AGA Abstracts sprue and intestinal lymphoma. 4 Anti-enterocyte antibodies and/or rapid response to cortico- steroid treatment (prednisone 40 mg, PO, daily for 7 days) The rapid response to corticos- teroid treatment is a useful criterion in diagnosing AIE, while awaiting the result of anti- enterocyte antibodies. We do not recommend malnutrition to be a diagnostic criterion, as with more awareness, patients are expected to be diagnosed earlier. The presence of other autoimmune antibodies or diseases is supportive but not necessary in making the diagnosis of AIE. W1021 Adherence to Evidenced-Based Guideline for the Prescription of Nonsteroidal Anti-Inflammatory Drugs in Japanese Patients Hidetaka Tsumura, Tsuyoshi Fujita, Isamu Tamura, Yoshinori Morita, Tsuyoshi Sanuki, Masaru Yoshida, Takashi Toyonaga, Hidekazu Mukai, Hideto Inokuchi, Hiromu Kutsumi, Takeshi Azuma Objective Recently, guidelines for the treatment and prevention of non-steroidal anti-inflam- matory drugs (NSAIDs) induced ulcers were established. Our aim was to assess the current adherence to the guidelines, and the incidence of gastric mucosal lesions caused by NSAIDs in Japanese patients. Methods This study included 254 NSAIDs users (128 regular and 126 on-demand users) who underwent upper gastrointestinal endoscopy. The patients were characterized as high-risk based on the following: Age 65 years or older, history of peptic ulcers, concurrent use of corticosteroids or anticoagulants, high-dose NSAIDs use. Adherence was defined as the prescription of NSAIDs with proton pump inhibitors (PPIs), prostaglandin analogues (PAs), or high-dose histamine 2 receptor antagonists (H2RAs) in high-risk NSAIDs user. The severity of gastric mucosal lesions was evaluated using the modified LANZA score (MLS). Results Seventy-nine (61.7%) of the regular NSAIDs users and 65 (51.6%) of the on-demand NSAIDs users met our definition of high-risk patients. Adherence in the regular NSAIDs users and on-demand NSAIDs users was 25(31.7%) and 16(24.6%), respectively. The incidence of gastric mucosal lesions (MLS≧1) was significantly higher in the nonadher- ence group than in the adherence group for both regular NSAIDs users (59.3% vs 28.0% P=0.01) and on-demand NSAIDs users (63.3% vs 25.0% P=0.01). Gastric ulcers in the regular NSAIDs users were more frequently observed in the nonadherence group than in the adherence group (29.6% vs 4.0% P<0.01). Conclusion Adherence to the guidelines was low. Nonadherence was found to be associated with a high prevalence of NSAIDs induced gastric mucosal lesions. W1022 Diverticulosis: Clinical Predictors. A Retrospective Case-Control Study Maryam Khorrami, Muhammad F. Azrak, Steven Keilin Objective: To examine clinical factors associated with colonic diverticulosis in adults. Methods: Retrospective case control study of patients presented to Emory University Hospital and Clinics for colonoscopy between 8/1/2007 and 1/31/2008. We restricted inclusion to patients who had complete colonoscopy and had complete data on the studied variables. 346 patients with diverticulosis were included. 346 patients who did not have diverticulosis were randomly selected as a control group. Variables such as age, race, gender, BMI and co-morbid conditions were collected. Wald Chi-Square method was used to calculate unad- justed odds ratios with 95% confidence intervals. Student T test was used to compare means of continuous variables. We used logistic regression model to calculate the adjusted odds ratios. Results: Diverticulosis was significantly more prevalent with increased age, with increase in BMI, White race, hypertension and dyslipidemia (Table 1). Four significant predictors of diverticulosis were found by the logistic regression model: Age, BMI, White race and hypertension. BMI showed modest but significant increase in the risk of diverticulosis (3% more likely to have diverticlusosis with each unit increase in BMI). Conclusion: HTN and increased weight are treatable clinical factors that are associated with increased risk of diverticulosis. With the obesity epidemic and aging population in US, diverticulosis may become more prevalent. Further studies are needed to further confirm these associations. Characteristics of the study sample and significant unadjusted OR's of diverticulosis with the study variables Statistically significant adjusted OR's of diverticulosis S-634 AGA Abstracts W1023 Heartburn Symptoms are Stronger Than Dyspepsia Symptoms in Motivating General Population to Seek Medical Attention Motoyasu Kusano, Kazuma Fujimoto It is unclear whether reflux or dyspepsia symptoms provide stronger motivation for the population to seek medical attention. We developed the frequency scale for symptoms of GERD (FSSG), a GERD-specific questionnaire. FSSG contained 12 questions according to symptom in Japanese GERD patients, 7 reflux related symptoms and 5 dyspepsia related symptoms. The cutoff in FSSG was set at 8 points for GERD. (Sensitivity:62%, specificity:59%, accuracy :60%, Kusano et al, J Gastroenterol, 2004). We surveyed members of the general population using the FSSG over the internet, classifying respondents with mainly reflux (GERD) symptoms or upper gastrointestinal symptoms (UGI), and compared the 2 groups. Methods and Subjects: We created a homepage that users were able to access by entering only two key words; ‘reflux' and ‘heartburn'. The FSSG was used to assess respondents' symptoms. Other questions included: 1) the presence of UGI; 2) recognition of disease by symptoms 3) history of presentation for medical attention for treatment of symptoms. A total of 15,814 subjects (age: 20-70, male/female: 8,165/7,649), who visited the homepage and answered all questions during the surveillance period from January to February 2008, were enrolled. The diagnosis of GERD was made on the basis of an FSSG score ≥8, and UGI with an FSSG score ≥1. Results: 1. The rate of medical consultation was 9.2% (1449/ 14365). The rate of not seeking medical attention despite having UGI, non-consulting UGI was 82.5% (4666/5659), and the rate of not seeking medical attention despite having GERD symptoms, non-consulting GERD, was 70.5% (2301/3625). 2. For respondents with GERD, the rate of medical consultation increased significantly as the number of positive responses to the 3 reflux questions related to heartburn increased (P<0.0001). The rate of medical consultation did not increase as the number of positive responses to the 3 dyspepsia questions related to abdominal fullness and bloating increased. 3. We calculated odds ratios for seeking medical attention with multivariate analysis. This showed that the number of positive responses to questions related to heartburn was a significant factor (odds ratio 1.5, P= 0.0001), but the number of positive responses to questions related to dyspepsia did not yield a significant odds ratio. Other significant factors were age≥60 (odds ratio 2.2, P<0.0001), FSSG score≥8 (odds ratio 1.5, P<0.0001), and awareness of disease (odds ratio 6.1, P<0.0001), although gender was not a significant factor. Conclusions: Our results indicate that reflux symptoms such as heartburn are stronger than dyspepsia symptoms in motivating patients to seek medical attention. W1024 Knowledge and Attitudes of Junior Medical Doctors Towards Gastric Cancer Boon Bee George Goh, Damien M. Tan, Yu Tien Wang, Khoon-Lin Ling Background: Gastric cancer (GC) is the 4th most common cancer globally and accounts for the second most common cause of cancer related death. It remains the 5th most common cancer among Singapore males with age standardized incidence rate of 14.4 per 100,000 per year. As doctors play an important part in persuading patients to undergo screening, and as screening may have an important role in diagnosing early GC, we sought to determine the knowledge and attitudes of interns and residents towards GC and GC screening. Aims: To ascertain knowledge and attitudes of interns and residents in a tertiary Singapore hospital towards GC. Methods: Self-administered questionnaires regarding knowledge and attitudes to gastric cancer and screening were distributed to a cohort of junior doctors (JD) in Singapore General Hospital between April 2009 to November 2009. Results: There were a total of 104 JD. 82.5% of JD felt that GC is common in Singapore. 94.2%, 98.1%, 83.7%, 91.3%, 60.6% and 89.4% of JD correctly identified smoking, Helicobacter pylori, older age, family history of GC, Chinese race and male gender as risk factors respectively. However, only slightly more than a third of JD realized high salt diet (34.3%) and low vegetable/fruit intake (36.5%) were also risk factors for GC. Majority of JD (95.1%) knew that GC can be asymptomatic but if detected early is potentially curable (97.1%). 96% of JD felt that GC was best diagnosed by endoscopy and the best time to diagnose it was when asymptomatic (84%). However, only 52% of the JD cohort would be willing to undergo screening gastroscopy. For those willing to pay for screening gastroscopy, the mean cost they were willing to pay was US$175. 85% of JD were more willing to undergo gastroscopy if tested positive for Helicobacter pylori. Conclusion: JD were generally knowledgeable in most important aspects with regards to risk factors, symptoms and management of GC. However, JD were less aware of dietary risk factors for GC. JD were ambivalent about screening gastroscopy despite knowing that GC is common in Singapore and can be asymptomatic. Should a population based GC screening program be introduced in Singapore, this ambivalence of doctors towards GC screening may result in a lower take-up rate for screening in a population. W1025 Positive Gastric Cancer Association With Wood Stove (fogón) use in Central America, Independent of H. pylori Infection Jean Paul Higuero Sevilla, Ricardo Dominguez, Christopher F. Martin, Paris Heidt, Douglas R. Morgan AIMS. Gastric cancer is the second-leading cause of cancer mortality worldwide, with high incidence in Asia and the mountainous pacific rim of Latin America. Exposure to wood burning and wood stove cooking (fogón) has been linked to a variety of cancers, including upper aerodigestive tract, cervical, and gastric and esophageal cancers. The potential fogón - H. pylori (Hp) interaction is uninvestigated. Our aim was to investigate the association of gastric cancer to exposure to fogón use in western Honduras. This mountainous region is identified as a region of high incidence. (ASRs: 35.9 males and 14.5 females, per 106 per year, 2002-08). METHODS. We conducted a prospective, population-based case-control study in western Honduras. Incident gastric cancer cases were evaluated at the time of diagnosis. Household interviews were conducted for the population-based controls in villages in the region. Village size was accounted for by noting populations of less than or greater than 25,000 inhabitants. (All villages had populations < 50,000). A standardized health