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Further investigations

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

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

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