P237 Value of 75SeHCAT in the diagnosis of bile acid malabsorption in Crohn’s Disease with chronic diarrhoea

Abstract

Aim: The objective of this study is to analyze the utility of 75SeHCAT in patients with Crohn's disease and chronic diarrhoea with suspected bile acid malabsorption (BAM), and to assess whether there is a relationship between the malabsorption degree and the presence of ileal resection. Material(s) and Method(s): We analyzed retrospectively 31 patients with Crohn's disease and chronic diarrhoea with and without ileal resection during the period between August 2015-April 2016. In all patients an inflammatory process was previously discarded. No patients had received treatment with bile acid sequestrants (Cholestyramine) before the study. We perform the test after the ingestion of a 75SeHCAT capsule (0,37 MBq) prior fasting the night before. Three hours later an initial gamma measurement is taken from a large field of view gamma camera, equipped with high sensitivity and parallel-hole collimator. Abdominal retained activity was measured in anterior and posterior views for 5 minutes. Room background is also measured for 5 minutes before and after the patient has been scanned. Seven day measurements were compared with 3 hours activity to calculate the abdominal retention percentage. BAM was diagnosed when retention was <10% at seventh day. Result(s): We studied 16 women and 15 men with mean age of 43 years old. 24/31 patients had undergone ileal resection (ranged from 2 to 80 cm, average= 27,87 cm). 96,8% of patients demonstrated abnormal values of 75SeHCATscan defined as < 10% abdominal retention of 75SeHCATafter seven days. 24/24 patients with ileal resection and 6/7 patients without resection had BAM. 92% of patients with ileal resection had severe malabsorption and 8% moderate malabsorption. 72% of patients without resection had severe malabsorption, 14% moderate malabsorption and 14% had normal retention. We performed linear regression analysis and we found no significant association between 75SeHCAT retention and performing surgery or not, type or length of resection. Conclusion(s): 75SeHCAT is an useful procedure for diagnosing BAM in patients with Crohn's disease and chronic diarrhea, with and without ileal resection. There was no significant association between 75SeHCAT retention and performing surgery or not, type or length of resection.