The absorption of 75Se-23-selena-25-homotaurocholate (
SeHCAT) was compared with vitamin-B12 absorption and conventional radiography in 44 patients with
inflammatory bowel disease. The retention of
SeHCAT was normal in 11 patients with
ulcerative colitis but was abnormally low in 9 patients with terminal-ileal resection, 9 out of 14 patients with small-bowel
Crohn's disease and in 2 out of 10 patients with Crohn's
colitis. The 5 patients with small-bowel
Crohn's disease and normal retention had either inactive disease or no radiological evidence of terminal ileal involvement. Measurements of the absorption of
vitamin B12 did not discriminate between these groups, and there was very poor correlation between B12 and
SeHCAT absorption (r = 0.506, P less than 0.05). There was extremely good correlation of
SeHCAT retention measured using a wholebody counter with that measured using an uncollimated
gamma camera (r = 0.96, P less than 0.001). The results suggest that
SeHCAT retention may prove complementary to conventional methods of assessing small-bowel disease in patients with
inflammatory bowel disease. As measurement by
gamma camera is feasible, this test can be used in most departments of nuclear medicine.