© 2016 by the American College of Gastroenterology The American Journal of GASTROENTEROLOGY Abstracts S103 Methods: A retrospective chart review between January 2008 and October 2015 of patients with biopsy- confirmed lymphocytic, collagenous, or microscopic colitis was conducted. Patient-reported average bowel movements/day (BMs/D) was reviewed pre-treatment, during therapy, and during exacerbations. Demographic data, dates of colonoscopy, follow up, type and dose of medications used, therapy start/ stop dates were reviewed. Results: Patients with colonoscopy (114) were predominantly female (88%), Caucasian, with a mean BMs/D of five at presentation. A total of 58 patients were on a therapy, 4 had unknown start dates, 13 began therapy prior to colonoscopy, 8 on the day of and 33 post-colonoscopy. Patients taking budesonide saw BMs/D reduced from 3.5 to 1.3 whereas patients given 5-aminosalicylic acid (5-ASA) saw reductions in BMs/D from 8.8 to 3.0. First line medications failed in 18 patients. budesonide was replaced in 5/28 patients. 5-ASA was replaced in 5/10 patients and diphenoxylate/atropine in 4/5 patients. Other drugs bismuth subsalicylate (1/3), antibiotics (2/3) and fiber tablet (1/1) also resulted in therapy changes. Ten of the second line medications were successful. Two that were not successful were switched back to the first line medication, either budesonide or 5-ASA. Symptom exacerbations were documented during therapy for 10/58 (17%) of patients. ree of the patients with flares had been switched from budesonide to 5-ASA. Four patients were on budesonide (9mg for three, 3mg for one). ree patients were on 5-ASA and were switched to budesonide with good results. Conclusion: Almost half lymphocytic colitis diagnosed by colonoscopy improves without requiring therapy. Patients requiring therapy usually respond well to budesonide. is therapy worked for 82% of our patients. Similarly, 50% of our patients responded when using 5-ASA as the first line of therapy. Budesonide was the drug of choice for flares, typically 9 mg/day for at least 2 months. Tailoring drug therapy to meet individual patient needs appears to be the best current approach to managing lympho- cytic colitis. 215 Association of Diverticulosis and Spinal Cord Injury Michael Putnam, BA, Michael Sprang, MD. Loyola University Medical Center, Maywood, IL. Introduction: Spinal cord injury (SCI) patients have been shown to have decreased quality of life and higher rates of GI complaints including chronic constipation. Etiologies for diverticulosis including chronic constipation have previously been proposed. With access to a large SCI population at Hines VA, this investigation looks for statistically significant differences in specific colonic lesions in a SCI population. Methods: We investigated colonoscopy and flexible sigmoidoscopy reports for 246 spinal cord injury vet- erans who had these procedures at Hines VA. To build a control list, we then randomly selected 1025 unique colonoscopy reports from non-SCI patients performed during the same period. Procedures per- formed through ostomies and those cancelled due to poor bowel prep were excluded due to inability to visualize the colon properly. ese procedures were performed on veterans, by the same endoscopists, with the same equipment and reporting procedures, during the same time frame. All reports were reviewed for documentation of observed diverticulosis. Both SCI and non-SCI reports were also reviewed for colo- noscopy prep grade as noted in the report and were reported as excellent, very good, good, fair, and poor. Results: Of the 246 SCI patients, 79 had diverticulosis present providing a rate of 32.1%. is is in con- trast to the control group of 1025 non-SCI patients who had 551 cases of diverticulosis providing a rate of 53.7% (P value < 0.001). is trend also holds within given prep qualities. For 74 SCI patients with colonoscopies marked ‘good,’ 37.8% had diverticulosis compared to the 51.9% of 462 non-SCI patients (P value = 0.0328). For 145 SCI patients with preps marked ‘fair,’ 29% had diverticulosis compared to the 56% of 515 non-SCI patients (P value < 0.0001). Of note, average age of SCI patients at colonoscopy is 67 while the average age of non-SCI patients at colonoscopy is 61.6. Conclusion: ere is a significant association between SCI patients and reduced rates of diverticulosis com- pared to our control population. is difference is further reinforced by the observation that this holds true despite the SCI population being older. While diverticulosis is likely multifactorial in etiology, a negative association between nerve injury and rates of diverticulosis is strongly suggesting by these findings. Further investigation into these processes may help clarify some of the elusive mechanisms of diverticulosis. 216 Body Mass Index Changes Aſter Fecal Microbiota Transplant for Recurrent Clostridium difficile Infection George Saffouri, MD, Darrell Pardi, MD, MS, Purna Kashyap, MBBS, Sahil Khanna, MBBS, MS. Mayo Clinic, Rochester, MN. Introduction: e existing literature exists suggests an association between alterations in the gut micro- biome and obesity. One case report suggested weight gain aſter Fecal Microbiota Transplantation (FMT) performed for recurrent Clostridium difficile infection (CDI). In this study, we assessed changes in body mass index (BMI) aſter FMT in recurrent CDI patients and correlated these changes with donor BMI. Methods: A retrospective chart review of patients who underwent FMT for recurrent CDI was per- formed. Data on demographics, pre- and post-FMT BMI, and corresponding stool donor BMI were abstracted. BMI was classified based on the World Health Organization (WHO) BMI classification: underweight < 18.5; normal 18.5-24.9; overweight 25-29.9; obese class I 30-34.9; obese class II 35-39.9, obese class III ≥40. Pre- and post-FMT BMI were correlated to donor BMI. Weight group increases/ decreases were defined as increasing/decreasing in BMI range according to WHO classification. Results: Overall, 328 patients underwent FMT for recurrent CDI (median age 56; 69% female) with 97.5% being white. Aſter excluding those who did not have BMI data post-FMT, a total of 156 patients (47.5%) were analyzed. e average number of weeks till recording of post-FMT BMI data was 34 weeks (range 8.4- 115 weeks). Overall, 43% of donor BMIs were 18.5-24.9, 53% were BMI 25-29.9, and 4% were BMI 30-34.9. e pre-FMT BMI of the stool recipients and the corresponding changes in weight group are shown in Table 1. Overall, 103 (65%) patients undergoing FMT maintained their weight group, 19 (12%) patients decreased by one weight group, 33 (20%) patients increased by one weight group, and one patient increased by two weight groups. Using stool donor BMI information, changes to the patients’ BMI were assessed and shown in Table 2 and there seemed to be no effect of donor BMI on recipient BMI aſter one time FMT. Conclusion: e BMIs of FMT recipients largely remained the same aſter the procedure. e stool donors’ BMIs did not significantly affect those of the recipients. 217 e Risk of Microscopic Colitis in Patients Who Underwent Cholecystectomy in a Minority Popula- tion – a Retrospective Study Sandar Linn, MD, Nami Safai Haeri, MD, Mel A. Ona, MD, MS, MPH, MA, Ibrahim Barry, MD, Sury Anand, MD. Brooklyn Hospital Center, Brooklyn, NY. Introduction: Microscopic colitis (MC) is an uncommon condition manifesting as chronic, watery, non- bloody diarrhea with distinctive histopathological findings. e exact mechanism for the development of this condition is unknown. However, studies have shown that patients with MC have evidence of bile acid malabsorption and respond to treatment with bile acid blocking agents. In this study, we examined the association of cholecystectomy and MC in a minority population. Methods: We retrospectively studied all adult patients diagnosed with microscopic colitis at our institu- tion from 1990 to 2015. Controls were subjects who had diarrhea and diagnosed with other type of colitis such as inflammatory bowel disease, ischemic colitis, infectious colitis, radiation colitis, and eosinophilic colitis. Using the medical record, we reviewed the demographics, medication history, surgical history, colonoscopy and pathology findings. e rate of preceding cholecystectomy in MC was analyzed and compared with other forms of colitis using SAS statistical soſtware. Results: 230 patients with colitis were identified during the study period. Aſter excluding subjects with incomplete documents, a total of 93 subjects were included. 57% (53/93) of subjects diagnosed with coli- tis were female; 64% (60/93) of subjects were African American. Mean age of the subjects was 48 years old (range 18-86). Average body mass index was 27 (Range 17.4-51). ere were no significant differences in age, gender, ethnicity, or smoking habits between subjects and controls. Subjects with microscopic colitis who had prior cholecystectomy were 0.1% compared to 0.01% subjects with non-microscopic colitis. Using Fischer Exact Test, there was no association between colitis type and cholecystectomy (p-value = 0.20). e results were unchanged aſter controlling for proton pump inhibitor and NSAID use. However, patients with microscopic colitis were 0.8795 times more likely to undergo cholecystectomy than patients with other types of colitis (RR 0.1205; 95% CI 0.0082 to 1.7803). Conclusion: In this minority predominant study, antecedent cholecystectomy was not significantly associ- ated with development of microscopic colitis compared to non-microscopic colitis. e cause and effect of bile acid malabsorption in MC patients warrants further investigation and studies with larger sample sizes. 218 Safety and Efficacy of Heat Energy Treatment Hemorrhoidectomy (HET) for Symptomatic Grade I and II Hemorrhoids Dhruvan Patel, MD 1 , Adil Mir, MD 2 , Tawseef Dar, MD 2 , Joseph Alukal, MD 2 , Michaela Breski, PA 3 , Ronald Concha-Parra, MD 1 , Mervyn Danilewitz, MD, FACG 1 . 1. Mercy Catholic Medical Center, Philadelphia, PA; 2. Mercy Catholic Medical Center, Darby, PA; 3. Mercy Philadelphia Hospital, Philadelphia, PA. Introduction: Treatment for symptomatic grade I and II hemorrhoids include rubber band ligation, infrared coagulation, radiofrequency bipolar energy or direct current. However, these treatments are associated with appreciable post-procedural complications. e HET bipolar (HET system, Northvale, [216] Table 1. Change in weight group after FMT PRE-FMT BMI (kg/m 2 ) a <18.5 (n=6) 18.5-24.9 (n=58) 25-29.9 (n=46) 30-34.9 (n=32) 35-39.9 (n=14) POST-FMT CHANGE b Decreased by one weight group - 2(3) 6(13) 7(22) 4(29) Maintained weight group 4(67) 43(74) 29(63) 20(62) 7(50) Increased by one weight group 2(33) 13(23) 10(21) 5(16) 3(21) Increased by two weight groups - - 1(2) - - Data presented as n(column%). a FMT = fecal microbiota transplantation; BMI = body mass index. b Weight groups: <18.5; 18.5-24.9; 25-29.9; 30-34.9; 35-39.9; >40. [216] Table 2. Change in weight group after FMT based on stool donor BMI Stool Donor BMI (kg/m 2 ) a 18.5-24.9 (n=60) c 25-29.9 (n=74) c 30-34.9 (n=7) c FMT recipients' weight change b Decreased by one weight group 8(13) 8(11) - Maintained weight group 39(65) 53(72) 4(57) Increased by one weight group 13(22) 13(17) 3(43) Data are presented as n(column %). a FMT = fecal microbiota transplantation, BMI = body mass index. b Weight groups: <18.5; 18.5-24.9; 25-29.9; 30-34.9; 35-39.9; >40.