Bile salts

Folate

B12

Carbohydrate

fat soluble vitamins

>15 ppm

>12 ppm

>10 ppm

<15 ppm

>20 ppm

Patient takes bowel cleansing preparation

Radiation dose is smaller so views of extra-colonic organs is limited

Radiation dose is higher to the image is clearer

If not sit to take preparation then fgastrograffin used to tag faeces which can be subtracted by computer software

Air is insufflated into the colon using a flatus tube

Its not

Bile acids enter the colon in larger than normal amounts are result in irritation and diarrhoea

Bile acids are reabsorbed into the circulation in the distal/terminal lieum and reconstituted into bile

More bile acids in the circulation

Resection of the distal/terminal ileum

Disease

In 10 days

In 5 days

At baseline

In 7 days

5%

15%

20%

50%

Normal bile salt absorption

Bile salt malabsorption

Loperamide

Atropine

Cholestyramine

Hexamethonium

Evidence of oesophageal mucosal damage/infection

Acid reflux complications (Barrett's oesophagus, strictures, cancers)

Allows biopsies

Differentiate gastric from bile acid reflux