Bile Acid Malabsorption Demonstrated by SeHCAT in Chronic Diarrhoea, with Special Reference to the Impact of Cholecystectomy

Abstract

SeHCAT is a gamma-labelled synthetic bile acid, suitable for external measurements and detection of bile acid malabsorption. In this study 138 subjects were investigated with ⁷⁵SeHCAT. The technique was modified by calculating the biologic half-life of the isotope (WBR-50) within 48 h. All patients with ileocaecal resection had reduced WBR-50 values, as did most (8 of 12) with Crohn's disease affecting the small bowel. Among patients with chronic diarrhoea 24 out of 62 patients had reduced WBR-50 values. Four of the patients with low WBR-50 and one in the group with normal WBR-50 had previously been cholecystectomized. In a consecutive study, 15 patients were investigated before and after Cholecystectomy. In 12, WBR-50 decreased after the operation (p < 0.05). The results demonstrate the impact of Cholecystectomy on the interpretation of the SeHCAT retention results. The results may also add to the understanding of diarrhoea secondary to Cholecystectomy.

Key Words:

• Bile acid malabsorption
• Cholecystectomy
• chronic diarrhoea
• SeHCAT