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Brief report: length of ileal resection correlates with severity of bile acid malabsorption in Crohn’s disease  

Skouras T et al. Int J Colorectal Dis2018; doi:10.1007/s00384-018-3144-1.

Short summary

In patients with Crohn’s disease who had a prior surgical resection there was a modest correlation between the length of ileal resection and the severity of bile acid malabsorption (BAM), as defined by tauroselcholic (75selenium) acid (SeHCAT) retention values. Response to bile salt sequestrant therapy was not dependent on SeHCAT retention values.

A total of 91 patients with Crohn’s disease were included in the study. These patients had a previous resection and subsequent SeHCAT scan. Eighty eight patients (97%) had SeHCAT retention values of <10% and 85 (93%) had retention of <5%. The median length of resected ileum was 24 cm (range 15–165 cm) with a median of one resection (range 1–4). 

Statistical analysis demonstrated a modest correlation (rs=− 0.392, P=0.0001) between the length of resected ileum and the severity of BAM, defined by SeHCAT retention. There was no correlation between the severity of BAM and response to bile salt sequestrant therapy.

While SeHCAT is considered the gold standard for diagnosis of BAM, the test is not widely available in some countries. The correlation between ileal resection and BAM suggests that patients with less extensive resection and symptoms of BAM should be tested and offered bile salt sequestrant therapy.

Job number: JB57410GBy Date of Preparation: June 2019

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