AGA Abstracts DM vs ID was found. Results were also adjusted for diabetic status and charge pulse (Table 2). Baseline nausea scores were associated with ICC inner (p=0.03) and ICC outer (p=0.02). Baseline anorexia score was associated with S100 outer (p=0.03). After tGES placement, vomiting was associated with mast cells inner (p=0.04) and abdominal pain was associated with ICC outer (p=0.05). The change in baseline to day 5 in S100 outer was associated with anorexia (p=0.01), bloating (p=0.03) and total symptom scores (p=0.01). Conclusions: There may be utility in using charge, energy, power and average power, as they relate to inner/outer muscle gastric cells to predict symptom outcome in DM vs ID Gp. Use of energy parameters with FTB results may better guide the application of GES for optimal Sx outcome in Gp patients. Table 1. Number of cells by each energy metric by diabetes status. Table 2. Symptoms in relation to full thickness biopsies adjusted for diabetes status and charge pulse. Mo1585 Is the Electrogastrogram a Clinically Useful Tool? Shifat Ahmed, Steven Ramos, Chirag M. Patel, Munish Ashat, Lindsay McElmurray, Michael G. Hughes, Ed Miller, Abigail Stocker, Christina Pinkston, Guy Brock, Christopher J. Lahr, Thomas L. Abell Background: Cutaneous electrogastrography (cut EGG) is of uncertain clinical value. We aimed to examine the clinical usefulness of cut EGG in a large group of patients with the symptoms (Sx) of gastroparesis (Gp) undergoing temporary gastric electrical stimulation (tGES). Patients and Methods: 717 patients, (average age 46 years, 84% white, 80% female, with 43% with diabetes) had Sx data with a standardized PRO symptom scale, solid gastric emptying tests (GET), cut EGG data, and mucosal electrogram (mEG), as previously described (GIE 74: 496-503). Baseline and 5-day post tGES symptoms, GET, cut EGG and mEG were analyzed by quantitative signal analysis averaging, reported as mean frequency (F), amplitude (A), and their ratio (FAR). Patients were classified as EGG frequency: normal or high, and GET: non-delayed or delayed, using standardized criteria (GIE, above) and thus stratified as 4 possible groups. Baseline to follow-up Sx scores, GET (1,2, 4 hours, total), F, A and FAR changes were noted as "+" and "-" if values were higher or lower than baseline. Pearson correlations of the cut EGG measures, mEG measures, Sx scores and GET were calculated and reported as mean and SE. Results: Adjusted for age, race, and gender, cut EGG FAR correlated to baseline nausea scores (p=0.016) and cut EGG FAR correlated to baseline nausea scores (r=0.07, p=0.050, n =759). Cut EGG and mEG baseline F (r=0.11, p=0.003, n=712) and post tGES F (r = 0.28, p<.001, n=380) correlated before and after tGES.. Unadjusted baseline cut EGG and mEG FAR values correlated at 5 day post tGES (r=0.11, p=0.040, n=380). mEG FAR negatively correlated to baseline gastric emptying at 1 hour (r=-0.08, p=-0.032, n=683). Cut EGG F increases after tGES for all patients, subgroups with normal baseline cut EGG F, and delayed, or non-delayed GET (+0.5 cpm, p<0.0001; +1.6 cpm, p<0.0001; +1.6 cpm, p<0.0001 ). Cut EGG F decreases after tGES in patients with abnormal cut EGG F with delayed, and non-delayed GET (-0.6, p<0.0001; -0.5 cpm, p<0.0001). All 4 subgroups decreased Sx scores post tGES, with nausea improving most (p<0.0001 for all Sx).(Table 1) Patients with non-delayed GET had equal or lower Sx scores except for vomiting,. The subgroup with normal EGG and non-delayed GET had the best F and FAR response and total symptom scores after tGES . Delayed GET patients had decreased GET measures after tGES (p<0.0002, p<0.0001, p=0.009, p=0.0001 at 1, 2, 4 hours and total time), while patients with normal GET had increased GET after tGES S-720 AGA Abstracts (p<0.0001 at 1, 2, 4 hours and total time). (Table 2) Conclusion: Cut EGG correlates with a number of baseline and post tGES measures. Cut EGG and GET, when combined, can help predict which patients will do best with a trial of tGES. We conclude that cut EGG, in the setting of patients with the Sx of GP undergoing tGES, has clinical usefulness. Table 1: Symptom Scores in Patients with Normal and Abnormal Baseline Cutaneous Fre- quency Table 1: Individual symptom scores and total symptom. Table 2: Cutaneous and Mucosal Frequency, Amplitude and FAR in Patients with Normal and Abnormal Cutaneous Baseline Frequency Table 2: Cutaneous and mucosal frequency, amplitude and FAR. Mo1586 Effects of Hemin on Heme Oxygenase-1, Gastric Emptying, and Symptoms in Diabetic Gastroparesis Adil E. Bharucha, Phillip A. Low, Simon J. Gibbons, Michael Camilleri, Jessica J. Saw, Gianrico Farrugia, Alan R. Zinsmeister Background: Therapeutic options for management of diabetic gastroparesis are limited. Failure to maintain upregulation of heme oxygenase (HO1) in macrophages leads to loss of interstitial cells of Cajal and delayed gastric emptying in diabetic non-obese diabetic (NOD) mice and in the diabetic human stomach. Hemin is one of the most powerful inducers of HO1 known. Our hypothesis was that hemin upregulation of HO1 would restore normal gastric emptying (GE) in humans with diabetic gastroparesis. Aims: To compare the effects of hemin and placebo infusions on HO1 activity and protein concentration, GE, autonomic function, and gastrointestinal symptoms in gastroparesis. Methods: In a single-center, dou- ble-blind, placebo-controlled, randomized clinical trial, we compared intravenous hemin (3 mg/kg iv prepared in albumin, 11 patients, 9 women, age 46 ± 5y) or albumin alone (placebo, 9 women, 35 ± 5y) in 20 patients with diabetic gastroparesis. Randomization was balanced on gender, estimated GFR (<60 or ≥60 mL/minute/1.73m 2 ) and C-peptide (< or ≥0.6 ng/mL). GE was evaluated with scintigraphy at baseline. After infusions on days 1, 3, and 7, weekly infusions were administered for 7 weeks. Assessments included plasma HO1 protein concentration (ELISA) and WBC HO1 activity levels, GE with 13C-spirulina breath test, autonomic functions (baseline and end), and gastrointestinal symptoms (PAGI-SYM, PAGI-QOL) every 2 weeks. Results: At baseline, GE at 4 hours was 62 + 4% (hemin) and 60 + 6% (placebo). Nine of 11 patients randomized to hemin completed all study procedures; 1 each withdrew before the study and week 8. Compared to placebo, hemin increased HO1 protein on days 3 ( P=.0002) and 7 ( P=.008) and HO1 activity on day 3 ( P=.0003) but not after (Table 2). GE, autonomic functions, and symptoms did not differ significantly in the hemin group relative to placebo. Hemin and placebo infusions were well tolerated by all subjects. AEs included headaches (3 placebo, 2 hemin), nausea (3 placebo, 1 hemin) dizziness (0 placebo, 2 hemin), but not phlebitis. After adjusting for baseline values, the platelet count on day 4 was lower ( P=.01) after hemin than placebo. The hemoglobin and erythrocyte count declined after starting therapy in both groups. After adjusting for baseline values, the hemoglobin on day 7 was lower ( P<.05) for placebo than hemin. There were no other statistically significant changes in laboratory tests after starting therapy. Conclusions: Hemin failed to sustain increased HO1 levels beyond a week and did not improve GE or symptoms in diabetic gastroparesis.. Further studies are necessary to ascertain whether more frequent hemin infusions or other drugs would have a more sustained effect on HO1 and improve gastric emptying. Supported by DK68055.