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Whole Body and Abdominal Retention of75 SeHCAT

  • G. Sciarretta
  • G. Fagioli
  • A. Furno
  • G. Vicini
  • P. Malaguti

Abstract

Bile acid malabsorption, (BAM). either idiopathic1 or resulting from disease or resection of the distal ileum2, 3, is one of the causes of chronic diarrhoea. The diagnosis of structural disease of the ileum is established by radiology and by endoscopy and biopsy. The diagnosis of ileal dysfunction associated with bile acid malabsorption has, however, been based on the Schilling test4, the 14C-glycocholate breath test5 and the serum primary bile salt curve following a fat-rich meal6, none of which is particularly accurate. More specific methods such as measurement of faecal total bile salt excretion7 or of faecal 14C after the administration of 24-14C-taurocholate8, are seldom used in clinical practice as they require the collection of faeces.

Keywords

Bile Acid Irritable Bowel Syndrome Bile Salt Chronic Diarrhoea Distal Ileum 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Reference

  1. 1.
    Thaysen, E.H. and Pedersen, L. (1976). Idiopathic bile acid catharsis. Gut 17, 965–70PubMedCrossRefGoogle Scholar
  2. 2.
    Hofmann, A.F. (1967). The syndrome of ileal disease and broken enterohepatic circulation: cholereic enteropathy. Gastroenterology 52, 752–7PubMedGoogle Scholar
  3. 3.
    Hofmann, A.F. and Poley, J.R. (1972). Role of bile acid malabsorption in pathogenesis of diarrhoea and steatorrhoea in patients with ileal resection. Gastroenterology 62, 918–34PubMedGoogle Scholar
  4. 4.
    Fromm, H., Thomas, Pol. and Hofmann, A.F. (1973). Sensitivity and specificity in tests of distal ileal function: prospective comparison of bile acid and vitamin B12 absorption in ileal resection patients. Gastroenterology 64, 1077–90PubMedGoogle Scholar
  5. 5.
    Heaton, K.W. (1977). Disturbances of bile acid metabolism in intestinal disorders. Clin. Gastroenterol. 6, 69–89PubMedGoogle Scholar
  6. 6.
    Aldini, R., Roda, A., Festi, D., Mazzella, G., Morselli, A.M., Sarna, C., Roda, E., Scopinaro, N. and Barbara, L. (1982). Diagnostic value of serum primary bile acids in detecting bile acid malabsorption. Gut 23, 829–34PubMedCrossRefGoogle Scholar
  7. 7.
    Sheltawy, M.J. and Losowsky, M.S. (1975). Determination of faecal bile acids by an enzymatic method. Clin. Chim.Acta 64, 127–32PubMedCrossRefGoogle Scholar
  8. 8.
    van Blankenstein, M., Hoyset, T., Horschner, P., Frenkel, M. and Wilson, J.H.P. (1977). Faecal bile acid radioactivity, a sensitive and relatively simple test of ileal dysfunction. Neth. J. Med. 20, 248–52PubMedGoogle Scholar
  9. 9.
    Boyd, G.S., Merrick, M.V., Monks, R. and Thomas, I.L. (1981). Se-75-labelled bile acid analogues, new radiopharmaceuticals for investigating the enterohepatic circulation. J. Nucl. Med. 22, 720–5 <PubMedGoogle Scholar
  10. 10.
    Merrick, M.V., Eastwood, M.A., Anderson, J.R. and Ross, H. McL. (1982). Enterohepatic circulation in man of a gamma-emitting bile-acid conjugate, 23-selena 25-homotaurocholic acid (SeHCAT).J. Nucl. Med. 23, 126–30PubMedGoogle Scholar
  11. 11.
    Delhez, H., van den Berg, J.W.O., van Blankenstein, M. and Meerwaldt, J.H. (1982). New method for the determination of bile acid turnover using 75Se-homocholic acid taurine. Eur.J. Nucl. Med. 7, 269–71PubMedCrossRefGoogle Scholar
  12. 12.
    Merrick, M.V., Boyd, G.S., Eastwood, MA. and Monks, R. (1982). SeHCAT - a new radiopharmaceutical for evaluating ileal function and the enterohepatic circulation of bile acids. In Proceedings ofthe ThirdWorldCongress ofNuclearMedicineand Biology. Vol. III, pp. 2430–33. (Paris: Pergamon Press)Google Scholar
  13. 13.
    Galatola, G., Jazrawi, R.P., Bridges, C., Joseph, A.E. and Northfield, T.C. (1986). First pass ileal clearance of bile acid in man. Clin. Sci. 13, 71pGoogle Scholar
  14. 14.
    Ferraris, R., Bridges, C., Jazrawi, R. and Northfield, T.e. (1983). Comparison of differentmethods of using gamma-labelled bile acid as a test of ileal function. Clin. Sci. 64, 14pGoogle Scholar
  15. 15.
    Ludgate, S.M. and Merrick, M.V. (1985). The pathogenesis of post-irradiation chronic diarrhoea: measurement of SeHCAT and B12 absorption for differential diagnosis determines treatment. Clin. Radiol. 36, 275–8PubMedCrossRefGoogle Scholar
  16. 16.
    Soundy, R.G., Simpson, J.D., Ross, H.McL. and Merrick, M.V. (1982). Absorbed dose to man from the Se-75 labelled conjugated bile salt SeHCAT: concise communication. J. Nucl. Med. 23, 157–61PubMedGoogle Scholar
  17. 17.
    Warner, G.T. and Oliver, R. (1966). A whole-body counter in clinical measurements utilising the ‘shadow-shield’ technique. Phys. Med. Biol. 11, 83–94PubMedCrossRefGoogle Scholar
  18. 18.
    Nyhlin, H., Merrick, M.V., Eastwood, M.A. and Brydon, W.G. (1983). Evaluation of ileal function using 23-selena-25-homotaurocholate, a gamma-labelled conjugated bile acid. Gastroenterology 84, 63–8PubMedGoogle Scholar
  19. 19.
    Merrick, M.V., Eastwood, M.A. and Ford, M.J. (1985). Is bile acid malabsorption underdiagnosed? An evaluation of accuracy of diagnosis by measurement of SeHCATretention. Br.Med.J. 290, 665–8CrossRefGoogle Scholar
  20. 20.
    Fagan, E.A., Chadwick, V.S. and Baird, I. McL. (1983). SeHCAT absorption: a simple test of ileal dysfunction. Digestion 26, 159–65PubMedCrossRefGoogle Scholar
  21. 21.
    Scheurlen, C., Kruis, W., Bull, U., Stellaard, F., Lang, P. and Paumgartner, G. (1986). Comparison of 75SeHCAT retention half-life and faecal content of individual bile acids in patients with chronic diarrhoeal disorders. Digestion 35, 102–8PubMedCrossRefGoogle Scholar
  22. 22.
    Sciarretta, G., Vicini, G., Fagioli, G., Verri, A., Ginevra, A. and Malaguti, P. (1986).Use of 23-selena-25-homocholyltaurine to detect bile acid malabsorption in patients with ileal dysfunction or diarrhoea. Gastroenterology 91, 1–9PubMedGoogle Scholar
  23. 23.
    Thaysen, E.H., Orholm, M., Arnfred, T., Carl, J. and Rodbro, P. (1982). Assessment of ileal function by abdominal counting of the retention of a gamma emitting bile acid analogue. Gut 23, 862–65PubMedCrossRefGoogle Scholar
  24. 24.
    Freundlieb, O., Szy, D., Balzer, K. and Strotges, M.W. (1983). Comparative study of various methods of measuring bile acid loss using 75SeHCAT. Nucl. Med. 22, 258–61Google Scholar
  25. 25.
    Hames, T.K., Condon, B.R., Fleming, J.S., Phillips, G., Holdstock, G., Smith, C.L., Howlett, PJ. and Ackery, D.M. (1984). A comparison between the use of a shadow shield whole body counter and an uncollimated gamma camera in the assessment of the seven-day retention of SeHCAT. Br.J. Radiol. 57, 581–4PubMedCrossRefGoogle Scholar
  26. 26.
    Holdstock, G., Phillips, G., Hames, T.K., Condon, B.R., Fleming, J.S., Smith, C.L. and Ackery, D.M. (1985). Potential of SeHCAT retention as an indicator of terminal ileal involvement in inflammatory bowel disease. Eur. J. Nucl. Med. 10, 528–30PubMedCrossRefGoogle Scholar
  27. 27.
    Sciarretta, G., Fagiolis G., Furno, A., Vicini, G., Cecchetti, L., Grigolo, B., Verri, A. and Malaguti, P. (1987). 75SeHCAT test in the detection of bile acid malabsorption in functional diarrhoea and its correlation with small bowel transit. Gut 28, 970–5CrossRefGoogle Scholar

Copyright information

© Kluwer Academic Publishers 1988

Authors and Affiliations

  • G. Sciarretta
    • 1
  • G. Fagioli
    • 2
  • A. Furno
    • 2
  • G. Vicini
    • 3
  • P. Malaguti
    • 1
  1. 1.Gastroenterology UnitBolognaItaly
  2. 2.Department of Nuclear MedicineBolognaItaly
  3. 3.Department of Health and Medical PhysicsBolognaItaly

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