Movatterモバイル変換

[0]ホーム
URL:

Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
Thehttps:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

NIH NLM Logo
Log inShow account info
Access keysNCBI HomepageMyNCBI HomepageMain ContentMain Navigation
pubmed logo
Advanced Clipboard
User Guide

Full text links

HighWire full text link HighWire Free PMC article
Full text links

Actions

Share

.2016 May 25;3(1):e000091.
doi: 10.1136/bmjgast-2016-000091. eCollection 2016.

Multicentre prospective survey of SeHCAT provision and practice in the UK

Affiliations

Multicentre prospective survey of SeHCAT provision and practice in the UK

Jennifer A Summers et al. BMJ Open Gastroenterol..

Abstract

Objective: A clinical diagnosis of bile acid malabsorption (BAM) can be confirmed using SeHCAT (tauroselcholic ((75)selenium) acid), a radiolabelled synthetic bile acid. However, while BAM can be the cause of chronic diarrhoea, it is often overlooked as a potential diagnosis. Therefore, we investigated the use of SeHCAT for diagnosis of BAM in UK hospitals.

Design: A multicentre survey was conducted capturing centre and patient-level information detailing patient care-pathways, clinical history, SeHCAT results, treatment with bile acid sequestrants (BAS), and follow-up in clinics. Eligible data from 38 centres and 1036 patients were entered into a validated management system.

Results: SeHCAT protocol varied between centres, with no standardised patient positioning, and differing referral systems. Surveyed patients had a mean age of 50 years and predominantly women (65%). The mean SeHCAT retention score for all patients was 19% (95% CI 17.8% to 20.3%). However, this differed with suspected BAM type: type 1: 9% (95% CI 6.3% to 11.4%), type 2: 21% (95% CI 19.2% to 23.0%) and type 3: 22% (95% CI 19.6% to 24.2%). Centre-defined 'abnormal' and 'borderline' results represented over 50% of the survey population. BAS treatment was prescribed to only 73% of patients with abnormal results.

Conclusions: The study identified a lack of consistent cut-off/threshold values, with differing centre criteria for defining an 'abnormal' SeHCAT result. BAS prescription was not related in a simple way to the SeHCAT result, nor to the centre-defined result, highlighting a lack of clear patient care-pathways. There is a clear need for a future diagnostic accuracy study and a better understanding of optimal management pathways.

Keywords: BILE ACID; DIARRHOEA; IMAGING; IRRITABLE BOWEL SYNDROME; MALABSORPTION.

PubMed Disclaimer

Figures

Figure 1
Figure 1
SeHCAT retention by suspected BAM types: box and whisker plots. Circles represent outliers. BAM, bile acid malabsorption; SeHCAT, tauroselcholic (75selenium) acid.
Figure 2
Figure 2
SeHCAT retention result by centre-defined result. *Other often described as ‘severe BAM’ or ‘moderate BAM’. BAM, bile acid malabsorption; SeHCAT, tauroselcholic (75selenium) acid.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ford GA, Preece JD, Davies IH, et al. . Use of the SeHCAT test in the investigation of diarrhoea. Postgrad Med J 1992;68:272–6.doi:10.1136/pgmj.68.798.272 - DOI - PMC - PubMed
    1. Thomas PD, Forbes A, Green J, et al. . Guidelines for the investigation of chronic diarrhoea, 2nd edition. Gut 2003;52(Suppl V):v1–v15.doi:10.1136/gut.52.suppl_5.v1 - DOI - PMC - PubMed
    1. NICE diagnostics guidance [DG7], SeHCAT (tauroselcholic [75 selenium] acid) for the investigation of diarrhoea due to bile acid malabsorption in people with diarrhoea-predominant irritable bowel syndrome (IBS-D) or Crohn's disease without ileal resection, National Institute for Health and Care Excellance 2012.
    1. Riemsma R, Al M, Corro Ramos I, et al. . SeHCAT [tauroselcholic (selenium-75) acid] for the investigation of bile acid malabsorption and measurement of bile acid pool loss: a systematic review and cost-effectiveness analysis. Health Technol Assess 2013;17:1–236.doi:10.3310/hta17610 - DOI - PMC - PubMed
    1. Wedlake L, A'Hern R, Russell D, et al. . Systematic review: the prevalence of idiopathic bile acid malabsorption as diagnosed by SeHCAT scanning in patients with diarrhoea-predominant irritable bowel syndrome. Aliment Pharmacol Ther 2009;30: 707–17.doi:10.1111/j.1365-2036.2009.04081.x - DOI - PubMed

Related information

LinkOut - more resources

Full text links
HighWire full text link HighWire Free PMC article
Cite
Send To

NCBI Literature Resources

MeSHPMCBookshelfDisclaimer

The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unauthorized use of these marks is strictly prohibited.

[8]ページ先頭
©2009-2025 Movatter.jp