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Introduction

Endoscopic submucosal dissection (ESD) is the preferred method for the treatment of superficial gastric neoplasms. In cases of curative resection, the outcome is excellent with recurrence rates of less than 5% and disease-free survival rates greater than 95%. However, surgical resection is indicated in cases of non-curative resection, although recent studies suggest that this strategy may have an unfavorable risk/benefit ratio.

Aims & Methods

The aim of this study is to analyze the evolution of patients with non-curative resection in our center. Patients who did not meet the criteria for cure after ESD of superficial gastric neoplasms were prospectively evaluated. Clinical (before and after ESD), endoscopic (location, size, and morphology of the lesion), pathological (tumor size, degree of dysplasia, vertical and horizontal margins, vascular, lymphatic, and perineural invasion), and surgical (type of intervention, pathological characteristics of the specimen) data were collected and analyzed.

Results

Of the 203 patients who underwent ESD of upper digestive tract lesions, 20 patients with non-curative resection of gastric neoplasms were identified (median age 70 years, 65% of whom female). The mean size of the lesions was 20 ± 9 mm, and 40% were depressed (Paris Classification 0-IIa+c [n = 6] and 0-IIb+c [n = 2]). Resection was R1 in five cases, nine had submucosal invasion greater than 500μm, nine had lymphatic invasion, and four had vascular invasion. Of these, 15 patients underwent surgical resection (75%), mostly partial gastrectomy (n = 12). In the remaining cases, surveillance (n = 3) or pending multidisciplinary discussion (n = 2) was opted for. Pathological evaluation revealed a "white" specimen in 10 cases (2/3). The clinical characteristics and histological data of the ESD specimen (including the eCura score [Hatta et al., 2017]) were not statistically different in patients with and without residual neoplasia in the operative specimen (p>0.05).

Conclusion

Despite the small sample size, this series suggests the need to identify better predictors of "clinically significant non-curative resection," in which disease persistence after ESD is more likely.

References

Hatta W, Gotoda T, Oyama T, et al. A Scoring System to Stratify Curability after Endoscopic Submucosal Dissection for Early Gastric Cancer: "eCura system" [published correction appears in Am J Gastroenterol. 2019 Dec;114(12):1925-1926]. Am J Gastroenterol. 2017;112(6):874-881.

SALVAGE SURGERY AFTER NON-CURATIVE GASTRIC ENDOSCOPIC SUBMUCOSAL DISSECTION - CASE REVIEW AND EVALUATION OF PREDICTORS OF DISEASE PERSISTENCE

Maria Manuela Estevinho 1, Rolando Pinho 1, Jaime Rodrigues 1, João Carlos Silva 1, Joao Paulo Laranjeira Correia 1, Pedro Filipe da Silva Mesquita 1, Teresa Freitas 1

1 Centro Hospitalar Vila Nova de Gaia Espinho, Vila Nova de Gaia, Porto, Portugal

Conference

UEG Week Copenhagen 2023

Topics

Oesophagus

Submission format

Abstract

Session

PP 01 Oesophageal, gastric and duodenal disorders (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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Introduction

Despite new therapeutic strategies, substantial proportion of patients with ulcerative colitis (UC) undergo colectomy at some point. Restorative proctocolectomy with ileal pouch ano anastomosis (IPAA) is regarded as intervention of choice in these patients. However, the disease conversion to Crohn´s disease (CD) is reported in up to one third of these patients who necessitate immune suppressive treatment after IPAA. Considering the life-long need for immune suppressive therapy in these patients, ileo-rectal anastomosis (IRA) would represent a good alternative to IPAA in this specific group of patients. Todate, no data are available to predict the UC-CD conversion. One of the possibility to reduce the risk of performing IPAA in patients developing CD in pouch is to use the modified two-stage proctocolectomy approach and identify patients who develop CD endoscopically between colectomy and the restoration of continuity.

Aims & Methods

The aim of the present study was to assess the UC-CD conversion rate identified prior IPAA via ileoscopy.
All patients with UC operated in one tertiary IBD center between 2016 and 2021 were identified in medical records. The main outcome was CD detected at ileoscopy between the first stage operation, i.e. total colectomy with terminal ileostomy and the restoration of continuity either via IPAA or IRA. The ileoscopy was performed between three to six months after colectomy. The secondary outcome was the rate of conversion to CD after IPAA or IRA.

Results

Sixty patients underwent total colectomy (mean age 41 years, range 22-77; 62% were men); seven patients were lost to follow-up, finally the data from 53 patients were analysed. The majority of these patients (36 - 68%) underwent colectomy for therapy resistent chronically active UC, 9 (17%) patients for acute severe UC, 2 patients had benign colonic stenosis, 5 had high-grade dysplasia or colorectal cancer detected at surveillance colonoscopy and one patient had extensive pseudopolyposis.
All resection specimen were reviewed and no histopathological features of CD were found. Three out of the 53 (6%) ileoscopically assessed patients prior IPAA or IRA were diagnosed with CD in prestomal terminal ileum. During the further follow-up, additional 4 patients developped CD, two after IPAA, one with definitive ileostomy in prestomal ileum and one in neoterminal ileum after IRA.
In total 7 out of 53 patients in this cohort developped CD (13%). Using the two stage approach with ileoscopy between colectomy and restoration of continuity, three out of these seven patients with CD convertion in this cohort were detected prior the decision on the type of second-stage operation.

Conclusion

The conversion from ulcerative colitis to Crohn`s disease occurs in a significant proportion of IBD patients after colectomy. Ileoscopy performed between the two stages of restorative proctolectomy is helpfull in detecting these patients and guiding the decision on the type of surgical intervention to restore continuity.

Disclosure

Nothing to disclose.

ULCERATIVE COLITIS – CROHN´S DISEASE CONVERSION RATE IN THE COHORT OF PATIENTS WITH ULCERATIVE COLITIS UNDERGOING COLECTOMY

Zuzana Zelinkova 1, Dusan Podmanicky 1, Katarina Berakova 2, Barbora Kadlečková 1

1 Nemocnica Bory - Penta Hospitals, Bratislava, Slovakia

2 Martinske Biopticke Centrum, Zilina, Slovakia

Conference

UEG Week Copenhagen 2023

Topics

IBD

Submission format

Abstract

Session

PP 05 IBD (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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Introduction

Paediatric-onset inflammatory bowel disease (PIBD) is a distinct phenotype with more aggressive and extensive gut inflammation at diagnosis in comparison to adult-onset IBD.¹ Disease activity in paediatric IBD is typically monitored using a combination of clinical, endoscopic, and laboratory parameters. Circulating cell-free DNA (cfDNA) and mitochondrial DNA (mtDNA) are damage-associated molecular patterns (DAMPS) released into the bloodstream during tissue damage and cell death and can be detected in peripheral blood samples. There is a growing interest in the use of cfDNA and mtDNA as potential non-invasive biomarkers for disease activity. Recent studies have suggested that levels of cfDNA and mtDNA may correlate with disease activity in adult IBD² but their utility in paediatric populations, where mitochondrial dysfunction is strongly implicated,³ remains largely unexplored. This study aims to present initial data on the potential use of cfDNA and mtDNA as biomarkers for disease activity in paediatric-onset IBD.

Aims & Methods

GI-DAMPs/MUSIC is an ongoing cross-sectional and longitudinal multi-centre translational research study in Scotland (2020 – 2025) with a primary aim of investigating the inflammatory mechanisms of IBD with a focus on multi-omics, immune- and microbiome-profiling aligned to careful clinical prospective follow-up. We measured circulating cfDNA and mtDNA, using mtDNA-specific ND2 gene dPCR, in the peripheral blood of patients diagnosed under 17 years (A1 phenotype)⁴ and correlated this with detailed phenotypic data, clinical disease activity scores and standard biomarkers.

Results

24 patients, out of a total GI-DAMPS cohort of 338, were A1 phenotype and included in the analysis (14/24 (58%) male, 23 Crohn’s disease (CD), 1 Ulcerative colitis (UC)) with a median (IQR) age at diagnosis of 13 (11.5-15 years). Patients with highly active disease had higher levels of cfDNA levels compared to those in remission (median 0.435 (0.246-0.700 ng/µl) vs 0.123 (0.066-0.160 ng/µl), p=0.005). mtDNA levels were also significantly higher in those with highly active disease compared to those in remission (median 363.6 (135.2-639.6 copies/µl) vs 96.4 (78.2-129.8 copies/µl), p=0.024). cfDNA was moderately correlated with total white cell count (Pearson correlation, r=0.41, p=0.48) and negatively correlated with haemoglobin (r=-0.42, p=0.41), though these correlations were not seen with mtDNA (all p=>0.05).

Conclusion

In conclusion, our initial data demonstrate that the levels of circulating cell-free DNA (cfDNA) and mitochondrial DNA (mtDNA) in the blood are potentially valuable biomarkers for differentiating disease activity in paediatric IBD. These findings suggest that measuring cfDNA and mtDNA levels could provide a non-invasive method for monitoring disease activity in young patients with IBD, enabling early detection of disease flare-ups and facilitating prompt intervention. Further investigation is needed to validate these results and determine the clinical utility of these biomarkers in the management of paediatric IBD.

References

1. van Rheenen, P. F. et al. The Medical Management of Paediatric Crohn’s Disease: an ECCO-ESPGHAN Guideline Update. J. Crohn’s Colitis 15, 171–194 (2021).
2. Boyapati, R. K. et al. Mitochondrial DNA Is a Pro-Inflammatory Damage-Associated Molecular Pattern Released During Active IBD. Inflamm. Bowel Dis. 24, 2113–2122 (2018).
3. Haberman, Y. et al. Ulcerative colitis mucosal transcriptomes reveal mitochondriopathy and personalized mechanisms underlying disease severity and treatment response. Nat Commun 10, 38 (2019).
4. Levine, A. et al. ESPGHAN revised porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents. J. Pediatr. Gastroenterol. Nutr. 58, 795–806 (2014).

CIRCULATING CELL-FREE DNA AND MITOCHONDRIAL DNA PREDICT DISEASE ACTIVITY IN PAEDIATRIC-ONSET INFLAMMATORY BOWEL DISEASE

David Wands 1, Siu-Ying Lau 2, Shaun Chuah 2, Rebecca Hall 2, Robert Whelan 2, Lena Fischer 2, Rahul Kalla 2, Peter Cartlidge 2, Broc Drury 2, Gareth R Jones 2, David C. Wilson 2, Gwo-Tzer Ho 2

1 University of Edinburgh, Edinburgh, United Kingdom|||University of Edinburgh, Edinburgh, United Kingdom

2 University of Edinburgh, Edinburgh, United Kingdom

Conference

UEG Week Copenhagen 2023

Topics

IBD

Submission format

Abstract

Session

PP 05 IBD (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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Introduction

Fibrosis constitute an important complication of CD. MicroRNAs (miRNAs), which are small RNA molecules that regulate gene expression, have been shown to participate in the molecular interactions of both inflammation and fibrosis. Lower levels of miR-378a-3p have been reported associated to murine liver fibrosis [1] and we analyze here the relevance of miR-378a-3p on intestinal fibrosis.

Aims & Methods

B57BL/6 mice were intravenously injected with 2,5mg/kg of negative control (NC) or mm-miR-378a-3p mimic, twice a week and received vehicle or Dextran Sulfate Sodium (DSS) for 2 cycles (7 days drinking DSS 2% in water solution followed by 10 days drinking water). Body weight and DAI score was obtained every day and the colon was collected after sacrifice. Sirius and hematoxylin-eosin dyes were employed to determine the fibrosis and structural state in 5µm slides of intestinal tissue. Gene expression and miRNA profiles were analyzed by RT-qPCR. Human small intestinal fibroblasts (HSIF; P10760, Innoprot, Spain) were transfected with 20nM of NC or hsa-miR-378a-3p mimic during 24h.

Results

No significant changes in body weight, DAI score, and colon length were detected between mice receiving NC and those receiving mimic, all along the two DSS cycles. Colon of mice treated with DSS, exhibited a significant diminution in the mRNA expression of mm-miR-378a-3p compared with naïve samples. In DSS-treated mice, the iv administration of the mimic compared with the NC: a) significantly increased levels of miR-378a-3p in the colon; b) increased the number of neutrophils, and heightened changes in the glandular epithelia and architectural distortion C) decreased the number of lymphoid follicles; d) slightly increased collagen deposition, as analyzed by sirius red and e) significantly increased the mRNA expression of Tgfb1, Il1b, and Mmp2. Treatment of human intestinal fibroblasts with hsa-miR-378a-3p mimic did not significant modify the mRNA expression of markers of fibrosis but it significantly increased the mRNA expression of two antiapoptotic molecules BCL2 and MCL1.

Conclusion

Levels of mm-miR-378a-3p are diminished in a murine model of intestinal fibrosis; The exogenous administration of miR-378a-3p, increased the acute inflammatory response and the expression of fibrosis markers in murine fibrotic colon and the expression of antiapoptotic molecules in human intestinal fibroblasts.

References

1. Hyun, J.; Wang, S.; Kim, J.; Rao, K.M.; Park, S.Y.; Chung, I.; Ha, C.S.; Kim, S.W.; Yun, Y.H.; Jung, Y. MicroRNA-378 limits activation of hepatic stellate cells and liver fibrosis by suppressing Gli3 expression. Nat Commun 2016, 7, 10993, doi:10.1038/ncomms10993.

THE ADMINISTRATION OF MM-MIR-378A-3P EXACERBATES CHRONIC INFLAMMATION AND FIBROSIS IN A MURINE INTESTINAL MODEL

Cristina Bauset 1, Marta Seco-Cervera 2, Laura Gisbert Ferrándiz 1, Gorka Arbelo 1, Josep Samper-Minbo 1, Maria Beltran-Viel 1, Dulce Carolina Macías-Ceja 1, Jesus Cosin-Roger 1, Dolores Ortiz-Masia 3, Sara Calatayud 1, María Dolores Barrachina 1

1 Universitat de València, València, Spain

2 Universitat de València, València, Spain|||FISABIO, València, Spain

3 Universitat de València, Valencia, Spain

Conference

UEG Week Copenhagen 2023

Topics

IBD

Submission format

Abstract

Session

PP 05 IBD (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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Introduction

Fecal microbiota transplantation (FMT) is a highly effective treatment for recurrent Clostridioides difficile infection (CDI), but its safety is jeopardized by the potential risk of transmitting microbial pathogens. Stool biobanks have established to provide both a widespread and equitable access to FMT and high safety, quality, and traceable workflows. To guarantee the safety of each donor stool batch, international guidelines recommend either a quarantine or a direct stool testing with a rapid molecular assay for gut pathogens. While reports of the quarantine-based approach are emerging, data on the direct testing-based approach are still limited

Aims & Methods

Our aim is to report outcomes of a donor screening program for FMT including a direct stool testing-based approach based on a rapid molecular assay for gut pathogens.We prospectively evaluated all candidates enrolled in our FMT donor program since the introduction of a direct stool testing with a rapid molecular assay for gut pathogens, in 2019. Following international guidelines, donor screening consisted of a five-step framework, including: 1) collection of clinical history; 2) blood and stool testing; 3) a further questionnaire the day of each donation; 4) nasopharyngeal swab and stool RT-PCR assay for SARS-CoV-2 the day of each donation (after March 2020); 5) a direct stool testing with a rapid molecular assay for gut pathogens and cultures for MDRO evaluation. Specifically, the RT-PCR Allplex™ Gastrointestinal Panel Assay (Seegene, Korea) was used for a comprehensive identification of common gastrointestinal pathogens. The QIAamp Fast DNA Stool Mini Kit (QIAGEN, Hilden, Germany) was used for nucleic acid extraction. We evaluated rates of donations per year, rates and reasons of candidates’ exclusion at each step of the donor screening, as well as the rate of unsuitable fecal donations and the intestinal pathogens that caused their rejection. Finally, we recorded the number of total fecal aliquots provided by eligible donors, and related safety outcomes at 12 weeks after their use within FMT.

Results

From January 2019 to December 2022, 227 candidates were assessed for eligibility. Of them, 122 were excluded at different steps of the screening process. Finally, we enrolled 69 eligible donors (37 females, 53,6%; mean age 37, 30% of the total pool). Thirty-seven fecal aliquots were collected in 2019 (13 donors), 39 in 2020 (20 donors); 51 in 2021 (24 donors), and 104 in 2022 (43 donors). Overall, we collected 231 fecal donations, of which 136 (58.8%) were considered eligible and stored at -80°C for FMT. Eight donations were discarded for insufficient amount of feces (<50 g - 3%), and 87 (37.6%) for positivity to intestinal pathogens, including Enteropathogenic E. coli (EPEC) (n=31 samples – 13.4%), ESBL (extended-spectrum beta-lactamase) E. coli (n=15 samples, 6.5%), Blastocystis hominis (n=17 samples, 7.3%).Notably, we found a seasonal variation among pathogen positivity, as most pathogens were observed in Autumn (from September to December: n=48/87, 55.8%).All donations have been used, and no serious adverse events or infections have been observed at 12 weeks after FMT.

Conclusion

Our screening of donor feces based on direct stool testing guarantees high safety of FMT, although with high rates of donor exclusion, with the need of a well-established framework to guarantee a continuous availability of eligible donors to avoid shortages of fecal aliquots.

Disclosure

G.I. has received personal fees for acting as speaker for Biocodex, Danone, Sofar, Malesci, Metagenics and Tillotts Pharma, and for acting as consultant and/or advisor for Ferring Therapeutics, Giuliani, Malesci and Tillotts Pharma. A.G. reports personal fees for consultancy from Eisai Srl, 3PSolutions, Real Time Meeting, Fondazione Istituto Danone, SinergieSrl, Board MRGE and Sanofi SpA personal fees for acting as a speaker for Takeda SpA, AbbVie and Sandoz SpA and personal fees for acting on advisory boards for VSL3 and Eisai. G.C. has received personal fees for acting as advisor for Ferring Therapeutics. All other authors have no conflicts of interest to disclose.

SCREENING OF DONOR FECES WITH A DIRECT STOOL TESTING-BASED APPROACH: FRAMEWORK AND OUTCOMES OF A LARGE-VOLUME DONOR STOOL BIOBANK FOR FECAL MICROBIOTA TRANSPLANTATION

Debora Rondinella 1, Gianluca Quaranta 2, Tommaso Rozera 1, Pasquale Dargenio 3, Federica Pelliccia 1, Giovanni Fancello 2, Alessandra Guarnaccia 2, Serena Porcari 1, Stefano Bibbò 1, Marcello Fiorani 1, Andrea Severino 1, Maria Rosa Ingrosso 1, William Fusco 1, Chiara Agrillo 2, Maurizio Sanguinetti 2, Antonio Gasbarrini 1, Luca Masucci 2, Giovanni Cammarota 1, Gianluca Ianiro 1

1 Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Dipartimento Universitario di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy

2 Microbiology Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy

3 Università Cattolica del Sacro Cuore, Rome, Italy

Conference

UEG Week Copenhagen 2023

Topics

Colorectal

Submission format

Abstract

Session

Gut microbiome in clinical practice: From diagnosis to therapy (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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INHIBITION OF PLASMINOGEN ACTIVATOR INHIBITOR-1: A PROMISING NEW APPROACH FOR THE TREATMENT OF CHRONIC PANCREATITIS

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Introduction

Chronic pancreatitis (CP) is a complex inflammatory disorder characterized by progressive destruction of the pancreatic tissue, with fibrotic transformation of the tissue as a major morphological feature. The incidence of the disease is steadily increasing, but no specific therapy is currently available, making the identification of new therapeutic targets a priority. Plasminogen activator inhibitor-1 (SERPINE1/PAI-1) has been implicated in various pathological processes, including fibrosis and inflammation. However, its specific involvement in the pathogenesis of CP is not yet fully understood.

Aims & Methods

We therefore aimed to explore the role of PAI-1 in the development of CP and assess the therapeutic potential of PAI-1 inhibitors as antifibrotic agents to prevent the progression of CP.

The PAI-1 expression of the pancreatic tissue was determined in mouse and human pancreatic tissue samples with immunohistochemistry. CP was induced in FVB/N mice with 8X50 µg/kgbw i.p. cerulein injection, given every hour, every 3 days for a total of 5 times. PAI-1 activity was inhibited with a specific inhibitor, which was administered per os at a dose of 10 mg/kgbw for 6 consecutive days after the 3rd cerulein treatment. To assess the extent of inflammation and fibrosis hematoxylin-eosin and Crossman’s trichrome staining were performed, and biochemical assays were used to determine amylase activity and hydroxyproline concentration. PAI-1 expression and location in the pancreas was examined by RT-qPCR and immunofluorescence co-staining.

Results

PAI-1 expression was significantly higher in pancreatic tissue samples obtained from CP patients. After induction of CP in mice, the body weight and the pancreatic weight/body weight ratio significantly reduced, whereas histopathology showed significant pancreatic atrophy and fibrosis. This was also confirmed by the increased hydroxyproline concentration and decreased amylase activity of the pancreatic tissue. The gene expression of SERPINE1 increased in pancreas tissue and fibroblast cell culture in CP group, moreover the elevated PAI-1 signal localization suggests a possible expression role for activated stellate cells. Administration of PAI-1 inhibitor resulted in a decrease in both body weight and pancreatic weight loss rates, additionally the atrophy, tissue fibrosis, hydroxyproline concentrations and SEPRINE1 gene expression were significantly decreased compared to the CP group.

Conclusion

Our results indicate an elevation in PAI-1 expression in CP, with the potential for fibrosis and tissue atrophy reduction by the inhibition of PAI-1. These findings propose PAI-1 as a promising therapeutic target for the treatment of chronic pancreatitis.

INHIBITION OF PLASMINOGEN ACTIVATOR INHIBITOR-1: A PROMISING NEW APPROACH FOR THE TREATMENT OF CHRONIC PANCREATITIS

Tünde Molnár 1, Viktória Szabó 1, Boldizsár Jójárt 1, Noémi Csákány-Papp 1, Petra Pallagi 1, József Maléth 1

1 University of Szeged, Szeged, Hungary|||ELKH-USz Momentum Epithelial Cell Signaling and Secretion Research Group, Szeged, Hungary|||University of Szeged, Szeged, Hungary

Event

UEG Week Vienna 2024

Topics

Digestive Oncology Mechanisms & Personalised Medicine Pancreas

Submission format

Abstract

Session

Pancreatic diseases: From mechanisms to therapy

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

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Introduction

Rectal sensory function plays a critical role in normal bowel function. For example, rectal hypersensitivity is associated with Irritable Bowel Syndrome (IBS), whereas rectal hyposensitivity is linked to constipation.
The International Anorectal Physiology Working Group (IAPWG) (1) has established a standardised investigation protocol for anorectal physiological function. According to this protocol, the rectal sensory function is evaluated by simple balloon distension using an elastic balloon during a standard high-resolution anorectal manometry investigation (HRAM). However, the gold standard for rectal sensory assessment is the rectal barostat investigation, as described by the European COST action GENIEUR group (2).
The correlation between these two methods is largely unknown. The two methods use different balloons (elastic vs. non-elastic balloons, different size and shape). Moreover, the barostat is pressure-controlled whereas the HRAM is volume-controlled. For this reason, assessment of the level of agreement is not feasible.

Aims & Methods

We assessed the correlation between rectal sensory testing with the HRAM and rectal barostat investigations for each sensory threshold, in a group of healthy volunteers.
Twenty-six healthy volunteers (mean age 42 years, 50% females) were recruited and investigated using both HRAM according to the IAPWG protocol and rectal barostat using the GENIEUR protocol on the same day.
Sensory thresholds for first sensation (FS), first urge (FU), intense urge (IU) and maximum tolerable volume (MTV) were recorded for both methods.
Spearman’s rank correlation coefficient was used for analysis, since it does not assume normal distribution.

Results

Median values, along with the 1^st and 3^rd quartile are presented in Table 1.
There were statistically significant positive correlations between the sensory thresholds for first urge, intense urge and maximum tolerable volume. However, the correlation coefficients were generally weak, with only MTV showing a correlation coefficient above 0.5.

Table 1. Quartiles of the four sensory thresholds used and Spearman’s correlation factor between HRAM and barostat based investigations.

	First sensation		First urge		Intense urge		MTV
Quartiles	HRAM	B	HRAM	B	HRAM	B	HRAM	B
1st	12.00	43.00	60.25	91.75	86.25	155.00	116.75	189.25
2nd	27.50	76.00	79.00	142.50	111.50	210.00	175.50	230.50
3rd	48.75	108.00	96.00	177.00	164.50	259.50	224.75	319.00
Spearman’s rho	.151		.433		.400		.573
p	.460		.026		.043		.002

Conclusion

There is a weak correlation between the two methods, suggesting that HRAM balloon distension and barostat cannot be used interchangeably with respect to rectal sensory testing. Standardisation of rectal sensory testing is warranted to improve the accuracy and reliability.

References

(1). Carrington E. et al. The international anorectal physiology working group (IAPWG) recommendations: Standardized testing protocol and the London classification for disorders of anorectal function. Neurogastroenterology & Motility. 2020;32: e13679.
(2). https://genieur.eu/Downloads/PhenotypingTool/SOP_Rectal_barostat.pdf

POOR AGREEMENT BETWEEN MANOMETRY-BASED AND BAROSTAT-BASED RECTAL SENSORY TESTING

Lucian Marinica Grando 1, Jonas Halfvarson 2, Michiel Van Nieuwenhoven 1

1 Örebro University Hospital, Örebro, Sweden

2 Örebro University, Örebro, Sweden

Conference

UEG Week Copenhagen 2023

Topics

Colorectal

Submission format

Abstract

Session

PP 06 Other lower GI disorders (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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