Use of the SeHCAT test in the investigation of diarrhoea (original) (raw)

Abstract

The SeHCAT test was used to investigate possible bile acid malabsorption in 166 patients presenting to a district general hospital with chronic diarrhoea of uncertain cause. Eighty-four (51%) patients had impaired SeHCAT retention. These included 23 of 28 patients with a possible type I abnormality (terminal ileal resection or disease, previous pelvic radiotherapy), 20 of 74 with a possible type II abnormality (idiopathic diarrhoea), 32 of 45 with a possible type III abnormality (post-cholecystectomy, post-vagotomy), and 9 of 19 with diarrhoea associated with diabetes. Patients with severe bile acid malabsorption demonstrated a good response to cholestyramine whereas the response in patients with a mildly abnormal SeHCAT retention was variable. Bile acid malabsorption is an important cause of diarrhoea in patients presenting with unexplained chronic diarrhoea.

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Selected References

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  1. Blake G., Kennedy T. L., McKelvey S. T. Bile acids and post-vagotomy diarrhoea. Br J Surg. 1983 Mar;70(3):177–179. doi: 10.1002/bjs.1800700313. [DOI] [PubMed] [Google Scholar]
  2. Boyd G. S., Merrick M. V., Monks R., Thomas I. L. Se-75-labeled bile acid analogs, new radiopharmaceuticals for investigating the enterohepatic circulation. J Nucl Med. 1981 Aug;22(8):720–725. [PubMed] [Google Scholar]
  3. Condon J. R., Robinson V., Suleman M. I., Fan V. S., McKeown M. D. The cause and treatment of postvagotomy diarrhoea. Br J Surg. 1975 Apr;62(4):309–312. doi: 10.1002/bjs.1800620415. [DOI] [PubMed] [Google Scholar]
  4. Condon J. R., Suleman M. I., Fan Y. S., McKeown M. D. Letter: Cholestyramine and diabetic post-vagotomy diarrhoea. Br Med J. 1973 Nov 17;4(5889):423–423. doi: 10.1136/bmj.4.5889.423. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Delhez H., van den Berg J. W., van Blankenstein M., Meerwaldt J. H. New method for the determination of bile acid turnover using 75Se-homocholic acid taurine. Eur J Nucl Med. 1982;7(6):269–271. doi: 10.1007/BF00251479. [DOI] [PubMed] [Google Scholar]
  6. Fromm H., Malavolti M. Bile acid-induced diarrhoea. Clin Gastroenterol. 1986 Jul;15(3):567–582. [PubMed] [Google Scholar]
  7. Hames T. K., Condon B. R., Fleming J. S., Phillips G., Holdstock G., Smith C. L., Howlett P. J., Ackery D. A comparison between the use of a shadow shield whole body counter and an uncollimated gamma camera ain the assessment of the seven-day retention of SeHCAT. Br J Radiol. 1984 Jul;57(679):581–584. doi: 10.1259/0007-1285-57-679-581. [DOI] [PubMed] [Google Scholar]
  8. Heaton K. W. Bile salt tests in clinical practice. Br Med J. 1979 Mar 10;1(6164):644–646. doi: 10.1136/bmj.1.6164.644. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Heaton K. W., Read A. E. Gall stones in patients with disorders of the terminal ileum and disturbed bile salt metabolism. Br Med J. 1969 Aug 30;3(5669):494–496. doi: 10.1136/bmj.3.5669.494. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Heaton K. W. Staying cool with a hot test: gastroenterologists and 75SeHCAT. Br Med J (Clin Res Ed) 1986 Jun 7;292(6534):1480–1481. doi: 10.1136/bmj.292.6534.1480. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hofmann A. F. The syndrome of ileal disease and the broken enterohepatic circulation: cholerheic enteropathy. Gastroenterology. 1967 Apr;52(4):752–757. [PubMed] [Google Scholar]
  12. Merrick M. V., Eastwood M. A., Ford M. J. Is bile acid malabsorption underdiagnosed? An evaluation of accuracy of diagnosis by measurement of SeHCAT retention. Br Med J (Clin Res Ed) 1985 Mar 2;290(6469):665–668. doi: 10.1136/bmj.290.6469.665. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Molloy A. M., Tomkin G. H. Altered bile in diabetic diarrhoea. Br Med J. 1978 Nov 25;2(6150):1462–1463. doi: 10.1136/bmj.2.6150.1462. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Orholm M., Pedersen J. O., Arnfred T., Rødbro P., Thaysen E. H. Evaluation of the applicability of the SeHCAT test in the investigation of patients with diarrhoea. Scand J Gastroenterol. 1988 Jan;23(1):113–117. doi: 10.3109/00365528809093859. [DOI] [PubMed] [Google Scholar]
  15. Popović O. S., Kostić K. M., Milović V. B., Milutinović-Djurić S., Miletić V. D., Sesić L., Djordjević M., Bulajić M., Bojić P., Rubinić M. Primary bile acid malabsorption. Histologic and immunologic study in three patients. Gastroenterology. 1987 Jun;92(6):1851–1858. [PubMed] [Google Scholar]
  16. Scarpello J. H., Hague R. V., Cullen D. R., Sladen G. E. The 14C-glycocholate test in diabetic diarrhoea. Br Med J. 1976 Sep 18;2(6037):673–675. doi: 10.1136/bmj.2.6037.673. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Schiller L. R., Hogan R. B., Morawski S. G., Santa Ana C. A., Bern M. J., Norgaard R. P., Bo-Linn G. W., Fordtran J. S. Studies of the prevalence and significance of radiolabeled bile acid malabsorption in a group of patients with idiopathic chronic diarrhea. Gastroenterology. 1987 Jan;92(1):151–160. doi: 10.1016/0016-5085(87)90852-3. [DOI] [PubMed] [Google Scholar]
  18. Soundy R. G., Simpson J. D., Ross H. M., Merrick M. V. Absorbed dose to man from the Se-75 labeled conjugated bile salt SeHCAT: concise communication. J Nucl Med. 1982 Feb;23(2):157–161. [PubMed] [Google Scholar]
  19. Stryker J. A., Hepner G. W., Mortel R. The effect of pelvic irradiation on ileal function. Radiology. 1977 Jul;124(1):213–216. doi: 10.1148/124.1.213. [DOI] [PubMed] [Google Scholar]
  20. Thaysen E. H., Pedersen L. Idiopathic bile acid catharsis. Gut. 1976 Dec;17(12):965–970. doi: 10.1136/gut.17.12.965. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. van Tilburg A. J., de Rooij F. W., van den Berg J. W., van Blankenstein M. Primary bile acid diarrhoea without an ileal carrier defect: quantification of active bile acid transport across the ileal brush border membrane. Gut. 1991 May;32(5):500–503. doi: 10.1136/gut.32.5.500. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. van Tilburg A. J., de Rooij F. W., van den Berg J. W., van Blankenstein M. Primary bile acid diarrhoea without an ileal carrier defect: quantification of active bile acid transport across the ileal brush border membrane. Gut. 1991 May;32(5):500–503. doi: 10.1136/gut.32.5.500. [DOI] [PMC free article] [PubMed] [Google Scholar]