Loading...
A single faecal bile acid stool test demonstrates potential efficacy in replacing SeHCAT testing for bile acid diarrhoea in selected patients
Kumar, Aditi Al-Hassi, Hafid Omar Jain, Manushri Phipps, Oliver Ford, Clare Butterworth, Jeffrey McLaughlin, John
Kumar, Aditi
Al-Hassi, Hafid Omar
Jain, Manushri
Phipps, Oliver
Ford, Clare
Butterworth, Jeffrey
McLaughlin, John
Editors
Other contributors
Affiliation
Epub Date
Issue Date
2022-05-18
Submitted date
Subjects
Alternative
Abstract
This study examines the validity of measuring faecal bile acids (FBA) in a single stool sample as a diagnostic tool for bile acid diarrhoea (BAD) by direct comparison to the <sup>75</sup>selenium-homotaurocholic acid (SeHCAT) scan. A prospective observational study was undertaken. Patients with chronic diarrhoea (> 6 weeks) being investigated for potential BAD with SeHCAT scan provided stool samples for measurement of FBA, using an enzyme-linked immunosorbent assay. Patients were characterised into four groups: SeHCAT negative control group, post-cholecystectomy, idiopathic BAD and post-operative terminal ileal resected Crohn's disease. Stool samples were collected at baseline and 8-weeks post treatment to determine whether FBA measurement could be used to monitor therapeutic response. 113 patients had a stool sample to directly compare with their SeHCAT result. FBA concentrations (μmol/g) and interquartile ranges in patients in the control group (2.8; 1.6-4.2), BAD (3.6; 1.9-7.2) and post-cholecystectomy cohort 3.8 (2.3-6.8) were similar, but all were significantly lower (p < 0.001) compared to the Crohn's disease cohort (11.8; 10.1-16.2). FBA concentrations in patients with SeHCAT retention of < 15% (4.95; 2.6-10.5) and < 5% (9.9; 4.8-15.4) were significantly higher than those with a SeHCAT retention > 15% (2.6; 1.6-4.2); (p < 0.001 and p < 0.0001, respectively). The sensitivity and specificity using FBA cut-off of 1.6 μmol/g (using ≤ 15% SeHCAT retention as diagnostic of BAD) were 90% and 25% respectively. A single random stool sample may have potential use in diagnosing severe BAD or BAD in Crohn's patients. Larger studies are now needed to confirm the potential efficacy of this test to accurately diagnose BAD in the absence of SeHCAT testing.
Citation
Kumar, A., Al-Hassi, H.O., Jain, M. et al. A single faecal bile acid stool test demonstrates potential efficacy in replacing SeHCAT testing for bile acid diarrhoea in selected patients. Scientific Reports, 12, 8313 (2022). https://doi.org/10.1038/s41598-022-12003-z
Publisher
Journal
Research Unit
PubMed ID
35585139 (pubmed)
PubMed Central ID
Embedded videos
Additional Links
Type
Journal article
Language
en
Description
© 2022 The Authors. Published by Springer Nature. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https: https://doi.org/10.1038/s41598-022-12003-z
Series/Report no.
ISSN
2045-2322
EISSN
2045-2322
ISBN
ISMN
Gov't Doc #
Sponsors
The research department of MJB received project funding from Bowel and Cancer Research for part of this work; The research department of MJB received project funding from an unrestricted grant from Tillotts Pharma for part of this work.
Rights
Licence for published version: Creative Commons Attribution 4.0 International