128 / 172
Abstracts of the 22
nd
National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231
e189
Results:
Efficacy of bowel preparation was 76.8% for subjects in the
PEG-ELS group, 74.6% for subjects in the PEG+BIS group and 72.6%
for PEG-ASC group. No statistical difference was found with regard
to efficacy (p=0.727). Also with regard to CIR (91.85, 87,9% and 89,4%,
respectively) and to ADR (28%, 35.7% and 28.3%, respectively) no
statistically significant difference was observed in the inter-group
analysis. Moreover, no statistical difference between groups emerged
in respect to compliance, acceptance, tolerability and safety.
Conclusions:
Split-dose bowel preparations is effective even when
applied to low-volume PEG solutions. Low volume preparation
compared to large volume preparation administrated in split dose
did not demonstrate significant difference in term of patients’
acceptance, compliance tolerability and safety profile.
P.13.2
DO WE REALLY NEED BIOPSY TO DIAGNOSE COLORECTAL
CANCER?
Pezzoli A.*, Cifalà V., Matarese V., Simone L., Zelante A., Trevisani L.,
Pazzi P.
Ospedale Sant’Anna, Ferrara, Italy
Background and aim:
Colorectal cancer (CRC) is a frequent
finding during colonoscopy and endoscopic biopsies are generally
performed to confirm the diagnosis. Aim of our study was to evaluate
the accuracy of endoscopic biopsy compared to the macroscopic
appearance in the diagnosis of colorectal cancer.
Material and methods:
We prospectively collected all the
colonoscopies in which the endoscopists have suggested a diagnosis
of colorectal cancer; 8 skilled endoscopists were asked to describe
the macroscopic aspect of the lesions, the size, the presence of
bleeding and the site of the lesions. Then they performed biopsy
with standard endoscopic forceps. The endoscopic diagnosis of CRC
were compared with the results of the histological analyses or with
surgical specimens when available.
Results:
We included in the study 71 patients with an endoscopic
diagnosis of CRC (44 males, mean age 70.2 yr). The lesions were
located in 24 cases in the right colon (34%), in 15 cases in the
transverse (21%), in 23 cases in the sigmoid colon (32%) and in 9
cases in the rectum (12%). The macroscopic description of the lesions
were protruding mass in 27 cases (38%), annular involvement in 24
(34%), stenotic in 10 (14%) and ulcerated in 10 (14%). The lesions
were bleeding in 28% of the cases. The sizes were over 4 cm in 66% of
the cases. We found concordance between macroscopic appearance
and histology in 63 cases (89%); in the remaining cases the biopsy
results showed tubulovillous adenomas (5 cases) and aspecific
inflammation (3 cases). Nonetheless the analysis of surgical
specimens revealed a diagnosis of adenocarcinoma in 4 cases (5.6%
histological false negative). The overall accuracy of endoscopic
appearance was 95.8% with 3 cases of false positive diagnosis (4.2%).
Conclusions:
Endoscopy is highly accurate in diagnosing CRC and
the confirmation by biopsy is probably unnecessary.
P.13.3
EFFICACY OF OSTEOPATHIC MANIPULATIVE TREATMENT ON
FUNCTIONAL CONSTIPATION: PILOT STUDY OUTCOME RESEARCH
Adragna V.*
2
, Carlucci F.
2
, Mansueto G.
1
, Persico L.
1
, Salzarulo D.
1
,
Quaranta C.
2
1
Andrew Taylor Still Academy Italia, Bari, Italy,
2
Research Department -
Andrew Taylor Still Academy Italia, Bari, Italy
Background and aim:
The American College of Gastroenterology
defines constipation as “unsatisfactory defecation, characterized by
infrequent bowel movements and/or difficult passage of stool for at
least three months” (Brandt et al, 2005). An Italian study (Cottone
et al, 2009) showed that about one third of the patients referred to
the clinics of family doctor considering suffering from constipation.
This percentage drops to 20% if the family doctor use ICD diagnostic
definitions. Laxatives are among the drugs most commonly used
the treatment. Only 2 studies in the literature show the application
of the Osteopathic Manipulative Treatment (OMT) for disorders
of constipation: a case report of a woman diagnosed with colonic
inertia and indication for surgery (Cohen-Lewe,2013) and a pilot
study on the impact of OMT on secondary constipation in children
neurologically (Tarsuslu et al, 2009). The aim of our study is to verify
the effectiveness of OMT on patients with functional constipation.
Material and methods:
30 subjects, 9 males and 21 females, with
diagnosis of functional constipation were included in one treatment
group. Have been used as an outcome the scale of quality of life
SF-12, the Patient Assessment of Constipation Quality of Life (PAC-
QOL) and the Cleveland Clinic Constipation, these were detected at
enrollment (t0) and after the last sitting of OMT (t1). All subjects
were submitted to three sessions of OMT at a distance of one week
between the first and the second and two weeks between the second
and the third. The OMT was applied to each subject individually
and different techniques were used depending on the Somatic
Dysfunction (SD) that was found. For each session of OMT it was
assessed the prevalence of somatic dysfunction and a comparison
was made between the sessions.
Results:
It was found, in all sessions of OMT a higher prevalence of SD
to sigma: 53% in the first session and 43% in the other two. Between
sessions of OMT was observed a reduction in SD that showed a
significant reduction of total dysfunctions in second (p=0.00) and
third (p=0.00) treatment, of the SD in the Musculoskeletal system
(p=0.02 and p=0.00), in the visceral system (p=0.00 p=0.00) and
those of the craniosacral system to the third treatment (p=0.04).
Were observed at t1 significant results (t-student test) on the SF-
12 for mental health (p=0.00) and physical (p=0.02) and all score
outcomes of PAC-QOL and the Cleveland Clinic Constipation
produced a statistically significant with p-value = 0.00.
Conclusions:
The results of this study of outcome research we
can observe how the OMT of somatic dysfunction in patients with
functional constipation can be effective on improving the quality
of life and act on the characteristic symptoms of constipation. The
authors would like to lay the foundations and turns the invitation
to structure more relevant methodological trial (RCT) to study the
somatic treatment of functional disorders.
P.13.4
A LOW FODMAP DIET IN IRRITABLE BOWEL SYNDROME
IMPROVES SYMPTOMS WITHOUT AFFECTING BODY
COMPOSITION AND EXTRACELLULAR BODY WATER
Rossi A.*
1
, Bellini M.
2
, Saviozzi A.
2
, Gambaccini D.
2
, Bertani L.
2
,
Ricchiuti A.
2
, Urbano M.T.
2
, Mumolo M.G.
2
, Costa F.
2
, De Bortoli N.
2
,
Bazzichi L.
1
, Mosca M.
1
, Marchi S.
2
1
Division of Rheumatology - University of Pisa, Pisa, Italy,
2
Gastrointestinal Unit - Dept. of Gastroenterology; University of Pisa,
Pisa, Italy
Background and aim:
FODMAPs, poorly absorbed in the small
intestine, enter the colon, where they are fermented, producing gas
responsible for bloating, abdominal discomfort and pain, symptoms
frequently complained of also by patients affected with irritable
bowel syndrome (IBS). A low FODMAP diet is frequently suggested to
IBS patients even if the evaluation of possibly significant nutritional
concerns remains to be clarified. The aim of this study was to test
the effects of a low FODMAP diet on body composition, abdominal
symptoms, quality of life, anxiety/depression and sleep disturbances
of IBS patients.