Colonoscopy and SeHCAT for investigation of chronic diarrhea.

Abstract

BACKGROUND/AIMS:

Chronic diarrhea is a common problem. Colonoscopy is the investigation of choice for diagnosis. Even a macroscopically normal mucosa on endoscopy can have abnormalities such as microscopic colitis and bile acid malabsorption (BAM). The aim of this study was to establish the value of colonoscopy with biopsies in patients with chronic diarrhea and to evaluate the additive value of a SeHCAT test for diagnosing BAM in these patients.

METHODS:

All patients who underwent a colonoscopy between November 1999 and December 2000 were included. Patient files, colonoscopy and pathology reports and SeHCAT test results were reviewed.

RESULTS:

205 patients were included. The most common diagnoses were diarrhea-predominant IBS (n = 76) and IBD (n = 38). 158 patients had non-bloody diarrhea, 113 (72%) of them had a macroscopically normal appearing mucosa. In 40 (35%) of these patients, a histological diagnosis could be made and microscopic colitis was the most common diagnosis (n = 27). SeHCAT test was performed in 36 patients and 15 (42%) of them had BAM. In the 47 patients with bloody diarrhea, IBD was the main diagnosis (n = 23).

CONCLUSION:

Colonoscopy with biopsies must be performed when investigating chronic diarrhea and BAM should be excluded.

• Authors: Marcella Müller, Roger Willén, Per-Ove Stotzer
• Journal: Digestion (Digestion) Vol. 69 Issue 4 Pg. 211-8 ( 2004) ISSN: 0012-2823 [Print] Switzerland
• PMID: 15205569 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Bile Acids and Salts
• Selenium Radioisotopes
• Taurocholic Acid

Topics

• Bile Acids and Salts (pharmacokinetics)
• Biopsy
• Chronic Disease
• Colonoscopy
• Diarrhea (etiology)
• Humans
• Inflammatory Bowel Diseases (complications, diagnosis)
• Intestinal Mucosa (pathology)
• Malabsorption Syndromes (diagnosis)
• Retrospective Studies
• Selenium Radioisotopes
• Taurocholic Acid