A single faecal bile acid stool test demonstrates potential efficacy in replacing SeHCAT testing for bile acid diarrhoea in selected patients
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 75selenium-homotaurocholic acid (SeHCAT) scan. A prospective observational study was undertaken. Patients with chroni...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-05-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-12003-z |
| _version_ | 1811256741041537024 |
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| author | Aditi Kumar Hafid O. Al-Hassi Manushri Jain Oliver Phipps Clare Ford Rousseau Gama Helen Steed Jeffrey Butterworth John McLaughlin Niall Galbraith Matthew J. Brookes Lauren E. Hughes |
| author_facet | Aditi Kumar Hafid O. Al-Hassi Manushri Jain Oliver Phipps Clare Ford Rousseau Gama Helen Steed Jeffrey Butterworth John McLaughlin Niall Galbraith Matthew J. Brookes Lauren E. Hughes |
| author_sort | Aditi Kumar |
| collection | DOAJ |
| description | 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 75selenium-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. |
| first_indexed | 2024-04-12T17:45:51Z |
| format | Article |
| id | doaj.art-19d68fedaf0a4562a01e7e23152a03bb |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-12T17:45:51Z |
| publishDate | 2022-05-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-19d68fedaf0a4562a01e7e23152a03bb2022-12-22T03:22:40ZengNature PortfolioScientific Reports2045-23222022-05-0112111010.1038/s41598-022-12003-zA single faecal bile acid stool test demonstrates potential efficacy in replacing SeHCAT testing for bile acid diarrhoea in selected patientsAditi Kumar0Hafid O. Al-Hassi1Manushri Jain2Oliver Phipps3Clare Ford4Rousseau Gama5Helen Steed6Jeffrey Butterworth7John McLaughlin8Niall Galbraith9Matthew J. Brookes10Lauren E. Hughes11The Royal Wolverhampton NHS TrustUniversity of WolverhamptonThe Royal Wolverhampton NHS TrustUniversity of WolverhamptonClinical Chemistry, Black Country Pathology Services, The Royal Wolverhampton NHS TrustClinical Chemistry, Black Country Pathology Services, The Royal Wolverhampton NHS TrustThe Royal Wolverhampton NHS TrustShrewsbury and Telford Hospital NHS TrustDivision of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology Medicine and Health, The University of Manchester, Manchester Academic Health Science CentreUniversity of WolverhamptonThe Royal Wolverhampton NHS TrustClinical Chemistry, Black Country Pathology Services, The Royal Wolverhampton NHS TrustAbstract 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 75selenium-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.https://doi.org/10.1038/s41598-022-12003-z |
| spellingShingle | Aditi Kumar Hafid O. Al-Hassi Manushri Jain Oliver Phipps Clare Ford Rousseau Gama Helen Steed Jeffrey Butterworth John McLaughlin Niall Galbraith Matthew J. Brookes Lauren E. Hughes A single faecal bile acid stool test demonstrates potential efficacy in replacing SeHCAT testing for bile acid diarrhoea in selected patients Scientific Reports |
| title | A single faecal bile acid stool test demonstrates potential efficacy in replacing SeHCAT testing for bile acid diarrhoea in selected patients |
| title_full | A single faecal bile acid stool test demonstrates potential efficacy in replacing SeHCAT testing for bile acid diarrhoea in selected patients |
| title_fullStr | A single faecal bile acid stool test demonstrates potential efficacy in replacing SeHCAT testing for bile acid diarrhoea in selected patients |
| title_full_unstemmed | A single faecal bile acid stool test demonstrates potential efficacy in replacing SeHCAT testing for bile acid diarrhoea in selected patients |
| title_short | A single faecal bile acid stool test demonstrates potential efficacy in replacing SeHCAT testing for bile acid diarrhoea in selected patients |
| title_sort | single faecal bile acid stool test demonstrates potential efficacy in replacing sehcat testing for bile acid diarrhoea in selected patients |
| url | https://doi.org/10.1038/s41598-022-12003-z |
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