AGA Abstracts all questions combined, McNemar's chi-square test assessed the differences from pre- to post-assessment with P values <.05 are considered statistically significant. Effect size was calculated using Cramer's V by determining the change in the proportion of participants who answered questions correctly from pre- to post- assessment. Results : Significant improvements were identified in both gastroenterologists' and primary care physician (PCP) competency following participation this the CME activity. On pre-assessment, 4% of gastroen- terologists (N=511) answered all 3 questions correctly whereas 79% answered them all correctly on post-assessment. 76% of gastroenterologists showed improvement in selecting appropriate tests to evaluate IBS-D, and 44% improved on selecting appropriate therapies. Overall, 23% of gastroenterologists also endorsed greater confidence in managing IBS (P<.001; V=0.541; large educational effect). PCPs also significantly increased their compe- tence (P<.001; V =0.614; large educational effect). While 2% answered all 3 questions correctly on pre-assessment, 66% answered them all correctly post-assessment. 66% of PCPs showed improvement in selecting appropriate tests to evaluate IBS-D, and 56% improved on selecting appropriate therapies. 41% of PCPs were more confident in managing IBS-D. Conclusions: Online case-based interactive CME that models real-life scenarios in IBS-D led to significant improvements in physicians' competence and confidence in diagnosing and managing IBS-D. Tu1634 MOOD DISORDERS DO NOT APPEAR TO IMPACT DISCONTINUATION OF CHRONIC PHARMACOTHERAPY FOR IBS WITH CONSTIPATION AND CHRONIC CONSTIPATION Jessica Jou, Suraj Suresh, Ryan W. Stidham, William D. Chey, Eric D. Shah INTRODUCTION: Irritable bowel syndrome with constipation (IBS-C) and chronic idio- pathic constipation (CIC) patients often experience co-morbid mood disturbances. In light of associations between an abnormal brain-gut axis and IBS pathogenesis, we aimed to evaluate whether the presence of mood disorders affected discontinuation rates on IBS-C/ CIC pharmacotherapy. METHODS: Patients starting FDA-approved pharmacotherapy for IBS-C and CIC were identified in an administrative dataset from a large academic medical system. Demographic data (age, gender, presence of IBS based on validated ICD-9 codes, tricyclic agent [TCA] or selective serotonin reuptake inhibitor [SSRI] use in a 90 day baseline period) were extracted. Medication start and stop dates were determined using manual chart review. Discontinuation was defined as the date the patient or prescriber stopped therapy. Length of follow-up was determined to assess censoring. Validated sets of ICD-9 codes for mood disorders (which were listed on at least two visits) were compiled into three categories: (1) depression, anxiety, and/or bipolar disorder; (2) depression and/or anxiety; (3) depression. A Cox model was constructed adjusted for demographic variables to assess whether the presence of comorbid mood disorders (based on each of the three categories) or baseline TCA/SSRI use affected the rate of drug discontinuation. Results are presented using hazard ratios [HR] with 95% confidence intervals (CI). RESULTS: Two cohorts (679 patients on lubiprostone; 933 on linaclotide) were identified. Baseline demographics are reported in Table 1. After adjusting for demographic variables, mood disorders were not associated with an increased hazard of discontinuing lubiprostone, whether defined as depression, anxiety and/or bipolar disorder (HR=1.2, 95% CI 1.0-1.5, p=0.08), depression and/or anxiety (HR= 1.2, 95% CI 1.0-1.5, p=0.12), or depression (HR=1.1, 95% CI 0.9-1.4, p=0.4). Similarly, mood disorders did not significantly affect the hazard of discontinuing linaclotide whether mood disorders were defined as depression, anxiety and/or bipolar disorder (HR=1.0, 95% CI 0.7-1.4, p>0.5), depression and/or anxiety (HR=1.0, 95% CI 0.7-1.5, p>0.5), or depression (HR=1.0, 95% CI 0.7-1.5, p>0.5). Baseline TCA and SSRI use did not significantly influence discontinuation of lubiprostone or linaclotide therapy. CONCLUSION: The presence of mood disorders does not appear to influence discontinuation of IBS-C/CIC pharmacotherapy. In other words, patients with mood disorders appear to remain on pharmacotherapy just as long as patients without mood disorders. Table 1: Baseline demographics for lubiprostone and linaclotide cohorts Tu1635 SYMPTOMS PROFILE AND ILEOCECAL HYPERSENSITIVITY IN IRRITABLE BOWEL SYNDROME, FUNCTIONAL CONSTIPATION AND HEALTHY CONTROLS. A STUDY USING THE WIRELESS MOTILITY CAPSULE (WMC) Jose M. Remes Troche, Orestes Cobos-Quevedo, Héctor A. Taboada-Liceaga, Blanca J. Franquez-Flores, Oscar Teramoto, Gildardo A Hernandez, Mercedes Amieva-Balmori Background/Aim: Irritable bowel syndrome (IBS) is considered a multifactorial disorder associated with visceral hypersensitivity, altered gut motility and dysfunction of the brain- gut axis. Recently, the wireless motility capsule (WMC), a non-invasive test that allows the study of motility, pH and temperature, has been used to study the whole gastrointestinal tract. Although previous studies have shown that IBS patients had lower colonic pH, information S-976 AGA Abstracts regarding motor patterns, pH and its association with the symptoms during the WMC is scarce. In this study, our aim was to analyze transit time, motility pattern, pH and associated symptoms during WMC in patients with IBS, functional constipation (FC) and healthy controls. Material and Methods: Eigtheen IBS patients according to Rome IV (15 women, mean age 38.9 y), 10 FC patients (10 women, mean age 46.9 y), and 10 asymptomatic healthy controls (7 women, mean age 40.4 y) were studied. All subjects underwent symptom evaluation (Likert scale) at baseline and during the WMC study. WMC study was performed after the ingestion of a standardized bar (SmartBar 260 kcal, 2% fat, 2 g fiber) using the SmartPill capsule (Given, Yoqneam, Israel). Combinations of pH and temperature profiles were used to calculate the gastric (GET), small bowel (SBTT), colonic (CTT) and whole gut (WGTT) transit time. Symptoms were evaluated during the entire study (total number of symptoms), and specifically the presence of pain/discomfort during the passage of the capsule through the ileocecal valve (5 minutes before and 5 minutes after the drop in ileocecal pH). Comparison among groups were performed. Results: There were no differences in gender, age, weight and height among the 3 groups (p> 0.05). Patients with IBS had more symptoms (total number) during SmartPill than patients with FC and controls (131 vs. 26 vs. 11, p = 0.001). Also the mean number of symptoms during the study was higher in IBS patients (11.1 vs. 2.2 vs 1.1, p<0.0001). Interestingly, patients with IBS reported more frequently the presence of abdominal pain/discomfort associated with the passage of the capsule through the ileocecal segment (55% vs 11% vs 20%, p = 0.03). Of the 10 patients with IBS and symptoms associated with the passage of the capsule through the ileocecal region, 5 had MII-S, 2 SII-D, and 3 SII-E (p = 0.38). FC patients had a more prolonged WGTT and CTT compared with IBS patients and controls (p <0.001). The ileal pH was lower in the patients with FC than in the other 2 groups (6.6 ± 0.22 vs 6.90 ± .21 and 6.96 ± 0.28, p = 0.12). Conclusions: IBS patients had more symptoms during a WMC study, which could be explained by hypervigilance. Also, IBS patients had more pain associated with the passage of the device through the ileocecal region, which could be considered a marker of intes- tinal hypersensitivity. Tu1636 PREVALENCE OF METHANOGENS AND ASSOCIATED FACTORS IN PATIENTS WITH IRRITABLE BOWEL SYNDROME (IBS) AND HEALTHY CONTROLS IN A MEXICAN POPULATION Jose M. Remes Troche, Mercedes Amieva-Balmori, Marco Aja-Cadena, Héctor A. Taboada- Liceaga, Orestes Cobos-Quevedo, Gildardo A Hernandez, Federico B. Roesch Dietlen, Arturo Meixueiro Background/Aim: Methane (CH 4 ) is an inert gas produced mainly by colonic anaerobes (Methaninobrevibacter smithii, M.oralis and Methanospaera stadmagnae), whose presence has been associated with constipation, obesity, irritable bowel syndrome (IBS) and colon cancer. CH 4 can be measured by breath tests and a subject is considered to be "methanogen" if their expired basal levels are greater than 3-5 ppm. The prevalence of methanogens ranges from 36%-63%, being higher in Africa and lower in the United States and Europe (35- 40%). In mexican population the prevalence of methanogens remains unknown. In thi study, our aim was to evaluate the prevalence of CH 4 producers and associated factors in Mexican IBS patients as well in healthy controls. Material and methods: 67 Rome III IBS patients(76% women, 34.4 ± 14 years) and 132 controls (53.8% women, mean age 28 ± 9 years) underwent a breath test analysus using a stationary gas chromatography (Gastro- CH4ECKl, Bedfont® Scientific Ltd, UK.). Basal levels of H 2 and CH 4 were evaluated and patients with H 2 levels of 0 ppm and CH 4 > 5 ppm were classified as methanogens according to the cutoff proposed by Rezaie et al. ( Am J Gastroenterol 2015; 110: S759-60). Demographic characteristics (age, gender, weight, height, body mass index and obesityy) between methano- gens and non-methanogens were compared. Results: Overall, the prevalence of methanogens was 76/199 (38.1%, CI 96% 0.31-0.45). Methane-producing patients had a higher BMI than non-methane producers (26.7 ± 5 vs. 24.9 ± 4, p = 0.023). Methane production was more prevalent in obese / overweight subjects (56.5 vs 39.8%, p = 0.028), especially in grade II-III obesity (23% vs. 10%, p = 0.011). As shown in Figure 1a, a higher degree of overweight / obesity increased methane production (p = 0.04). The prevalence of methano- gens in healthy controls was 41.6%(n=55) (95% CI of 0.33-0.49) while the prevalence in patients with IBS was 31.4% (n = 21) (CI 95% of 21.5 -0.43, p = 0.16). According to the subtypes of IBS there were 32 patients with IBS-C (47.8%), 25 with IBS-M (37.3%) and 10 (14.9%) with IBS-D. Of the 21 patients with IBS that were methanogenic 71% (n = 15) belonged to the IBS-C group, 29% (n = 6) to IBS-M and none (n = 0) to the IBS-D group (p = 0.012). Patients with IBS-C had higher methane levels compared to patients with IBS- M and IBS-D (18.6 ± 5 ppm vs. 9.8 ± 6.3 vs 1.5 ± 1, p = 0.008) (Figure 1B). Interestingly, 12 subjects (5 controls and 7 SII) did not produce H 2 or CH 4 , which is suggestive of a microbiota that produces mainly sulfhidric acid (H 2 S). Conclusions: In our population the prevalence of methanogens ranges from 31% to 41%. CH 4 production was associated with obesity / overweight. As reported in other studies, CH 4 is associated with IBS-C in mexican patients. 6% of our population can be carriers of a microbiota that predominantly pro- duces (H 2 S).