Bile Acid Absorption Study (NSEHC)

Introduction

You are receiving this information leaflet because you have been referred for a bile acid absorption test in the nuclear medicine department. Nuclear medicine involves the use of small amounts of radioactive tracers to help diagnose and sometimes treat medical conditions. These tests are valuable in identifying a wide range of health conditions. Your referring clinician will have already discussed with you why this test is necessary.

This leaflet aims to provide an overview of your test and answer general questions. A member of our team will explain the procedure in detail when you arrive. If you have any concerns beforehand, please feel free to contact us using the details at the back of the leaflet.

Bile acid absorption study

This test helps determine whether your body is properly absorbing bile acids, which play an important role in digestion. If absorption is impaired, excess bile salts can reach the large intestine, which may result in symptoms such as diarrhoea, bloating and abdominal discomfort.

Will it hurt?

No, the test is painless. You will simply be asked to swallow a small capsule. There are no side effects from the tracer, and no restrictions following the test. You will be able to continue with your usual daily activities.

How long will I be in the department?

Your appointment will take approximately 30 minutes, during which we will explain the test procedure and provide you with the capsule to ingest. If you have undergone any recent nuclear medicine or PET scans, a baseline scan may be required, adding an additional 15 minutes to your visit.

You will then return one week later for the imaging scan, which may take up to 30 minutes.

What to do when you arrive

Upon arrival, please check in at the reception desk located on level 3. Once checked-in, kindly take a seat in the waiting area. This allows our team to confirm your attendance and prepare for your test. This process typically takes about 15 minutes.

Staff you are likely to meet

Your care will be provided by our specialist team, including nurses, nuclear medicine technologist and radiographers, who will guide you through each step of the procedure.

Is this test suitable for my ethical beliefs?

The pharmaceutical used in this test is administered in a capsule which may contain gelatine derived from animal products. Therefore, this product is not suitable for vegans or vegetarians.

Preparation for procedure/examination

Please read and adhere to the following instructions:

The following medications need to be stopped 3 days prior to the test and should not be started again until its completion.

1. Bile acid sequestrants: Colestyramine (Questran) and Colestipol (Colestid).
2. Colesevelam.
3. Creon (pancrelipase).

Drugs that should be avoided for the same period if possible:

1. Drugs used to treat diarrhoea (Loperamide, Dioraleze and Imodium).
2. Drugs that affect gastric motility (Cisapride, Prepulsid, metoclopramide and Maxolon)
3. Drugs used for urinary retention: (Bethanecol/ Myotonine).

Please contact us in advance of your procedure/examination on 01223 217145 if you:

• Have additional requirements that may require a longer appointment
• Are claustrophobic
• Are pregnant or breastfeeding
• Require hospital transport
• Have mobility issues
• Require clarification on your preparation

Benefits

Nuclear medicine investigations provide doctors with information to help them diagnose a variety of conditions. These investigations help to confirm or rule out a suspected diagnosis, or occasionally identify a condition that was not suspected.

Risks

You have been referred for a nuclear medicine examination to help make a diagnosis or monitor your treatment. A specialist in radiology agrees that this is the best test to answer the clinical question that has been asked and that the benefit of the examination is greater than the risk. The test involves a low dose of ionising radiation equivalent to a few weeks or months of natural background radiation which we are all exposed to every day. Ionising radiation can cause cell damage that may turn cancerous however the risk of this happening from your examination is considered very low. The dose delivered will be kept as low as is practicable.

What will happen on the day of my procedure/examination?

This test is a two day procedure. How your test will be performed:

Day 1

During your first visit, a member of our team will explain the procedure and review your preparation, including any medications you had to stop. You will then be given a capsule containing a small amount of radioactive tracer to swallow. Once you have taken the capsule, you are free to leave the department as this completes your first day.

Please note: If you have undergone any recent tests or treatments involving radioactive materials, it is important to contact our department in advance. In such cases, we may need to perform a brief baseline scan before administering your capsule.

Day 7

One week later, you will return for your scanning appointment. This involves a 7 minute whole body scan performed while you lie comfortably on the camera bed. The imaging cameras will be approximately an arm’s length away from you, and we will ask you to remain still during the scan to ensure optimal image quality.

Accessibility requirements

If you require support for your appointment, e.g. if you find it hard to hear, see or be understood by others, please let the receptionist or healthcare professional know on arrival, email the accessibility team or call 01223 256998.

Pregnancy status

As a standard precaution, it is normally recommended to avoid radioactive tests during pregnancy. Please note that certain radioactive substances may pass into breast milk in small quantities. If you are currently breastfeeding, or if you know or suspect you may be pregnant, please contact our department in advance to discussion your situation. We also ask that you inform our staff upon arrival so we can ensure your safety and provide appropriate guidance.

We have a legal responsibility to enquire if you are pregnant. Any patient aged between 12-55 years will be asked if there is a possibility they could be pregnant. This is important for us to know before you have your examination involving ionising radiation. You can discuss this with a healthcare professional in private if you wish.

Medication

Bring a list of all of your medicines and a current repeat prescription from your GP as this will be helpful in the review of your preparation.

Can I bring someone with me?

To ensure the safety and comfort of all patients, we kindly request that you limit your companions to one adult during your visit. Please note that children and pregnant women are unable to accompany you in the department due to safety precautions. Your companion may be asked to wait outside during your procedure. We appreciate your cooperation and understanding. Should you require any special assistance, please contact us in advance.

Childcare whilst in department

Staff are unable to look after or supervise children whilst your procedure/examination is taking place. Please make alternative arrangements for the care of your children whilst you attend for your procedure/examination. If you attend an appointment with children with no one to look after them whilst you have your examination/procedure, then your appointment will unfortunately have to be cancelled and rescheduled.

Personal belongings

Please keep all your personal belongings with you at all times during your visit as we cannot accept responsibility for any lost, stolen or damaged items. Rest assure that you will be able to take these items with you into the scanning rooms.

Travelling abroad?

Please be aware that most airports have sensitive radiation monitors which detect very small amounts of radiation and may detect a residual trace from your test.

We advise you keep and travel with your appointment letter if you are travelling within 14 days after your scheduled scan. If you inform us of your travel we can provide you with a signed travel letter at your appointment. If residual trace is detected, the airport may have to contact our department as a precaution.

What happens after my procedure/examination?

Once we have verified the quality of your scan and have confirmed we have all the necessary information, you will be able to leave the department. You may resume all normal activities as there no restrictions following this test.

Possible side effects and additional aftercare

This test itself has no associated side effects. However, you may experience mild symptoms related to temporarily pausing of certain medications in preparation for the procedure. If you have any persistent or concerning effects after resuming your regular medication please contact your GP for advice.

How, when and by whom will my results be communicated?

Imaging examinations are reported in order of clinical priority to ensure those with the highest urgency are reported first. Your referring team or clinician will be responsible for communicating reports back to you.

While results are available through MyChart, please note there is a standard 3 week delay between when the examination is reported to when it appears on your portal. This allows your clinical team adequate time to review and act on your results before they are released to you.

Are there any alternative tests?

If this test isn’t suitable for you, please contact your referring clinician to discuss alternatives. They can recommend the best options based on your individual needs.

Contacts/further information

The Nuclear Medicine department is located on level 3, in the outpatient department of the hospital. If you have any queries or cannot make your appointment please contact the department as soon as possible on 01223 217145.

Opening times: Monday-Friday 8am-5pm.

Facilities available

Our clinic provides a toilet with disability access for your convenience, as well as a dedicated baby changing room and an alternative waiting area for returning patients. Please note that the waiting area and toilet facilities are reserved for radioactive patients only, as part of our safety protocols. If you are not a radioactive patient alternative restroom facilities can be found around the corner in the outpatient department.

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Directions to the department

The nuclear medicine department is located on level 3, at the outpatient end of the hospital.

Question, concern or complaint?

Firstly speak to your nurse, doctor or other staff member as soon as you can so they can do their best to put things right straightaway.

If you don’t feel able to speak directly to the people caring for you, contact the patient advice and liaison service (PALS). Please call 01223 216756, 9am to 4pm Monday to Friday, email the PALS team, or submit a form available via link on the CUH PALS webpage.

PALS is open every weekday, and you can leave a message in the evenings and weekends.

MyChart

We would encourage you to sign up for MyChart. This is the electronic patient portal at Cambridge University Hospitals that enables patients to securely access parts of their health record held within the hospital’s electronic patient record system (Epic). It is available via your home computer or mobile device

More information is available on our website: MyChart