Table 2

Use of SeHCAT or therapeutic trial to diagnose bile acid diarrhoea in specific clinical situations

ConditionProportion requesting test (%)
SeHCATTherapeutic trial
AlwaysUsuallySometimesRarelyNeverAlwaysUsuallySometimesRarelyNever
‘How often would you request [this test], in a patient without other significant findings on history or examination …’
‘… with episodic diarrhoea for >6 months, without predominant abdominal pain or bothersome bloating …’
 ‘… with >25% of the stools in the last 3 months being BSFS type 6/7?’65151550010202030
 ‘… with >25% of the stools being BSFS type 6/7 starting after cholecystectomy?’383319100729142921
‘… in Crohn’s disease with diarrhoea, ileal resection of 50–100 cm, and … ’
 ‘…negative inflammatory markers?’32162611163119251313
 ‘…raised inflammatory markers?’211121113870143643
‘… with features of IBS* …’
 ‘… with episodic diarrhoea in the last 3 months, with >25% of stools type 6/7, and <25% type 1/2?’4525255001473643
 ‘… with variable bowel habit in the last 3 months, with >25% of stools type 6/7, and >25% type 1/2?’19241929100731062
 ‘… with variable bowel habit in the last 3 months, with <25% of stools type 6/7, and >25% type 1/2?’201515252500141471
  • Inflammatory markers=serum C reactive protein and faecal calprotectin.

  • The following figures were suggested as an indication of the estimated frequency:.

  • ‘Always‘=>99%; ‘Usually‘=>70%; ‘Sometimes‘=30%–70%; ‘Rarely‘=<30%; ‘Never‘=<1%.

  • *Features of IBS=abdominal pain>1 day/week, related to defaecation and associated with change in frequency or form of stool for >6 months.

  • BSFS, Bristol Stool Form Scale; IBS, irritable bowel syndrome.