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sdone for the two-week wait service increased from 27% to 48% in the month after thecampaign. It is clearly important that referrals made are appropriate to justify this servicerequirement. This study compares referrals and outcomes before and after a GP educationsession. Two week wait GI Referrals to the Horton General Hospital between December 2011and February 2012 were assessed. A presentation was given to Primary Care Practitioners inMay highlighting NICE guidance and referrals were re-audited in June 2012. 100% ofreferrals met the two week wait target (to clinic, CT scan or endoscopy) and the mean timeto first test was 9 days. The results are summarised in Table 2. 24% of Upper GI referralsdid not meet NICE guidance, mostly patients referred with anaemia above the referralthreshold or for dyspepsia without concerning features. The cancer pick-up was 8.6% (2oesophageal, 2 gastric and 4 pancreatico-biliary). 26% of Lower GI referrals were non-compliant with guidance (mostly due to rectal bleeding or change in bowel habit shorterthan the required time). Cancer pick-up was 5.1%. All but one GI cancer was detected inappropriately referred patients. In June 2012 compliance improved to 81% of upper GI and79% of lower GI referrals. Reasons for referral outside NICE guidance were similar to theprevious cohort. Cancer detection rose to 12.9% for Upper GI and 8.6% for Lower GIcancers. All cancers in the second audit were in appropriately referred patients. The studyhighlights the importance of communication with Primary Care Practitioners who are respon-sible for referrals for GI cancer exclusion. There have been previous education sessions butdespite this there remains an advantage in re-stating the message and keeping regular contact.The cancer detection rate improved with better compliance with NICE guidance and mayindicate the value of adhering to this guidance. Larger studies are required to validate this.Table 2: Study results

Table 1: NICE guidance for two week wait referrals

Mo1114

The Effect of Time to Endoscopy on Patient and Procedural Outcomes AmongForeign Body SwallowersRabia Ali, Keri Herzog, Yixin Fang, Akansha Chhabra, David M. Poppers, Michael A.Poles

Background: In the setting of foreign body ingestion there is a perceived need for urgentendoscopy. Current guidelines concerning the timing of endoscopy in foreign body swallow-ers (FBS) are vague, often leaving the decision up to the discretion of the performingphysician. Objectives: The primary aim of our study was to examine the effect of timeinterval from both ingestion and hospitalization to endoscopy on the risk of complicationsamong FBS. Our secondary aim was to study the effect of time from ingestion and hospitaliza-tion to endoscopy on duration of hospital stay. Methods: We studied all patients whounderwent endoscopy for ingestion of a foreign body within the last 10 years at BellevueHospital in New York City (n=94). We excluded those for whom we were unable to identifythe time of ingestion, the time of hospital admission, the time of endoscopy, or the time ofdischarge. Results: Our study included 94 patients (86.2% male) with a mean age of 36;37% of whom were Caucasian, 29% African American, and 26% Hispanic. 66% wereprisoners, 78% were intentional FBS, and 68% had a psychiatric history (of whom 73%were being treated with psychiatric medications). We found that 75% of these patientsexperienced no complications related to ingestion or to endoscopy (group A), 10% for whomthe foreign body was not successfully retrieved (group B) and 15% of whom experiencedmucosal injury related to the ingestion (group C). The mean time from hospitalization to

S-582AGA Abstracts

endoscopy was 24.4 hours. We identified no difference in the time from hospitalization toendoscopy among the 3 groups (p=0.43). Patients in group C were found to have the longesttime from endoscopy to discharge (p,0.007, using log derivation of the time). 79% of theobjects ingested in group C were blunt (compared to 33% in group A and 63% in B) and29% were sharp (compared to 52% in group A and 13% in group B, p ,0.009). Amongthe prisoner population, 97% of FBS were intentional (p,0.001), 77% of the prisoners hada history of repeat ingestions (p,0.001), though prisoners were not found to have statisticallysignificantly increased complication rates compared to non-prisoners (p=0.54). Among thepsychiatric population, 97% of FBS were intentional (p ,0.0001), 76% had a history ofrepeat ingestions (p,.001) and did not experience increased complication rates comparedto non-psychiatric patients (p=0.39). Overall, intentional FBS were not found to havestatistically significantly increased complication rates compared to accidental FBS (p=0.25),nor were they found to have a statistically significant difference in time from endoscopy todischarge (p=0.16). Conclusions: In our study population, we did not observe a significantimpact of time between ingestion or hospitalization and endoscopy on complication ratesor post-endoscopy duration of hospital stay.

Mo1115

Differences in Symptom Profiles, Quality of Life, Anxiety and DepressionScores Between Patients WHO Suffered From Gastrointestinal Symptom Moreand Less Than 6 MonthsKessarin Thanapirom, Sutep Gonlachanvit

Background: The Rome III criteria use the 6month-duration of gastrointestinal (GI) symptomsas a cut off value for diagnosis of functional GI disorders (FGIDs) in adults. The importanceof the 6 month duration of GI symptoms in FGIDs has not been well understood. Aim:The aim of this study was to compare symptom profiles, quality of life (QOL) and anxietyor depression scores in patients who suffered from GI symptom more and less than 6months. Methods: 438 patients with various GI symptoms presented at King ChulalongkornMemorial hospital were invited to complete a Thai validated version of the FBDR3 question-naire, the Thai version of 36-item Short Form general health survey (SF-36) and HospitalAnxiety And Depression Scale (HADS). Results: 164 and 274 patients had symptom durationmore than and less than 6 months, respectively. There was no significant difference of theprevalence of gender (M:F= 1:2.6 vs.1:2.9), age(49±13vs.47±14yr) and co-morbid conditions(21% vs.29%) between patients who had been suffered from GI symptoms for more andless than 6 months (p.0.05). Prevalence of each GI symptom was also not significantdifferent between patients with the symptom duration .6months and ,6 months (p.0.05),except urgency of stool (23% vs. 36%, p,0.05) was significantly more prevalence in patientswith symptom duration ,6 months. The prevalence of each FGID as defined by the RomeIII symptom profiles were not significantly different between the 2 groups, except functionalvomiting was more prevalence in patients with symptom duration ,6 months (5%vs.10%,p,0.05) and Irritable bowel syndrome (IBS;36%vs.26%) or IBS+functional dyspepsia(34%vs.24%)was more prevalence in patients with the duration .6 months (p,0.05).HADS-Anxiety (8.6 ± 4.3vs. 7.8± 3.8) and HADS-Depression (7.2± 3.1vs. 6.6±2.5) scoreswere significantly higher in patients with duration of symptoms less than 6 months (p ,0.05).The QOL was significantly impaired in patients with symptom duration more than 6 monthscompared to ,6 months in nearly all dimensions (role physical 80±23vs.73±28, bodilypain 53±23vs.48±20, general health 56±18vs.51±21, vitality 53±16vs.48±20, mental health62±16vs.58±19, health transition 52±24vs.45±22, p,0.05) except physical functioning(74±27vs .73±31) , soc ia l funct ioning (59±20vs .59±20) and role emot iona l(73±24vs.72±26)(p.0.05). Conclusions: There was little difference of the GI symptomsprofiles between patients with symptom duration more than or less than 6 months. Patientswith symptom duration , 6 months had more prevalence of functional vomiting and higheranxiety and depression scores compared to those with the duration .6 months. Patientswith symptom duration more than 6 months had poor QOL and higher prevalence of IBS.This study provides an insight into the importance of the 6 months symptom duration usedin the Rome III criteria.

Mo1116

The Distribution and Appearance of Colorectal Polyps in the Right and LeftColon in Koreans : Implications for Screening ColonoscopyHee Sun Kim, Su Jung Baik, Kyung Hee Kim, Cho Rong Oh, Sang In Lee

Background/Aim: The preventive role of a screening colonoscopy in right colonic cancer isknown to be limited. Recent studies have suggested that advanced neoplasia in the rightcolon is smaller than that in the left colon, and is often overlooked in everyday practice.We aimed to evaluate the different characteristics of right and left colorectal polyps. Methods: We included 9,838 colorectal polyps from 5142 subjects who underwent a screeningcolonoscopy from July 2006 to January 2012 for analysis retrospectively. We comparedsize(small, ,6 mm vs ≥6 mm), shape(sessile vs pedunculated) and number between theright and left colon for all polyps, adenomas(low grade dysplasia, excluding non-neoplasticpolyps), and advanced polyps(HGCA, high grade dysplasia, .25% of villous componentand carcinoma). Results: The average sizes of right and left polyps, respectively, were 4.6and 4.9 mm for all polyps(p=0.0028), 4.8 and 5.4mm for adenomas (p ,0.0001), and 10.1and 12.4mm for HGCAs (p=ns). The general distribution of small or sessile adenomas inthe right and left colon were 51.2%:48.8%(p=0.001), as well as 37.2%:62.8%(p=0.004) forHGCAs. Moreover, adenomas in the right colon were more likely to be small or sessile thanthose in the left colon(90.1%:87.1%, OR=1.36, 95% CI: 1.16-1.58) as well as were HGCAs(39.1%:25.5%, OR=2.52, 95% CI: 1.32-4.81). Multiple polyps (.1, number) were foundmore often in the right colon than in the left(57.4% vs 32.9%, p ,0.0001). Conclusions:Colorectal adenomas and advanced polyps in the right colon were more frequently smallor sessile in size and shape than those in the left colon. Multiple polyps were more prevalentin the right colon. However, advanced polyps were more greatly distributed in the left colon.Accordingly, further consideration of the characteristics of right and left sided colonic polypsis necessary to reduce the missing rate thereof during screening colonoscopy.