Colonoscopy and SeHCAT for Investigation of Chronic Diarrhea
Colonoscopy and SeHCAT for Investigation of Chronic Diarrhea
复制标题
结肠镜检查和 SeHCAT 检查慢性腹泻
作者：
Marcella Müller;R. Willén;P. Stotzer
背景/目的：慢性腹泻是一种常见的疾病。结肠镜检查是诊断的首选。即使在内镜下宏观上正常的粘膜也可能出现异常，如显微镜下的结肠炎和胆汁酸吸收不良（BAM）。本研究的目的是确定结肠镜活检对慢性腹泻患者的价值，并评估SeHCAT检测对诊断这些患者的BAM的附加价值。方法：纳入1999年11月至2000年12月间行结肠镜检查的所有患者。回顾了患者档案、结肠镜检查和病理报告以及SeHCAT检查结果。结果：纳入205例患者。最常见的诊断是腹泻为主的IBS（76例）和IBD（38例）。158例患者无出血性腹泻，其中113例（72%）的粘膜在宏观上表现正常。其中40例（35%）患者可以进行组织学诊断，显微镜下结肠炎是最常见的诊断（n = 27）。36例患者行SeHCAT检测，其中15例（42%）存在BAM。47例带血性腹泻患者中，IBD为主要诊断（n = 23）。结论：检查慢性腹泻时必须进行结肠镜活检，应排除BAM。
Background/Aims: Chronic diarrhea is a common problem. Colonoscopy is the investigation of choice for diagnosis. Even a macroscopically normal mucosa on endoscopy can have abnormalities such as microscopic colitis and bile acid malabsorption (BAM). The aim of this study was to establish the value of colonoscopy with biopsies in patients with chronic diarrhea and to evaluate the additive value of a SeHCAT test for diagnosing BAM in these patients. Methods: All patients who underwent a colonoscopy between November 1999 and December 2000 were included. Patient files, colonoscopy and pathology reports and SeHCAT test results were reviewed. Results: 205 patients were included. The most common diagnoses were diarrhea-predominant IBS (n = 76) and IBD (n = 38). 158 patients had non-bloody diarrhea, 113 (72%) of them had a macroscopically normal appearing mucosa. In 40 (35%) of these patients, a histological diagnosis could be made and microscopic colitis was the most common diagnosis (n = 27). SeHCAT test was performed in 36 patients and 15 (42%) of them had BAM. In the 47 patients with bloody diarrhea, IBD was the main diagnosis (n = 23). Conclusion: Colonoscopy with biopsies must be performed when investigating chronic diarrhea and BAM should be excluded.