AGA Abstracts collected for 3 hours and BAO was determined before and after 10 days of treatment. We used three calcium channel blockers which have been administered p.o. as foloows: Group 1 - diltiazem, 300mg/day; Group 2 - amlodipine 10 mg/day; Group 3 - verapamil, 240 mg/ day. Fundic mucosa biopsies were collected endoscopically , before and after treatment. A control group of 15 patients received placebo and underwent the same investigations. Conclusions. In calcium channel blockers treated groups BAO, gastric mucosa CA II and CA IV significantly decreased after 10 days of treatment. No significant changes were detected in BAO, CA II and CA IV activity in controls. There is a correlation between the decrease of basal acid secretion in duodenal ulcers patients and the reduction of gastric mucosa CA II and CA IV activity, which might be assumed as being the mechanism of acid secretion inhibition by calcium channel blockers. RESULTS * statistic significance p<0.01 T1074 The Correlation of Endoscopic and Histological Diagnosis of Gastric Atrophy Nayoung Kim, Alisher Eshmuratov, Jong Chun Nah Background and Aim: Gastric atrophy is a premalignant condition. The aim of this study was to evaluate the correlation between the histological and endoscopic findings of atrophy, and to analyze the factors associated with the diagnosis. Methods: Atrophy was graded by endoscopy and confirmed by histology. Biopsies were performed in the antrum and body of the stomach for the histological diagnosis of atrophy according to the Sydney system in the 1330 subjects. A multivariate analysis was performed including age, gender, H. pylori infection, smoking, alcohol, and serum pepsinogen (PG) I/II levels to determine the sensitivity of endoscopy for the diagnosis of atrophy. Results: The sensitivity and specificity of endoscopy for the diagnosis of atrophy based on histological diagnosis of atrophy were 61.5% and 57.7% in the antrum, and were 47.8% and 76.4% in the body of the stomach. The findings were not significantly affected by H. pylori infection. Multivariate analysis showed that an age < 50 (OR 0.37, 95% CI 0.23-0.57) and a serum PG I/II ratio > 4 (OR 0.55, 95% CI 0.38-0.80) in the antrum, and an age < 50 (OR 0.43, 95% CI 0.19-1.00) and a serum CRP > 5 mg/dL (OR 0.53, 95% CI 0.30-0.94) decreased the sensitivity of the endoscopic diagnosis of atrophy in the body of the stomach. The mean grades of activity and chronic inflammation were higher in the age group < 50 y compared to those ≥ 50 y for both the antrum and the body of the stomach. Conclusions: The endoscopic diagnosis of atrophy was not accurate, especially in the age group below 50 y as well as in those with a PG I/II ratio > 4 (antrum) or a CRP > 5 mg/dL (body). Thus, a high index of suspicion of gastric atrophy is important, and confirmation of the diagnosis by histology is necessary. T1075 The Comparison of 2 Therapy Regimens Including Furazolidone, Amoxicillin and Omeprazole with and Without Bismuth for the Eradication of H. pylori in the Province of Qum,Iran Mohammad Reza Ghadir, Abolfazl Iranikhah Back ground: Treating all peptic ulcers associated with Helicobacter pylori with antimicrobial agents has become a standard practice nowadays. The aim of this study was to evaluate a two simple 2-week Therapies to cure H. pylori, based on omeprazole as the antisecretory agent plus amoxicillin and furazolidone , either with or without Bismuth subcitrate in order to assess the effectiveness of Bismuth. Materials and methods: After the routine diagnostic upper endoscopy, 100 patients with H. pylori-associated peptic ulcer disease or nonulcer dyspepsia between 18 and 60 years of age entered the study. Patients with known nonsteroidal antiinflammatory drug or ASA (acetylsalicylic acid), aspirin consumption were not included. The H. pylori status was determinded on a commercially available rapid urease test. 50 patients were each enrolled, randomized and treated for 2 week with either: AFO: Furazolidone 200mg BD, Amoxicillin 1gr BD and Omeprazole 20mg BD. or AFOB: Furazolidone 200mg BD, Amoxicillin 1gr BD, Omeprazole 20mg BD, Bismuth subcitrate 240mg BD . After 2 weeks,70 patients returned for follow up and evaluation of adverse effects, when they were placed on Omeprazole 20mg single dose daily for 4 weeks. A urease breath test was in the order after the treatment period was over. A negative result would indicat H. pylori's absence.. Results: There was no significant difference between age and sex in the two groups: 70 patients completed the study, the most common adverse events in AFO group were Fatigue (63.8%) dizziness (36.1%), nausea (30.5%), sleeplessness (27.5%), and in AFOB group were fatigue (82.3%), nausea (32.3%), loss of appetite (32.3%) and dizziness (23.5%) .No patient prematurely withdrew from the study as a result of side-effects. There was a statistically meaningful relation between the higher rate of eradication and level of education, and also a meaningful relation between higher rate of eradication and satisfaction of the drugs used. (P<0.05) There was also a statistically remarkable relation between the higher rate of eradication and patient's age in the AFO group (P<0.05) Eradication rate in AFO and AFOB groups were 61.1%, and 85.3% respectively .There were a statistically significant difference between the two groups (P=0.02). Conclusion: Addition of Bismuth subcitrate to the treat- ment regimen has an important effect in better eradication rates as also shown in this study. Added Bismuth has created a desirable result of The eradication rate which was about 85.3% . A-494 AGA Abstracts T1076 The Impact of Gastroesophageal Reflux Disease On Daily Life: the Systematic Investigation of Gastrointestinal Diseases in China (SILC) Epidemiological Study Rui Wang, Duowu Zou, Yanfang Zhao, Xiuqiang Ma, Xiaoyan Yan, Hong Yan, Jiqian Fang, Ping Yin, Xiaoping Kang, Yuantao Hao, Qiang Li, John Dent, Joseph J. Sung, Katarina Halling, Saga Johansson, Wenbin Liu, Jia He Introduction. The pain and discomfort associated with gastroesophageal reflux disease (GERD) impairs many aspects of everyday life in Western populations, but data from Asian countries are scarce. The aim of this study was to evaluate the impact of GERD (defined on the basis of symptoms) on the lives of affected individuals from five regions across China. Methods. A representative sample of 18 000 residents of China (aged 18-80 years) was selected from five different regions in China, namely Shanghai, Beijing, Wuhan, Xi'an and Guangzhou (n = 3600 from each region), using a randomized, stratified, multi-stage sampling method. Urban and rural residents were sampled in a ratio of 1:1 in each region. Subjects completed a Chinese version of the Reflux Disease Questionnaire. A randomized subsample of one-fifth of subjects (20% from each region) also completed Chinese versions of the Short Form-36 (SF-36) and Epworth Sleepiness Scale (ESS) questionnaires. GERD was defined as mild symptoms of heartburn or regurgitation occurring on at least 2 days a week, or moderate/ severe symptoms occurring on at least 1 day a week. A clinically meaningful impairment of health-related quality of life was defined as a statistically significant decrease of ≥ 5 points in a 100-point SF-36 domain, and clinically meaningful daytime sleepiness was defined as an ESS score > 12 (a score of 10-12 was borderline and < 10 was normal). Results. In total, 16 091 subjects completed the survey (mean age: 42.5 years; 52.2% female), and 3219 respondents were included in the 20% subsample. Response rates were 89.4% for both the main sample and the subsample. The prevalence of GERD based on symptoms was 2.77%. Subjects with GERD had impaired health-related quality of life in all eight SF-36 dimensions compared with those without GERD (mean SF-36 scores: physical functioning, 85.3 vs 94.3; role-physical, 67.0 vs 89.5; bodily pain 70.6 vs 88.7; general health, 50.5 vs 70.3; vitality, 54.5 vs 69.4; social functioning, 78.2 vs 88.3; role-emotional, 76.0 vs. 90.0; mental health, 65.3 vs 78.0; all p < 0.001). Clinically meaningful daytime sleepiness was significantly more prevalent among subjects with GERD, compared with those without GERD (37.5% vs 17.9%), and mean ESS scores were also significantly higher (9.3 vs 6.8, p < 0.001). Conclusions. As in Western countries, GERD defined on the basis of symptoms alone has a clinically meaningful impact on the daily lives of affected individuals in the general population of China. Further research is needed to assess the effect of appropriate therapy on health-related quality of life in Chinese patients with GERD. T1077 Symptoms Rather Than Histology Predict Psychological Co-Morbidity in Patients On a Barrett's Esophagus Surveillance Program Peter A. Bampton, Ann C. Schloithe, Helen Lewis, Jeff A. Bull, Jodie Oliver, Robert J. Fraser, David I. Watson Introduction: Studies have suggested that patients in a surveillance program for Barrett's may have a high perceived cancer risk and therefore increased anxiety and decreased quality of life. Aim: To determine whether a surveillance program whereby all patients are counselled and enrolled in a clearly defined surveillance program (unless they decide to “opt out”) would facilitate a accurate self assessment of cancer risk and reduce adverse psychological outcomes. Methods: We approached patients from 3 different treatment settings (public, veteran and private) enrolled in a Barrett's surveillance program. All patients were counselled on their risk and their planned surveillance program was outlined to them. They completed a SF36 to measure quality of life, DASS 21 and Speilberger (STAI) state scores measuring current anxiety and depression, a Speilberger (STAI) trait score measuring underlying anxiety and depression traits, a visual analogue score measuring perceived risk of cancer and a GERD impact score (GIS) measuring reflux symptoms. Results: The response rate was 67% (309 of 463, mean age 63 yrs). 16% (50) had a diagnosis of low grade dysplasia, 1% (4) high grade dysplasia with 83% (255) with no dysplasia during their surveillance (range 1- 4 years). STAI-trait anxiety & depression scores were within normal range as were SF36, DASS and STAI-state anxiety & depression scores. 75% of participants with no dysplasia (vs 71% with low grade dysplasia) rated their risk of cancer appropriately (less that 1%). 50 patients (16%) described at least one of the symptoms within the GIS as occurring frequently, despite 299 (97%) being on PPIs and/or having had a fundoplication. DASS and STAI-state anxiety were higher in patients with significant GIS symptoms (7.48 vs 2.76 p < 0.001 and 18.05 vs 14.84 p = 0.001). However, on both measures patients with dysplasia on histology were no more anxious that those with no dysplasia. Timing to next endoscopy was not correlated to DASS anxiety or STAI-state anxiety. In patients who had rated their risk of cancer as high, there was no relationship to presence of dysplasia, although they were more likely to have at least one of the GIS reflux symptoms occurring frequently (p = 0.003) or to have a higher STAI-trait anxiety score (p= 0.017) Conclusions: Patients on an opt-out Barrett' surveillance program overall do not have increased levels of psychological morbidity. Anxiety and over-estimation of risk of cancer is driven by the presence of reflux symptoms and underlying personality traits rather than by histological type or treatment set- ting. T1078 Persistent Symptoms and Impact On Quality of Life in Patients with Gastro- Esophageal Reflux Disease Managed in Primary Care Roger Jones, Claire L. Hunt, Michael Cohen Introduction : Proton pump inhibitors offer the prospect of symptom control in gastro- oesophageal reflux disease (GORD), but there is increasing interest in the substantial minority of patients who do not respond adequately to therapy. Little information is available about these patients outside clinical trials. Aims and objectives: To document the experience of symptoms and their impact on quality of life in patients with GORD and to assess their