From the Guidelines
SeHCAT testing is a diagnostic procedure used to assess bile acid absorption in the intestines, involving the ingestion of a small amount of selenium-75-homocholic acid taurine, a radioactive tracer that mimics bile acids, with a retention of less than 15% considered abnormal and suggestive of bile acid malabsorption. This condition can cause chronic diarrhea and is often associated with diseases like Crohn's disease or following gallbladder removal. The test requires no special preparation, but patients should inform their doctor of any medications they're taking, as some may interfere with the results.
Key Points:
- SeHCAT testing measures the retention of a radioactive tracer in the body over a period of 7 days to assess bile acid absorption in the intestines 1.
- A retention of less than 15% is considered abnormal and suggests bile acid malabsorption, which can cause chronic diarrhea 1.
- The test is particularly useful in diagnosing bile acid malabsorption when other causes of chronic diarrhea have been ruled out, providing a non-invasive method to guide treatment decisions for this often overlooked condition 1.
- SeHCAT testing has been shown to be effective in identifying patients with bile acid diarrhea, with a significant impact on patients' quality of life 1.
- The test is recommended for patients with chronic nonbloody diarrhea, particularly those with a history of terminal ileal resection, cholecystectomy, or radiotherapy 1.
Diagnosis and Treatment:
- SeHCAT testing can help identify patients with bile acid malabsorption, allowing for targeted treatment with bile acid sequestrants 1.
- The test can also help rule out other causes of chronic diarrhea, reducing the risk of misdiagnosis and unnecessary treatment 1.
- Patients with bile acid malabsorption may experience significant improvements in symptoms and quality of life with appropriate treatment 1.
From the Research
Tauroselcholic Acid (SeHCAT) Testing
- Tauroselcholic Acid (SeHCAT) testing is a diagnostic test used to measure bile acid malabsorption 2, 3, 4, 5, 6
- The test uses a radiolabeled synthetic bile acid, which is administered orally and its retention is measured over a period of time, typically 7 days 2, 3
- SeHCAT testing is used to diagnose bile acid malabsorption, which can be caused by various conditions such as ileal resection or disease, Crohn's disease, cholecystectomy, and chronic pancreatitis 2, 3, 5
Procedure and Interpretation
- The test involves administering a capsule containing radiolabeled SeHCAT to the patient, and then measuring the retention of the isotope over a period of time using a whole body counter or scan 2, 3
- The results are interpreted based on the percentage of SeHCAT retention, with lower retention indicating bile acid malabsorption 2, 4
- A positive SeHCAT test result is typically defined as a retention of less than 15% 6
Clinical Applications
- SeHCAT testing is used to diagnose and manage bile acid malabsorption in patients with chronic diarrhea of uncertain cause 2, 4, 6
- The test can help identify patients who may benefit from treatment with bile acid sequestrants, such as cholestyramine 2, 6
- SeHCAT testing can also be used to monitor the response to treatment and adjust the dosage of bile acid sequestrants as needed 6