RESULTS OF THE SE-75 HOMOTAUROCHOLATE-RET ENTION-TEST FOR DIAGNOSIS OF DIARRHEA

Background: Bile acid malabsorption is a well recognized cause of diar rhoea. Patients and Method: For that reason absorption of bile acids w as investigated using the Se-75-homotaurocholate (SeHCAT) in 239 patie nts with diarrhoea. SeHCAT retention time mas measured as 7 day retent ion time in a whole body counter. An intact bile acid absorption (nega tive SeHCAT test) was confirmed in 23 healthy volunteers within the ra nge of 11 to 50% (mean +/- double standard deviation). Result: In 135 patients with a possible type I bile salt malabsorption the SeHCAT tes t was positive in 78%, thus indicating bile salt malabsorption. The te st is very sensitive detecting bile salt malabsorption in Crohn's dise ase, identifying ileal disease more precisely than radiology. The SeHC AT test ascertained type II primary bile salt malabsorption in 7 patie nts, as well as type III bile salt malabsorption in patients (9 out of 28) with cholecystectomy, vagotomy, partial gastrectomy and chronic p ancreatitis. In addition, a positive SeHCAT test indicating bile acid malabsorption was found in 5 out of 11 patients with irritable bowel s yndrome, diarrhoeic form, and in 4 out of 12 patients with lactose int olerance. Conclusion: SeHCAT retention should be measured routinely in patients with chronic diarrhoea for which the cause is not obvious.