PWE-050 Is Sehcat Scanning Necessary? An Analysis of Sehcat Scans and Risk Factors for Bile Acid Diarrhoea in A Series of 262 Patients with Diarrhoea: Abstract PWE-050 Table 1

Abstract

Introduction Bile acid diarrhoea (BAD) is an under-diagnosed cause of diarrhoea and there is a suggestion that up to a third of patients with previously diagnosed diarrhoea-predominant irritable bowel syndrome have BAD diagnosed by a tauroselcholic [ 75 selenium] acid (SeHCAT) scan. 1 BAD risk factors include ileal resection (IR), right hemicolectomy (RH), radiotherapy (RT), cholecystectomy and Crohn’s (CD) but it is unclear whether SeHCAT scans add value to these patient groups. 1 This single-centre retrospective study evaluates SeHCAT scans in patients with/without risk factors and their responses to bile acid sequestrants (BAS). Methods We retrospectively evaluated the clinical data of all 269 patients who had a SeHCAT scan from February 2011 to December 2014. Patients with cholecystectomy, CD, RH/IR or previous pelvic RT were compared to those without BAD risk factors. Clinic correspondences were evaluated for presenting symptoms and BAD risk factors, treatment with BAS and their tolerance/effectiveness. Response was measured as good or absent according to patient report to physician. Seven cases were excluded due to absence of clinical data. Statistical analyses were calculated for each individual case group versus the control group with no risk factors for BAD. P-values were adjusted with Bonferroni correction. Results Average age at time of scan was 53.8. M:F was 1:2.74. 115/262 had BAD confirmed with a SeHCAT scan of Conclusion We demonstrate that a history of cholecystectomy, CD or RH/IR with chronic diarrhoea is highly suggestive of BAD. Of the six CD patients without BAD, four had isolated colonic disease. Pelvic RT did not increase risk of BAD. A SeHCAT scan can cost £486 2 whilst a month’s trial of either BAS costs 3 and have high response rates in BAD. Given the high probability of a positive scan in cases of RH/IR we suggest trials of empirical BAS could be used instead of SeHCAT for diagnosis in these patients. References 1 L Wedlake, et al . APT 30 :707–717. 2 NICE. Diagnostic guidance DG7, 2012. 3 BNF 2012; 64 . Disclosure of Interest None Declared