P0438 Altered Visceral Sensitivity in patients with Ulcerative Colitis in remission

Abstract Background Ulcerative colitis (UC) in remission is commonly associated with residual symptoms, despite adequate inflammatory control. Distinguishing between inflammatory and non-inflammatory causes is essential, in order to target therapy and avoid any unnecessary treatment escalation. Once mucosal inflammation has been excluded through endoscopic evaluation, high resolution anorectal manometry (HRAM) along with sensory testing could help symptom assessment. The aim on this study is to explore whether established physiologic diagnostic modalities such as HRAM could add value in investigation of patients with UC in remission. Methods Patients with confirmed UC in remission (after proper endoscopic assessment) were evaluated with Visceral Sensitivity Index (VSI, 15 items, ranging 0-75). They subsequently underwent HRAM with a solid-state catheter followed by the rectal sensory test by a gradual rectal distention according to the IAPWG Protocol, aiming to access rectal physiology and sensory perception. Results A total of 32 eligible adult patients (43% females, mean age 40,8 y.o.) were enrolled. Internal consistency for VSI was excellent (Cronbach’s alpha=0.933). Total mean VSI scores were 43.15 (26.11-60.19). An increased VSI score was reported in 12/37 (37.5%) of patients, whereas 20/32 (62.5%) of patients ranged low. Patients with increased total VSI scored significantly worse in bloating and abdominal distention, anxiety when going to new restaurants and worry, avoiding new foods, belief in a serious illness indication, a frightening abdominal discomfort and vigilance while no significant differences were found in mean rectal pressures and outcomes of balloon inflation (table 1). Conclusion Although a 37% of patients with UC in endoscopic remission score high in VSI, rectal pressures and perception as observed by the HRAM and ballon distention test are non-significant. VSI displays excellent consistency when evaluating patients with UC.