SeHCat scan

Your consultant may recommend a SeHCAT scan (SeHCAT study) if they suspect you have a condition called bile acid malabsorption (BAM).

Bile acid malabsorption, also known as bile acid diarrhoea, is a condition where your body can’t absorb bile acids properly and they build up in your intestines, causing chronic watery diarrhoea.

Bile is a substance produced by your liver to help you digest food properly. When you eat, bile is released into your stomach and small intestine where the bile acids help break down food and nutrients for your body to absorb. Bile acids are then reabsorbed from your colon (large bowel) back into your bloodstream. If you have bile acid malabsorption, the bile acids aren’t reabsorbed properly, triggering your colon (large bowel) to secrete too much water and leading to chronic diarrhoea and watery stools.

Bile acid malabsorption can occur in conditions such as Crohn’s disease, or if you have had surgery to remove all or part of your small intestine. In some cases, the cause of bile acid malabsorption is not known.

Symptoms of bile acid malabsorption may include:

• Watery, smelly or explosive diarrhoea
• Abdominal pain, bloating or swelling
• Diarrhoea that lasts a long time, or keeps coming back 
• Needing to go to the toilet urgently
• Faecal incontinence (loss of control of your bowels)

Your consultant may also recommend a SeHCAT scan if you have inflammatory bowel disease, to assess the function of the ileum (part of the small intestine that absorbs bile salts), and in the study of enterohepatic circulation (how drugs, bilirubin and other substances are excreted in bile and reabsorbed in the intestine).

The cost of a private SeHCAT scan will depend on various factors, including the hospital you have the test at, and your reasons for having the scan.

If you would like to get a tailored quote, give us a call and one of our advisors will give you an estimated price.

If you are having a SeHCAT scan as part of an ongoing treatment plan, it may be included in your fixed-price package, or if you have private health insurance it may be covered by your provider. Again, you can call our advisors to find out more. 

At your first consultation, you will typically be seen by a consultant gastroenterologist, a doctor specialising in conditions affecting the digestive system. Your first appointment is important as it’s where you’ll meet your consultant, the doctor responsible for your care.

At this first appointment, your consultant will ask you about your symptoms, your family and medical history, and your general health. They will spend time getting to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. At Circle Health Group, we want you to be as well-informed and comfortable as possible during your time with us, so please discuss any questions or concerns with your consultant during your appointment.

Your consultant may ask to see any tests or scans you have had previously, or they may arrange them on the day. These may include:

• Blood tests: To assess your general health and check for any underlying medical conditions
• A stool test: To check for bacteria or parasites that could be causing your chronic diarrhoea
• A colonoscopy or flexible sigmoidoscopy: To examine your colon and take biopsies if necessary
• An upper GI endoscopy: To examine your stomach and upper small intestine for abnormalities (also known as a gastroscopy)

At the end of your appointment, your consultant will decide if a SeHCAT scan is a suitable test for you based on your symptoms, general health and the results of any previous tests or scans. They will explain the procedure in full, including how to prepare, what happens during your SeHCAT scan and what to expect afterwards.

Your consultant will tell you everything you need to do to prepare for your SeHCAT scan. Instructions on how to prepare will also be in your appointment letter. If there’s anything you’re not sure about, or if you have any questions, please contact the hospital for advice.

Before your SeHCAT scan:

Tell your consultant about any medications you are taking. Some medicines may interfere with the test results, and you may need to stop taking them 48 hours before your scan and remain off them for the seven days between your two appointments. These include:

• Cholestyramine (Questran)
• Colesevelam
• Colestipol
• Antacids containing aluminium hydroxide (e.g. Co-magaldrox, Maalox, Mucogel)

Please inform the hospital immediately if you are, or could be pregnant, or are breast-feeding

You can wear your normal clothes during your SeHCAT scan, but you will need to remove any items containing metal such as some jewellery, belt buckles, zips or underwired bras.

You can eat and drink as normal before your SeHCAT scan

You should attend your appointment alone unless you need a carer to accompany you. Children should not come with you to your appointment as we perform investigations that are not safe for children in the department.

Having a SeHCAT scan involves attending the hospital for two separate appointments, seven days apart.

First appointment

At your first appointment, we will measure your height and weight, and you will be asked to remove your shoes. You will then be asked to swallow a small gelatine capsule with a glass of water. This capsule contains a small amount of radioactive material (radioactive tracer) that binds to bile acids. You will not feel any effects after swallowing the capsule.

You will then need to return to the department two hours later for the scan which takes around 15 minutes. During your SeHCAT scan, you will lie on a scanning table and a special machine called a gamma camera will be positioned above and beneath you. You will be able to leave the department immediately after your scan.

Second appointment

Seven days after your first appointment, you will need to return to the hospital for your second scan which also takes around 15 minutes. During the second scan, we measure the amount of bile acid remaining in your body to determine whether you have bile acid malabsorption (BAM). You may need to wait in the department for a few minutes after your scan while the radiographer checks your scan images. 

A SeHCAT scan is an outpatient procedure and there’s no recovery time after your scan. The scan does not affect your ability to drive, and you can resume all normal activities including returning to work immediately after your scan. You do not need to keep a distance from other people or take any other precautions after your SeHCAT scan.

You’ll be given a follow-up appointment with your consultant to get your results, normally a few days after your second SeHCAT scan. At your appointment, your consultant will give you your results, explain what they mean and discuss any further tests, or treatment options if needed.

During your SeHCAT scan, you will receive a small dose of radiation from the radioactive tracer in the capsule. This is around the same amount of radiation as you would get from natural sources over around two months and the risks are minimal. There are no obvious or known side effects from having a SeHCAT capsule, and the benefits of the scan far outweigh the risks. If you are worried about the risks of having a SeHCAT scan or have any questions about the procedure, please talk to your consultant.

 At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about having a SeHCAT scan, book your appointment online today or call a member of our team directly.

Overview: SeHCAT study - Guy’s and St Thomas’ NHS Foundation Trust 

Nuclear Medicine - SeHCAT Scan Information for patients, relatives and carers - York and Scarborough Teaching Hospitals NHS Foundation Trust 

Bile acid malabsorption: colesevelam - National Institute for Clinical Excellence (NICE)