P205 A new rapid test for fecal calprotectin (FC) predicts mucosal healing in ulcerative colitis (UC)

Abstract

tertiary IBD center were reviewed. Inclusion criteria: (1) Small bowel CD assessed by conventional techniques; (2) Detailed clinical history; (3) No stenosis/obstructions; (4) Small bowelCD assessed by entero-CT/-MRI, small intestinal contrast ultrasonography, barium follow through and/or ileocolonoscopy (IC) within 6mths from SBCE; (5) SBCE images reviewed by one single gastroenterologist. SBCE performed using the Given Pillcam SB (Given, Israel) after 2L PEG. Findings considered: (a) CD extent before vs after SBCE; (b) upper GI lesions (i.e. above the distal ileum proximal to the valve or to the anastomosis); (c) SBCE transit times; (d) impact rate. Results: A total of 40 CD pts (20M, median age 34 yrs, range 18 70) fulfilled the inclusion criteria. Previous ileo-colonic resection was shown by 29/40 (72.5%) pts (median interval 10mths, range 3 300). CD localization involved the ileum in 37/40 (92%) CD (recurrence in 26/37) and also the upper GI in 4/37 (10%), while 3 pts showed no recurrence. SBCE showed marked interindividual variations in terms of gastric (median 29min, range 3 360) and small bowel transit times (valve: median 350min, range 240 433 or anastomosis in resected CD: median 231 min, range 61 466). SBCE did not visualize the entire small bowel in 9/40 (22.5%) pts (5/11 CD not resected, 4/29 resected pts). Upper GI lesions were detected by SBCE in 23/40 (57.5%) pts, known before SBCE in only 4/40 (10%) pts. In one pt, SBCE visualized an ulcerated jejunal stenosis requiring surgery not detected by SBFT and IC. In 1/40 (2.5%) pts, SBCE impact requiring surgery within a “cul de sac” of an ileo-ileal anastomosis was observed. Conclusions: Upper GI lesions may be detected by SBCE in a high proportion of CD pts, although their clinical relevance needs to be determined. Before SBCE, CD pts need a careful selection due to possible incomplete small bowel visualization and to the impact risk occurring also in the absence of stenosis.