687 Topical Alginate Protection of Human Esophageal Epithelium for Gastro-Esophageal Reflux Disease. A Study Using Human Cell Culture and Biopsy Models

Abstract

G A A b st ra ct s extra-hepatic malignancies in patients with IBD and co-existent PSC using the Explorys database. In total the Explorys database contains over 40 million unique patient records across the United States from over 400 hospitals. Methods: Explorys database from 19992014 was queried for adults with medical records of at least 4 years with a diagnosis of IBD (ICD-9: 556.xx, 555.xx). Patients were divided into 2 groups, those with ulcerative colitis (UC) and those with crohn's disease (CD). Each group was further divided into patients that had PSC and those that did not. ICD-9 codes were used to identify extent and location of UC and CD, respectively. Medications were identified by generic and brand name. Analysis was completed using Chi-squared test and Odds ratio. A p-value < 0.05 was considered significant. Results: 2,170 of a total of 65,850 IBD patients had PSC. PSC was more common in UC than CD (p= 0.0001, Table 1). Caucasian males with UC were more likely to develop PSC (Table 1). While the majority of individuals with PSC were less than 65 years of age; interestingly, the data demonstrated that the incidence of PSC was highest in the age group 50-59 years (23.5%). In UC, the incidence of PSC increased with increased colonic involvement; however, disease distribution was not a factor in the CD. The current data also suggests that there is an increased risk of pancreatic cancer for both UC with PSC (p-value: 0.0001; OR: 6.53 95% (3.99-10.70)) and CD with PSC (p-value: 0.0001; OR 8.42 95% (5.14-13.80)). Conclusion: This study is the largest to date to assess the relationship of PSC and IBD. Confirming prior studies, the risk of PSC in greatest amongst Caucasian males with UC and its incidence increases with the degree of colonic involvement. The pooled data suggest a shift in the paradigm of PSC to an older patient population than previously thought, which may be reflective of the advent of potent anti-inflammatory medications limiting the degree of chronic inflammation. The relationship between CRC and PSC is well established; however a previously unknown phenomena, the increased risk of pancreatic cancer requires further exploration.