Effectiveness of treatment in patients with an abnormal SeHCAT scan

Background: Chronic diarrhoea may be attributed to bile acid malabsorption. It can occur in Crohn's disease, following bowel surgery or in diarrhoea predominant IBS. Selenium labelled surrogate (SeHCAT) bile acid retention scans provide a reliable method of studying bile salt malabsorption. Treatment is lifelong cholestyramine which patients often find unpleasant to take. A positive scan reduces the need for further investigations. Treatment of patients with indeterminate results varies widely. Aims: To determine the effectiveness of treatment with cholestyramine in patients with positive (<8%) and indeterminate (8–15%) scans. Methods: Records of all patients with an abnormal or indeterminate SeHCAT scan between 1999 and 2002 were examined to ascertain outcome of treatment with cholestyramine. Results: One hundred and eighty-two patients had a SeHCAT scan during this period. Results are given in Table 1.Table: 1 Outcome of treatment with cholestyramine and results of SeHCAT scansConclusion: Those patients with significant bile salt malabsorption do benefit from cholestyramine. Our results also suggest that patients with an indeterminate result often derive clinical benefit with cholestyramine, and thus they should be considered for treatment.