Overview

A SeHCAT (pronounced 'see cat') scan looks at how well your body absorbs bile salts.

Bile salt is produced in the liver and stored in the gallbladder. It helps to digest fats and get rid of toxins in the body.

If bile salts are not being absorbed properly, they interfere with how the bowel absorbs water and can cause diarrhoea. This is called bile acid malabsorption (BAM).

You might be referred for this test if you've had recurring diarrhoea for a long time.

The scan will measure the amount of radioactivity in your body after you've swallowed a capsule. The capsule contains a chemical like bile salt and a small amount of radioactive tracer.

This helps us to diagnose and treat bile acid malabsorption (BAM). If you're diagnosed with BAM, we can improve your symptoms dramatically with simple treatment.

Preparing for a SeHCAT study

You can eat and drink normally on the day of the study.

Please contact us if you:

• are taking medicines 
• are pregnant, or think you might be
• are breastfeeding

Please contact the nuclear medicine department urgently if you are taking the following medicines or any others for diarrhoea:

• CREON®
• cholestyramine
• colesevelam

It's very important to tell us about any medicines that you're taking. This is because some medicines will need to be stopped before the study as they interfere with the test results. We may not be able to carry out the study if you have not told us about your medicines.

If you're pregnant or breastfeeding

Radiation can be harmful for an unborn baby. If you are pregnant, or think you might be, you must tell us as soon as possible, ideally before confirming your appointment.

For all nuclear medicine studies we will check your pregnancy status with you before using any radioactive tracer.

Radioactive tracers can be passed into breast milk. Please tell us before you come for your test if you are breastfeeding and we can tell you whether you will need to stop for any amount of time.

During a SeHCAT scan

You'll have 2 appointments in the nuclear medicine department, a week apart.

You are welcome to bring a friend or relative with you if needed but space in the waiting area is limited. When you are called for your study, your friend or relative will be asked to wait for you in our waiting area until your study is complete.

Please do not bring children with you, as the area is not suitable for them because of the tests we perform in nuclear medicine.

First appointment

When you arrive for your appointment, you are given a capsule to swallow. This contains a synthetic bile salt with a small amount of radioactive tracer called selenium. A radioactive tracer has a very small amount of a type of radiation similar to X-ray (known as ionising radiation).

After you take the capsule you'll need to wait for 3 to 4 hours.

You then have a scan to measure the amount of radioactivity in your body. You are free to leave the department until it's time for your scan. If you prefer, you can sit in our waiting room.

We use a scanner called a gamma camera. You will be asked to lie down and stay as still as possible on a scanning couch. There is no need to undress, but we ask you to remove any metal objects from your clothing or pockets such as coins, belts, watches, and jewellery. Metallic objects can block the camera detecting radioactivity.

The gamma camera will not come close to you and will not touch you. A member of staff is with you at all times. We take a set of pictures and analyse them using a computer programme to measure the radioactivity.

After this, the nuclear medicine technologist or radiographer will ask you to wait for a few minutes while they check the images from your scan are saved on the computer correctly. They let you know when you can leave the department and go home.

Second appointment

One week later, you return to the department for the second part of the SeHCAT study. This happens in exactly the same way as the first time but without you needing to take the capsule again. This means, you will not need to wait 3 to 4 hours again.

The staff are not able to give you the result of the SeHCAT study on the day but they will write to the doctor who referred you with the results within 2 to 3 working days of the study being completed.

Risks of having a SeHCAT study

You receive a small radiation dose (0.3 millisieverts) from the radioactivity in the capsule when having a SeHCAT study. The amount of radiation is about the same as you would get from natural sources of radiation in about 2 months.

The risks from the radiation are minimal and there are no obvious side effects from taking this capsule, so the benefits of having the test outweigh the risk. This radioactivity leaves your body naturally in your urine (pee).

You should not feel sick or drowsy after swallowing the capsule or in the week afterwards and it will not affect your ability to drive a car. The radiation dose to other people around you is very low and you do not need to keep away from anyone if you are having this test. Please see above for risks if you are pregnant or breastfeeding.

Giving your consent (permission)

We want to involve you in decisions about your care and treatment. If you decide to go ahead, you will be asked for your verbal consent to have the treatment and that you understand what it involves. If you would like more information about our consent process, please speak to a member of staff caring for you. 

What happens after the study

As soon as the study is completed you can leave the hospital once instructed by a member of staff. After the study you can eat and drink as normal.

Follow-up appointment

After the study, the nuclear medicine consultant will study the measurements and write a report. They will write to the doctor who referred you for the study. You should already have an appointment booked with the team who referred you. If not, please contact them to arrange a follow-up appointment to discuss the results of the study and any treatment you may need.