{
  "abstract": "Introduction Bile acid diarrhoea (BAD) affects 1% of the UK population. It is most frequently diagnosed in patients with secondary causes, however it much more prevalent in those with idiopathic BAD when it is frequently misdiagnosed as irritable bowel syndrome. New pathways for the management of Functional Bowel Disease have been agreed across Lincolnshire. They include direct access referrals for primary care for SeHCAT scanning. This study assessed results from SeHCAT scanning since access was opened to primary care.Methods Patients referred for a SeHCAT scan are scanned 1.5 hours after ingestion of the capsule and 7 days later. A consecutive list of all patients scanned was provided by the nuclear medicine department.Results From March-October 2025 when primary care referrals started, 441 scans were performed: 391 patients were referred from secondary care; 342 from Gastroenterology, 27 from oncology, 21 from Surgery,1 from endocrinology.47 patients were referred by primary care from 22/84 Lincolnshire practices.Patient gender, age and reported symptoms were similar in primary and secondary care referrals. They included 149 (33%) male, 292 (67%) female, median age 52 (range 17-86) years. Symptoms usually included loose stools, frequency and urgency.158 (40.5%) of 391 patients referred from secondary care had risk factors for BAD including cholecystectomy n= 64 (40.5%), right hemicolectomy/ileal resection, 28 (17.7%), chemotherapy/radiotherapy, 28 (17.7%), Crohn’s disease without surgery, 24 (15.1%), microscopic colitis, 3 (1.8%), coeliac disease, 3 (1.8%), other upper GI surgery, 2 (1.2%), 2 different causes, n=3 (1.8%).14 (28.8%) of 47 patients referred from primary care had risk factors, which included cholecystectomy, n=12 (85.8%), microscopic colitis, 1 (7.1%) and radiotherapy, 1 (7.1%).Abnormal results were found in 202 (51.2%) patients from secondary care and 21 (44.6%) from primary care. Severity of BAD was similar in both groups 65 (29.1%) severe (<5% retention), 63 (28.2%) moderate (SeHCAT 5-10%), 47 (SeHCAT 10-15%) mild, 48 borderline (SeHCAT 15-20%).Conclusion This first reported experience of primary care referral for diagnostic SeHCAT scanning, suggests that criteria for referral are not very dissimilar between patients seen in primary and secondary care. Patients in both groups with a possible secondary cause for BAD appear disproportionately more likely to be referred than those with idiopathic BAD. Further research is needed to assess whether outcomes from treatment in patients diagnosed with BAD are similar in both groups and how much the diagnosis of BAD in primary care reduces referrals to gastroenterology.",
  "authors": [
    {
      "affiliations": [
        "United Lincolnshire Teaching Hospitals NHS Trust, Lincoln, United Kingdom"
      ],
      "name": "Lynsey Weaver"
    },
    {
      "affiliations": [
        "United Lincolnshire Teaching Hospitals NHS Trust, Lincoln, United Kingdom"
      ],
      "name": "Sally Willars"
    },
    {
      "affiliations": [
        "United Lincolnshire Teaching Hospitals NHS Trust, Lincoln, United Kingdom"
      ],
      "name": "Sarah Murten"
    },
    {
      "affiliations": [
        "United Lincolnshire Teaching Hospitals NHS Trust, Lincoln, United Kingdom"
      ],
      "name": "Laura White"
    },
    {
      "affiliations": [
        "United Lincolnshire Teaching Hospitals NHS Trust, Lincoln, United Kingdom"
      ],
      "name": "Jessica Hill"
    },
    {
      "affiliations": [
        "United Lincolnshire Teaching Hospitals NHS Trust, Lincoln, United Kingdom"
      ],
      "name": "Jervoise Andreyev"
    }
  ],
  "title": "FP53 Should primary care have open access to request diagnostic SeHCAT scans for bile acid diarrhoea?",
  "uid": "9c084310-132c-548a-a7dd-7c01c9272a43"
}