Abstracts of the 21 st National Congress of Digestive Diseases / Digestive and Liver Disease 47S (2015) e69–e208 e129 Conclusions: Increased release of chemokines IL-8, IL-16, CXCL1 and CCL4 in untreated CD supports the chemoattraction of immune cells in the duodenal mucosa of CD patients. Further studies are needed to better clarify the role of IL-8, IL-16, CXCL1 and CCL4 in untreated CD and, subsequently, to understand whether blocking them might be a new therapeutic tool in this disorder. P.02.15 GLUTEN AVOIDANCE BEFORE A DEFINITE DIAGNOSIS IS MORE COMMON AMONG NON-CELIAC SUBJECTS THAN CELIAC ONES G. Ianiro *,1 , G. Bruno 1 , S. Bibbò 1 , V. Arena 2 , A. Gasbarrini 1 , G. Cammarota 1 1 Internal Medicine and Gastroenterology Unit, “A. Gemelli” University Hospital, Rome, Italy; 2 Histopathology Unit, “A. Gemelli” University Hospital, Rome, Italy Background and aim: Gluten triggers not only celiac disease (CD), but also NCGS and wheat allergy, and causes gastrointestinal symptoms in IBS-D patients. Gluten-free claims are increasingly spreading on the Web, and many subjects start a gluten-free diet (GFD) without any prior medical consultation, with considerable waste of resources and diagnostic delay. Our aim was to assess the impact of gluten avoidance before a definite diagnosis in patients with and without CD. Material and methods: We reviewed the clinical history of patients refer- ring to our clinic from October 2012 to December 2013. We included only patients without a definite diagnosis of CD at their first examination at our Centre. Gluten was reintroduced for at least 2 months before any diagnostic assessment in all subjects already on GFD. All patients underwent blood dosage of EMA, TTG and total IgA levels, as well as upper endoscopy with duodenal biopsy. In all patients CD was diagnosed because of EMA and TTG positivity associated with Marsh-type intestinal lesions. Correlation between gluten avoidance and further diagnosis of CD was assessed by Chi-square test. Results: Over the study period, a total amount of 293 patients attended our Centre, of whom 150 (M 41, F 109 – mean age 39 y) for the first time. Of them, 39 (26%) were on GFD at the time of examination. Reasons for gluten avoidance without definite diagnosis were, respectively: gastrointestinal symptoms (12 cases), extraintestinal symptoms (7 cases), DQ2/DQ8 positivity (9 cases), antibody positivity (6 cases), histological features (9 cases). Sixteen patients started a GFD on their own (41%), and 23 upon medical advice (58%). Gender did not influence gluten consumption status (P=0.8376). A total of 93 of 150 subjects (62%) were diagnosed of CD. Of them, only 4 (4.5%) were on GFD, whereas 89 (95.5%) consumed a gluten-containing diet at the time of first examination (P<0.0001). Conclusions: Gluten avoidance before a clear definition of diagnosis is more common among subjects in whom CD is ruled out at a later stage than ones diagnosed of CD afterwards. The increasing interest of physicians and patients in gluten-related diseases, and unmotivated gluten-free claims may explain such reasons. Also symptom burden and gluten influence on mental component of patients may play a role in this phenomenon. P.02.16 ECONOMIC AND QUALITY-OF-LIFE BURDEN OF MODERATE-TO-SEVERE IRRITABLE BOWEL SYNDROME WITH CONSTIPATION (IBS-C) IN ITALY: THE IBIS-C STUDY V. Stanghellini *,1 , A. Lecchi 2 , J. Mackinnon 3 , J. Bertsch 3 , J. Fortea 2 , J. Tack 4 1 University of Bologna, Bologna, Italy; 2 Almirall S.A, Barcelona, Spain; 3 TFS Develop S.L, Barcelona, Spain; 4 University Hospital Gasthuisberg, Leuven, Belgium Background and aim: This study is the first study to assess the burden of IBS-C in 6 European countries (France, Germany, Italy, Spain, Sweden, UK). Here we present results for Italy. Material and methods: Observational, retrospective-prospective (6 months each) study in patients (pts) diagnosed with IBS-C in the last 5 years (Rome- III criteria) who had moderate-to-severe symptoms at baseline, as defined by IBS-Symptom Severity Score (IBS-SSS) ≥175. Health resource utilization was assessed in the retrospective and prospective periods. Symptoms evolution was assessed in the prospective period, and quality-of-life (QoL) was assessed at baseline with EuroQoL-5D (EQ-5D) and IBS-QoL. Results: The study included 112 patients (61% severe, mean age (±SD) 41.7±17.0 years, 86% female). At baseline, symptom severity (IBS-SSS; severe >300) was 311.1±75.1; presenteeism (Work Productivity and Activity Impairment (WPAI): IBS-C questionnaire; mean [±SD]): 27.7%±28.6 of time in week prior to inclusion; absenteeism: 3.1%±9.3; work productivity loss: 27.6%±27.7; and daily activity impairment: 41.1%±29.1. Mean IBS-QoL was 36.7±21.2 (scale: 0–100 [best-to-worst]), and the most affected domains were “food avoidance” (mean: 52.3) and “health worry” (46.6). Mean EQ-5D was 58.9±20.7 (scale: 0–100 [worst-to-best], mean in general population: 77.0) and 95% and 59% of pts reported moderate-to-severe problems in pain/discomfort, anxiety/depression respectively. The most prevalent symp- toms were: constipation (88%), abdominal pain (80%), bloating (72%) and abdominal distention (70%). Over the year, 58% of pts consulted a primary care physician, and 100% a gastroenterologist; mean: 6.4 and 4.0 visits, respectively. 13% required emergency department visits or hospitalization (mean stay (95% CI): 18 (0–42) days). 74% underwent a diagnostic test (mean (95% CI): 4.5 (3.9–5.2)).41% of pts took prescription drugs for their IBS-C, 37% received complementary therapies. After 6 months, 1 in 3 pts had no or mild symptoms. The mean (95% CI) annual direct cost for the Italian National Health System was 937 C (525–1528) and the mean cost for the pt was 485 C (372–627). 13% of pts took sick leave (mean: 6.9 times; mean duration: 12 days) and 16% had productivity losses (mean: 83 hours). Mean indirect costs were 339z C (182–517). Total costs amounted to 1761 C (1242–2433)/year. Conclusions: Moderate-to-severe IBS-C has a great impact on patient QoL, productivity, and healthcare resource utilization. P.02.17 THE NEW 360° PANORAMIC-VIEWING CAPSULE ENDOSCOPY SYSTEM: RESULTS OF THE FIRST MULTICENTER, OBSERVATIONAL, STUDY G.E. Tontini *,1 , F. Cavallaro 1 , P. Votta 2 , R. Marino 2 , L. Pastorelli 3 , S. Cadoni 4 , P. Vitagliano 5 , G. Bonitta 6 , P. Soriani 1 , M. Vecchi 3 1 UO di Gastroenterologia ed Endoscopia Digestiva, IRCCS Policlinico San Donato, San Donato Milanese, Italy; 2 Servizio di Endoscopia Digestiva e Gastroenterologia, A.O. della provincia di Lodi, Presidio di Lodi, Lodi, Italy; 3 UO di Gastroenterologia ed Endoscopia Digestiva, IRCCS Policlinico San Donato e Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy; 4 Servizio di Endoscopia Digestiva, Presidio Ospedaliero Santa Barbara, Iglesias, Italy; 5 Servizio di Endoscopia Digestiva, A.O. di Melegnano, Presidi di Melzo e Cernusco Sul Naviglio, Melzo, Italy; 6 Centro di Aritmologia ed Elettrofisiologia, IRCCS Policlinico San Donato, San Donato Milanese, Italy Background and aim: CapsoCam SV1 is a newly introduced device for small- bowel (SB) capsule endoscopy (CE) with wire-free technology, a long-lasting battery life, and 12–20 frames per second captured by four high-resolution cameras located on the capsule sides and facing the four quadrants of the digestive wall. Initial experiences have shown high operative performances, suggesting at least an equal clinical efficacy compared to other frontal view capsules [Friedrich K, et al. J Gastroenterol Hepatol 2013; Pioche M, et al. Endoscopy 2014; Tontini GE, et al. Endoscopy 2014]. We conducted a multicenter, observational, spontaneous study to assess the performance of CapsoCam SV1 in real life clinical practice. Material and methods: Patients with suspected SB disorders were consec- utively enrolled in four Italian centers during 2014. Two expert readers performed a centralized post-hoc revision of those video recordings with undefined findings. The P0/P1/P2 classification proposed by Saurin et al. for obscure gastro-intestinal bleeding (OGIB) [Saurin JC, et al. Endoscopy 2003] was used to assess the clinical relevance of all findings. Results: Fifty patients underwent SBCE (26 men; median age 67±17 years, range 16–86 years) with the following indications: 35 OGIB (27 occult), 8 iron-deficiency anemia, and 7 suspected Crohn’s disease. No procedure’s