas of the small intestine that cannot be fully examined during a colonoscopy.

An MRE helps doctors look at these areas and assess the bowel wall and surrounding tissues.

Your child's gastroenterologist may recommend an MRE to:

• Investigate possible Crohn's disease: It can help identify areas of inflammation in the small intestine.

• Assess disease activity: The scan can show changes in the bowel wall that may indicate inflammation.

• Look for complications: It can help identify narrowing, known as a stricture, or certain complications such as fistulas and abscesses.

• Monitor treatment: In some circumstances, it can help assess how the bowel responds to treatment.

• Investigate ongoing symptoms: It may be recommended if your child has persistent pain or other symptoms that need further assessment.

An MRE is particularly useful in Crohn's disease because the condition can affect deeper layers of the bowel wall and areas beyond the reach of a colonoscope.

It is not usually the main test for assessing ulcerative colitis, which affects the large intestine. Your child's healthcare team will decide whether it is appropriate based on their symptoms and medical history.

🧲 What is the difference between an MRE and an MRI?

An MRI, or magnetic resonance imaging, uses a strong magnetic field and radio waves to create detailed pictures of structures inside the body.

An MR enterography is a specialised type of MRI designed to examine the small intestine.

The main difference is the preparation and technique used. During an MRE, your child will usually drink a special liquid that helps the small intestine expand so the radiologist can see the bowel more clearly.

The scan may also use contrast material given through a vein to help highlight inflammation and surrounding structures.

Unlike X-rays and CT scans, MRI does not use ionising radiation. This is an important consideration for children who may need repeated imaging over many years.

🥤 How do you prepare your child for an MRE?

Your child's imaging department will provide specific preparation instructions. These may include fasting for a certain period before the scan and information about medicines or contrast.

Preparation varies between hospitals, so follow the instructions provided for your child's appointment.

Your child may need to:

• Stop eating for a specified period before the scan.

• Follow instructions about whether clear fluids are allowed.

• Tell the team about medications, allergies and previous reactions to contrast.

• Remove metal objects before entering the MRI room.

• Drink a prescribed amount of special oral contrast liquid at the imaging department.

If your child has diabetes, kidney problems, difficulty swallowing, significant nausea or trouble drinking large volumes, tell the imaging team before the appointment. They can advise you about any special arrangements.

Do not change your child's regular medication or fasting instructions without checking with the healthcare team.

🥛 What is the special drink, and why does my child need it?

One of the most challenging parts of an MRE for children can be drinking the oral contrast liquid.

The liquid helps fill and expand the small intestine, making it easier for the radiologist to examine the bowel wall and identify changes.

Your child will usually be asked to drink the liquid over a specified period before the scan. The amount and type vary according to the hospital's protocol and your child's circumstances.

The drink may have an unusual taste or texture, and some children find it difficult to finish. It can also cause temporary bloating, nausea or loose stools.

You can help by explaining why the drink is needed and asking the imaging team whether it can be chilled or whether any approved options are available to make it easier to tolerate.

If your child cannot finish the required amount, tell the staff rather than forcing them to continue without advice. The team can explain the available options.

💉 Will my child need an injection?

Some MRE scans use a contrast agent injected into a vein through an intravenous line, often called an IV.

The contrast helps the radiologist see certain tissues and identify changes associated with inflammation.

Depending on the imaging protocol, your child may also receive a medicine to temporarily reduce bowel movement during the scan. This helps produce clearer images.

Your child's team will explain which medicines are planned and why they are needed.

An IV insertion can be uncomfortable, especially for children who are anxious about needles. Let the staff know if your child has had difficult experiences with needles or needs additional support.

Tell the team about any previous reactions to MRI contrast, kidney problems, relevant medical conditions or concerns about medications before the scan begins.

🧲 What happens during an MRE?

Although procedures vary between imaging centres, an MRE usually follows these steps.

1. Arriving at the imaging department

The staff will check your child's details, review the preparation instructions and ask about relevant medical history, allergies and implants.

2. Drinking the oral contrast

Your child will drink the prescribed liquid over the period specified by the team. Staff may check how well they are tolerating it.

3. Getting ready for the scan

Your child will remove metal objects and change into suitable clothing if required. They may need to have an IV inserted for contrast or medication.

4. Lying on the scanner bed

Your child will lie on a table that moves into the MRI scanner. The scanner is a large machine with a tunnel-like opening.

A special coil may be positioned over their abdomen to help capture the images.

5. Holding still and following instructions

The scanner makes loud tapping or knocking sounds while taking pictures. Your child may be given earplugs or headphones.

The radiographer may ask your child to hold their breath briefly at certain points. Staying as still as possible helps produce clear images.

6. Finishing the scan

Once the images have been taken, your child can usually get dressed and leave when the team confirms it is appropriate.

The scan itself often takes around 30–60 minutes, but the full appointment can take longer because of drinking the contrast liquid, waiting and preparation.

Your imaging department can give you a more accurate estimate for your child's appointment.

😟 Will an MRE hurt?

An MRE is generally painless, but some parts of the experience can be uncomfortable.

Your child may experience:

• Fullness or bloating from the oral contrast liquid.

• Nausea or loose stools.

• Discomfort from lying still for an extended period.

• Anxiety about the scanner's noise or enclosed space.

• Discomfort when an IV is inserted, if one is needed.

The scan does not involve cutting or instruments being passed into the bowel.

If your child is worried about enclosed spaces, tell the imaging team before the appointment. They can explain the scanner, discuss support options and advise whether any additional arrangements are appropriate.

🧒 Can parents stay with their child?

This depends on the imaging centre and safety requirements.

A parent may be able to accompany their child into the MRI room in some circumstances, but anyone entering the room must be screened for metal objects, implants and other MRI safety considerations.

Your child may be able to communicate with the radiographer through an intercom during the scan.

Ask the imaging department in advance whether you can stay nearby or accompany your child. If your child is anxious, let the team know so they can help prepare them.

😴 Will my child need sedation?

Many older children and teenagers can complete an MRE without sedation, especially if they understand what will happen and can remain still during the scan.

Younger children or those who find the scanner particularly distressing may need additional support. In selected cases, sedation or anaesthesia may be considered.

The decision depends on your child's age, ability to remain still, medical needs and local hospital arrangements.

If sedation is planned, the team will explain the preparation, fasting requirements, monitoring and recovery process.

📊 What can an MRE show?

An MRE can provide detailed information about the small intestine and surrounding tissues.

It may help doctors identify:

• Thickening of the bowel wall.

• Areas of inflammation.

• Narrowing of the intestine.

• Changes in how the bowel wall enhances after contrast.

• Some fistulas or abscesses.

• Other changes that may help explain your child's symptoms.

The radiologist interprets the images and sends a report to your child's healthcare team.

An MRE is only one part of assessing IBD. The results are considered alongside your child's symptoms, blood tests, stool tests, endoscopy findings and medical history.

⏳ How long do the results take?

The radiologist needs time to review the images and prepare a report. The results may not be available immediately after the scan.

Your child's gastroenterologist will explain the findings and discuss whether they affect the diagnosis, monitoring or treatment plan.

Ask the team when you should expect the results and who to contact if you have not heard back within the expected timeframe.

If your child has worsening symptoms while waiting for the results, contact their healthcare team rather than waiting for the report.

🏡 What happens after the scan?

Most children can return to their usual activities after an MRE, unless they have received sedation or have been given different instructions.

Your child may need to use the toilet more often after drinking the oral contrast liquid, and some children experience temporary bloating or loose stools.

If an IV was used, staff will remove it when appropriate.

If your child received sedation, follow the hospital's instructions about supervision, eating, drinking and returning to normal activities.

Contact the healthcare team if your child develops concerning symptoms after the scan, particularly if they seem seriously unwell.

❓ Questions parents often ask

Is an MRE safe for children?

MRE does not use ionising radiation, which makes it useful for children who may need repeated imaging. However, the procedure still requires appropriate screening and preparation. Contrast agents and medicines used during the scan have their own risks, which the team can explain.

Can my child eat after an MRE?

Most children can return to eating and drinking after the scan unless they have been given different instructions or received sedation. Follow the advice provided by the imaging team.

Is an MRE the same as a CT scan?

No. Both can produce images of the bowel, but an MRE uses magnetic fields and radio waves, while a CT scan uses X-rays. The best test depends on the clinical question, urgency and your child's circumstances.

Does my child need an MRE instead of a colonoscopy?

Not necessarily. The tests provide different information. A colonoscopy allows doctors to examine the bowel lining directly and take biopsies, while an MRE provides images of the bowel wall and surrounding structures. Some children need both.

Does having an MRE mean my child's Crohn's disease is getting worse?

No. An MRE may be used during diagnosis, to monitor treatment or to investigate symptoms. Being referred for a scan does not automatically mean the disease has worsened.

💛 The takeaway

An MR enterography is a specialised MRI scan that helps doctors examine the small intestine and identify changes associated with Crohn's disease.

Although drinking the contrast liquid and staying still during the scan can be challenging for some children, the procedure is generally painless and does not use ionising radiation.

Following the imaging department's instructions, explaining the process to your child and asking questions beforehand can help make the experience less stressful.

If you are unsure why your child needs an MRE or what the results might mean, speak with their gastroenterologist or imaging team. They can explain how the scan fits into your child's individual care plan.