The SeHCAT test, performed at the Nuclear Medicine Department, is simple, fast, and well tolerated and requires two scans one week apart.
The SeHCAT test is currently available in twelve European countries and in Canada, but not in the USA; it is relatively expensive and it is usually available only at third-level centers.
The diagnosis of BAM in patients with chronic diarrhea has a great clinical relevance: since a positive SeHCAT test does not exclude other organic causes of diarrhea, patients should also undergo other tests as clinically indicated.
SeHCAT test enables the clinician to make a more rational use of BASs which may induce adverse events.
Despite the high percentage of patients with a positive SeHCAT test responding to BASs, there are currently limited data on the duration and the dosage of the BAS therapy and whether a clinical remission (negative SeHCAT test) after a long-term BAS treatment is possible [33, 42].
Use of the SeHCAT Test in Patients with Organic Diseases
In some cases, the SeHCAT test can provide important additional information.
, 215 out of 506 (42.5%) consecutive neoplastic patients treated with surgery, radiotherapy, or chemotherapy and sent to a gastroenterological evaluation for diarrhea reported a new diagnosis of BAM with the SeHCAT test. It was mild in 25.6%, moderate in 29.3%, and severe in 45.1%.
Up to 89% of the patients who have undergone Whipple's procedure may show a positive SeHCAT test .
The SeHCAT test can provide further diagnostic confirmation, and data on the response to BAS therapy have already been discussed above.
The SeHCAT test is a safe and effective method to diagnose BAM with high sensitivity and specificity.
Due to the high prevalence of BAM in FD and IBS-D, the SeHCAT test should be performed in chronic diarrhea with functional characteristics after evaluating FBC, CRP, coeliac serology, thyroid function, and stool exams (calprotectin, coproculture, ova, and parasites) [54, 55].