Introduction: Bile acid malabsorption (BAM) may be a contributing factor causing diarrhoea in patients with NETs, particularly among those who have undergone previous surgical resection of the terminal ileum and/or right colon or cholecystectomy (Naraev et al 2019).
Aim(s): To identify the prevalence of bile acid malabsorption in neuroendocrine tumour patients (NET) at the Queen Elizabeth Hospital Birmingham (QEHB).
Materials and methods: Data was obtained via informatics looking back at the NET patients seen at QEHB from the past 10 years. A sample of 1665 patients was taken, of these 22 had a SeHCAT scan completed. Data was collected including; primary tumour location, surgery, whether the patient had been prescribed any bile acid sequestrants and the result of any completed SeHCAT scans.
Results: A SeHCAT scan result was available for 22 patients. 17 (77%) patients had a positive SeHCAT scan result, 5 (23%) patients had a normal result.
Of those with confirmed BAM;
- 82% had been prescribed bile acid sequestrants.
- 94% had previously undergone surgery with the majority having had some form of small bowel resection and/or right hemicolectomy.
- 88% had a small bowel primary tumour, 6% pancreatic and 6% lung.
Conclusion: NET patients that have undergone surgical resections of the right colon and small bowel are at a greater risk of bile acid malabsorption and this should be a factor considered when undertaking nutritional assessments and reviewing bowel habits. Due to the covid 19 pandemic SeHCAT scans were temporarily stopped, the data captured during this time frame does not include the patients that were empirically treated. More research needs to be conducted looking at the efficacy of bile acid sequestrants on symptom control and incidence of BAM as a whole.
Keywords: SeHCAT | Bile acid malabsorption | Bile acid sequestrants | Surgery | NET