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Su1184 Anti-Secretory Therapy and Opioid Analgesics Confer Increased Risk for Developing Small Intestinal Bacterial and Fungal Overgrowth

2016; Elsevier BV; Volume: 150; Issue: 4 Linguagem: Inglês

10.1016/s0016-5085(16)31683-3

1528-0012

Albert M. Ding, John Temple, David C. Kunkel,

Colorectal Cancer Screening and Detection

concentration at the end of treatment was 123.5, 123.3 and 112.06 mg/g of stool in patients receiving Remicade, Inflectra and Humira respectively.Relapse was claimed in 6 (8,7%), 3 (13,04%), and 5 (14,29%) patients respectively, during follow up (p-value 0,684), and was comparable in 3 observed groups.Allergic reactions that were reported during treatment with both infliximabs (Remicade and Inflectra) were also comparable.Conclusion: We have shown for the first time efficacy and safety of biosimilar infiximab not only in induction and one year therapy, but also during 6 months of follow up.Further prospective studies with long-term follow-up periods will be needed to confirm the biosimilarity of this product. Su1183The Role of Endoscopy in the Management of Chronic Diarrhea in the Area with High Incidence of Intestinal Infection Julajak Limsrivilai, Phunchai Charatcharoenwitthaya, Nonthalee Pausawasdi Background: While colonoscopy and esophagogastroduodenoscopy (EGD) are recommended in the assessment of patients with chronic diarrhea in western countries, their benefits in Asian countries, where the incidence of infection is higher, are not well established.Aims: To determine the diagnostic yield of EGD, colonoscopy, and enteroscopy in patients with chronic diarrhea who have negative results of stool examinations.Methods: A retrospective review of medical records of patients with chronic diarrhea who underwent EGD or colonoscopy from January 2008 to December 2012 was performed.Only patients with negative stool examinations were included.The definite diagnoses were made by histology and/or response to therapy.Results: 193 patients were included: 94 underwent EGD, 192 underwent colonoscopy, and 93 underwent both procedures.Mean age was 54.5 years, and 83 (43%) were male.Of 193 patients, 124 had definite causes and 69 were suspected to have functional causes.The etiologies of diarrhea are shown in table1.The sensitivity, specificity, and accuracy of EGD for detection of causes of diarrhea was 60%, 100%, and 26%, respectively, and for colonoscopy was 71%, 93%, and 79%, respectively.For 100 patients with negative colonoscopy, 51 underwent EGD.Of these, there were no positive EGD findings.Push enteroscopy (PE) and balloon assisted enteroscopy (BAE) were subsequently performed in 2 and 5 patients, respectively.The definite diagnoses were made in both PE with the diagnoses of SLE with protein losing enteropathy and small bowel Crohn's disease, and in 3 of 5 BAE with the diagnoses of 2 intestinal capillariasis and 1 small bowel Crohn's disease.Among the patients who underwent small bowel evaluations, mean serum albumin was significantly lower in those with positive findings compared to negative findings (1.47 vs 2.75 g/dl, p=0.037)Conclusion: In Thailand where the common causes of chronic diarrhea are infections, EGD had very low sensitivity for diagnosis of chronic diarrhea, and did not add more diagnostic value to colonoscopy; therefore, it should not be performed as a routine investigation in these patients.Enteroscopy which has potential to reach the abnormal small bowel segments should be considered in patients with severe low hypoalbuminemia which may reflect the extensive small bowel lesions.Etiologies of chronic diarrhea