further investigations
Last reviewed 01/2018
Histology:
- duodenal, jejunal or ileal mucosal biopsy
- area from mid-jejunum to distal ileum is difficult to reach endoscopically. If definitive abnormalities are identified radiologically, further investigation may necessitate laparotomy
Anatomy:
- barium follow through or small bowel enema; the latter provides better anatomical definition
- abdominal CT - good for demonstrating abdominal lymphadenopathy, hepatic metastases, pancreatic anatomy
- ERCP - better than CT for diagnosing chronic pancreatitis
Function:
- specific carbohydrate absorption - most commonly, lactose breath hydrogen test
- pancreatic function - particularly, NBT-PABA and fluorescein dilaurate indirect methods
- ileal function:
- Schilling's test - vitamin B12, intrinsic factor
- SeHCAT - bile salt absorption
Small bowel contamination:
- see investigation of bacterial overgrowth
SeHCAT (tauroselcholic (75 selenium) acid) as a test for diagnosing bile acid malabsorption