SeHcat scan for Bile Acid Malabsorption (BAM)

[BAM28]

Hi everyone.

A consultant suspects I have bile acid malabsorption and I agree. I’ve been taking colestyramine while waiting for my seHcat scan.

Since taking the colestyramine and significantly reducing the fat in my diet my symptoms have for the most past disappeared. Occasionally they come back if I eat high fat over the course of a day.

I’ve just got through that my seHcat scan is next week and been told to stop taking the medication until both parts of the scan a week apart are complete. My question is should I still keep a low fat diet or will I eat as normal? Will reducing the fat I eat before the scan skew the results?

I only ask as I’m also coeliac and while waiting for the diagnosis of this I had to keep eating gluten to ensure the internal damage/reaction was visible with the scope.

I want to make sure I’m prepared so the scan is accurate.

Thanks in advance!

[Edgar77]

I am also coeliac. I had to stop lansoprazole, but was not told to eat gluten!!!! I don't remember any change in diet. They give you a tablet and it's all about how you absorb that over the next week.

[Edgar77 in reply to Edgar77]

PS I was border line BAM As the only meds they give is to stop diarrhoea and I am IBSC I take nothing for it. So for me it was all a waste of time. I have also recently had a S.I.B.O test but try as I might I could NOT blow the thing hard enough to move the dial at all. So that was a waste of time too. I have run out of options now and believe I will always have this pain and fear going out at all.

[BAM28 in reply to Edgar77]

Thank you. What is IBSC? Even though I’ve not had the test yet the Dr prescribed me the sachets of colstyramine. I think they have helped me significantly, but I noticed the best difference when I also cut my fat intake to less than 40g per day. It seems so many people with coeliac have other autoimmune issues 🥲. I won’t be eating gluten before seHcat, I meant for coeliac tests I had to - I know some people are told to stop eating gluten immediately.

[Edgar77 in reply to BAM28]

IBSC - constipation. IBSD - diarrhoea.

[BAM28 in reply to Edgar77]

Sorry, so obvious when you’ve said it! Yes, I can see how the treatment wouldn’t work with you, I know the sachets have certainly blocked me up a bit. But in my case that was useful.

[BabsyWabsy in reply to BAM28]

Sometimes, a diagnosis can be based on your reaction to a sequestrant. Looks like it is positive for you alongside reducing your fat intake. Brilliant. You seem to have found a way to manage your symptoms. Good news that you don't need to eat gluten ahead of your seHcat. The results will be interesting. Perhaps you should ask your medical team if you should eat as before, or your new regime?

[BAM28 in reply to BabsyWabsy]

Thanks BabsyWabsy. I think I saw advice on this forum about cutting the fat in the diet down and that along with the sequestration seems to have really had an impact! I know if I eat more fat than I should that I will suffer for it the next day. Hopefully if I get a diagnosis I can get some diet advice from Dr/dietician. The advice I’ve had so far has been from the internet - and thankfully it’s all worked. Because the initial Dr never told me to cut down the fat in my diet - I suppose he wanted to wait until seHcat results are in first.

[jbrking]

Hi. I have bam, diagnosed with sehcat and on meds now for 8 years. As you know you have to stop meds before the scan, very much keep to a low fat diet, otherwise you will suffer badly. It’s not about how much bile you have in system (usually more when you eat fat)‘it’s about the retention/reabsorption rate. Keeping low fat won’t skew the results but will help you not suffer as much. I had best week ever between scans, no diarrhoea at all and was worried it wouldn’t show, but it did.

[BAM28 in reply to jbrking]

Thank you so much jbrking, that is very reassuring! I was worried that keeping low fat or if I had a lucky good week that it might skew the results. 😀

[Bracondale in reply to jbrking]

Whilst I agree that it is about retention/resorption rate rather than absolute bile volume produced, I do think that if there is an abnormally low amount of bile then the terminal ileum may have the capacity to absorb it all successfully, but if there is a higher (say normal amount) then it will not cope. I personally think that staying low fat may result in a false negative result and condemn someone to a low fat diet forever with all the sequelae that has in terms of absorbing fat soluble vitamins, fats needed for hormone synthesis and heathy cell membranes. Sorry if this is just adding to the confusion BAM28. (I personally worked out my bile problems by looking for the underlying cause, and have more info if you don't have any luck with your scan.)

[BAM28 in reply to Bracondale]

Thank you Bracondale . I’ve rang them to check and they just said eat whatever I want but stop taking all medication. I’m not sure they understood my concern. I’m going to mention to them on the day and tell them what I’ve been doing so that I make sure everything is as accurate as it can be! Thank you.

[Bracondale]

My instinct is to say eat as you normally would so that you excrete the same amount of bile for the test that you would normally be prompting your body to do (whether or not it actually over-responds). So, I too think that staying low fat may skew the results...but you could always ask those who are doing the test. (Not that they always know best I always remember being told by a nurse to provide a sample for a urinary tract infection after I'd already started antibiotics, and even as a teenager and pre any medical training thought it was a stupid idea!)