AGA Abstracts Table 1. Patient Characteristics Table 2. Motility Testing and Transplant Rejection Tu1334 A STUDY ON THE EFFECT OF ATYPICAL GASTROESOPHAGEAL REFLUX DISEASE SYMPTOMS AND COEXISTING FUNCTIONAL DYSPEPSIA SYMPTOMS ON THE DAILY LIFE ACTIVITIES AND QUALITY OF LIFE IN GERD PATIENTS Akio Koizumi, Kimio Isshi, Hiroto Furuhashi, Yosuke Kawahara, Shingo Ono, Shunsuke Kamba, Hiroaki Matsui, Tomohiko R. Ohya, Hideka Horiuchi, Yuko Hara, Naoto Tamai, Hiroko Inomata, Masayuki Kato, Kazuki Sumiyama, Koji Nakada In clinical practice of gastroesophageal reflux disease (GERD), atypical symptoms and/or associated symptoms of functional dyspepsia (FD) are frequently encountered. However, much remains unknown about the effect of these symptoms on the daily life activities of patients and their quality of life (QOL). Aim: To investigate the effect that associated FD symptoms and atypical symptoms seen in GERD patients have on the daily life activities and QOL. Methods: The subjects consisted of 113 patients who visited our clinic with chief complaints of typical symptoms of GERD symptoms. These patients were asked to complete two questionnaires of the modified Frequency Scale for the Symptoms of GERD (MFSSG) and Gastroesophageal Reflux Therapeutic Effect and Satisfaction Test (GERD-TEST), and the Short-Form 8-Item Health Survey (SF-8) prior at the start of treatment and again four weeks after treatment. Multiple regression analysis was used to determine the effect that the MFSSG results for typical GERD symptoms (heartburn [Q1, Q3, Q6], acid regurgitation [Q5]), atypical GERD symptoms (rubbing the chest with the palm of the hand [Q2], difficulty swallowing [Q4], throat discomfort [Q7]), typical FD symptoms (postprandial fullness [Q9], early satiation [Q11], epigastric pain [Q13, Q14]), and atypical FD symptoms (epigastric bloating [Q8], nausea [Q10], belching [Q12]) had on the items that affect the degree of satisfaction with daily life on the GERD-TEST (eating [Q6], sleeping [Q7], daily activities [Q8], mood [Q9], daily life-subscale) and the QOL on the SF-8 (physical Component Summery [PCS] and mental Component Summery [MCS]). Results: The symptoms had a particular effect on daily life including eating ( R 2 =0.39; R 2 : coefficient of determination), daily activities ( R 2 =0.37), and mood ( R 2 =0.26). In addition, the symptoms that had a significant effect on daily life were as below: 1. Eating: FD atypical symptoms ( =0.32; : standardized regression coefficient), FD typical symptoms ( =0.31). 2.Daily activities: FD atypical symptoms ( =0.36), FD typical symptoms ( =0.27), GERD typical symptoms ( = 0.17). 3.Mood: FD atypical symptoms ( =0.29). 4.General daily life activities: FD atypical symptoms ( =0.42), FD typical symptoms ( =0.30). 5.PCS: FD typical symptoms ( =-0.39). 6.MCS: FD atypical symptoms ( =-0.48). However, no symptoms were found to have a significant effect on sleeping. Conclusion: The effect of symptoms on the daily life of GERD patients were more grater in coexisting FD symptoms than GERD symptoms and more in atypical symptoms than typical symptoms. Providing treatment focused on atypical concomi- tant symptoms is an important way to increase patient satisfaction. S-1064 AGA Abstracts Tu1335 SLEEP DISORDERS ARE VERY COMMON IN PATIENTS WITH BARRETT'S ESOPHAGUS Subhan Ahmad, Venkata Sunkesula, Fahmi Shibli, Ronnie Fass BACKGROUND: There is growing interest in evaluating the association between gastrointes- tinal disorders and sleep abnormalities as both affect quality of life. Sleep disturbance is commonly reported by patients with gastrointestinal disorders. Gastroesophageal reflux disease (GERD), which is the main underlying mechanism behind Barrett’s esophagus (BE), has been shown to be associated with obstructive sleep apnea (OSA), insomnia, and various sleep abnormalities. However, few studies have looked at the association between BE and common sleep disorders. The aim of this study was to assess the association of BE with common sleep disorders including restless legs syndrome (RLS), insomnia, and OSA using a large population-based database. METHODS: We performed a population-based study using a commercial database (Explorys Inc., IBM), a HIPPA-enabled web platform which includes over 65 million patient data, pooled from multiple healthcare systems with distinct electronic health records. All patients with BE were included. The control group was patients without BE or GERD. Variables were adjusted for ages 50-79, male gender, and Caucasian race. Data was analyzed with R statistical software (RStudio, Inc. Boston, MA). RESULTS: A total of 22,050 BE patients were identified and 455,530 controls (no BE or GERD). Patient demographics included ages 50-79, male gender, and Caucasian race. The prevalence of RLS, insomnia, and OSA was significantly higher among patients with BE as compared to those patients without BE or GERD (12% vs. 8%, 43% vs. 37%, 69% vs. 67% respectively; p-value <.0001). Insomnia appears to be particularly more common in BE patients as compared with the control group. CONCLUSION: In this study, there was a significantly increased association of RLS, insomnia, and OSA in patients with BE. Insomnia was particu- larly more common in BE patients. Future studies should further assess the relationship between BE and these sleep disorders. Sleep Disorders and Barrett's Esophagus Tu1336 REFLUX MONITORING WITH IMPEDANCE-PHMETRY: NEW SET OF NORMAL VALUES OBTAINED FROM CONSENSUS ANALYSIS OF TRACINGS FROM HEALTHY ASYMPTOMATIC SUBJECTS. A MULTICENTRE INTERNATIONAL COLLABORATIVE STUDY. PRELIMINARY RESULTS Daniel Sifrim, Sabine Roman, Edoardo Savarino, Akinari Sawada, Yoshimasa Hoshikawa, C. Prakash Gyawali Background Although normal values for pH-metry and impedance-pHmetry are available, their application for conclusive diagnosis of GERD worldwide has limitations. Possible reasons include small normative patient cohorts from only one or two countries, and significant technical limitations in analysis, such as inclusion of pH drops from meals/artifacts and inconsistent rules for identification of impedance reflux events, leading to large inter- reviewer variability. Software for automated analysis suffers from similar limitations resulting in over-diagnosis of reflux. We aimed to obtain a new set of normal values for impedance- pHmetry based on consensus analysis of tracings from a large number of healthy asymptom- atic subjects from different countries worldwide. Methods Impedance-pHmetry tracings from healthy asymptomatic subjects from Europe, Asia, North America, South America and Africa were collected and de-identified. Tracings with technical artifacts and/or marked symptoms were excluded. The included tracings were manually analysed by two expert reviewers working together either in person or through video-conference. Analysis included 1. Editing of incompletely identified meal times, 2. editing of pH drops (to exclude artifacts and meal/drink induced pH drops), 3. recognition of impedance reflux events using strict pre-established criteria, 4. Measurement of distal mean nocturnal baseline impedance (MNBI). 5.Identification and scoring of post reflux swallow-induced peristaltic waves (PSPW). Results We collected 356 de-identified tracings. Thus far, consensus analysis has been performed in 170 tracings [mean age 31 (range 18-66), 69 females/101 males], from three systems, Sandhill (n=130), MMS (n=41), Given (n=7). Mean time for consensual analysis was 14:27 min/tracing. Normal values are presented in the table. There were no differences in normal values between males and females but there was a higher number of total reflux events in subjects younger than 40y (31 vs 17) (p < 0.01). Comparing normal values between tracings utilizing the same pH-impedance system from West Europe/USA, Asia, South America and South Africa, we observed regional differences i.e. higher median MNBI in Asian subjects (Sandhill system) and in South African subjects (MMS). Conclusion We have established normal values for reflux monitoring with impedance pHmetry based on a large number of tracings from healthy asymptomatic subjects that can be used worldwide. These values are obtained using manual consensus analysis and consistent criteria for inclusion of pH drops, reflux recognition, MNBI and PSPW. It is expected that this new set of normal values will