Luisa M ª Mena Bares1, José M Benítez Cantero2, Eva Iglesias Flores3, Beatriz Gros Alcalde4, Estefanía Moreno Ortega5, Francisco R Maza Muret5, Elvira Carmona Asenjo5, M ª Valle García Sánchez6, Juan A Vallejo Casas7. 1. Medicina Nuclear, Hospital Universitario Reina Sofía. Córdoba, ESPAÑA. 2. Unidad de Gestión Clínica Aparato Digestivo. , Hospital Universitario Reina Sofía. Córdoba, España. 3. Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Reina Sofía. Córdoba, ESPAÑA. 4. Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Reina Sofía. Córdoba, España. 5. Unidad de Gestión Clínica de Medicina Nuclear, Hospital Universitario Reina Sofía. Córdoba, España. 6. Unidad de Gestión Clínica Aparato Digestivo, Hospital Universitario Reina Sofía , España. 7. Unidad de Gestión Clïnica de Medicina Nuclear, Hospital Universitario Reina Sofía. Córdoba, España.
Abstract
INTRODUCTION AND AIM: Crohn's disease (CD) is a form of inflammatory bowel disease and is mainly characterized by diarrhea and abdominal pain. The aim of our study was to analyze the usefulness of performing a 75SeHCAT scan in CD patients with chronic diarrhea and suspected bile acid malabsorption (BAM). In addition, we aimed to determine whether there was a relationship with the clinical features of the disease and a previous bowel resection. PATIENTS AND METHODS: this was an observational cross-sectional study of 39 patients with a diagnosis of CD and chronic diarrhea. All cases underwent a 75SeHCAT scan for BAM diagnosis, after discarding disease activity. RESULTS: the study cohort included 19 females and 20 males. The median age was 44 years and the majority of patients were A2 L1 B1 according to the Montreal classification; 84.6% of patients had undergone a previous bowel resection. BAM was present in 97.4% of patients (100% and 83.3% of patients with and without previous surgery, respectively), which was severe in 92.1% of cases. Treatment with bile acid sequestrants was initiated and a favorable response was obtained in 72.2% of patients. The relationship between BAM degree (moderate or severe), bowel surgery and the response to bile acid sequestrant treatment was also analyzed but not statistically significant. CONCLUSION: BAM is a frequent cause of diarrhea in CD patients in endoscopic or radiological remission. This condition was present in all patients with a history of a bowel resection. A response to bile acid sequestrants treatment was observed in 73% of patients.
INTRODUCTION AND AIM: Crohn's disease (CD) is a form of inflammatory bowel disease and is mainly characterized by diarrhea and abdominal pain. The aim of our study was to analyze the usefulness of performing a 75SeHCAT scan in CDpatients with chronic diarrhea and suspected bile acid malabsorption (BAM). In addition, we aimed to determine whether there was a relationship with the clinical features of the disease and a previous bowel resection. PATIENTS AND METHODS: this was an observational cross-sectional study of 39 patients with a diagnosis of CD and chronic diarrhea. All cases underwent a 75SeHCAT scan for BAM diagnosis, after discarding disease activity. RESULTS: the study cohort included 19 females and 20 males. The median age was 44 years and the majority of patients were A2 L1 B1 according to the Montreal classification; 84.6% of patients had undergone a previous bowel resection. BAM was present in 97.4% of patients (100% and 83.3% of patients with and without previous surgery, respectively), which was severe in 92.1% of cases. Treatment with bile acid sequestrants was initiated and a favorable response was obtained in 72.2% of patients. The relationship between BAM degree (moderate or severe), bowel surgery and the response to bile acid sequestrant treatment was also analyzed but not statistically significant. CONCLUSION: BAM is a frequent cause of diarrhea in CDpatients in endoscopic or radiological remission. This condition was present in all patients with a history of a bowel resection. A response to bile acid sequestrants treatment was observed in 73% of patients.