± 10.8, –27.0 ± 2.8, –42.3 ± 4.3 for KH, NaCl, I 2 and ML-8 respectively (p = 0.11). PD time 0: –5.8 ± 2.4, 2.9 ± 0.5, –3.6 ± 0.4, –3.2 ± 1.1 (p = 0.24). Transepithelial Electrical Resist- ance (TEER W.cm 2 ) higher in control group: 118.5 ± 29.2, 47.7 ± 16.4, 92.0 ± 15.4, 69.8 ± 11.5 but did not reach significance (p = 0.05). Tissues responded to carbachol although attenuated in I 2 treated tissue (p = < 0.05). Papp higher in all treated tis- sues but this did not reach significance (p = 0.07). Histopatho- logical assessment revealed no overt damage to tissues and crypt heights uniform. Conclusion ML:8 rapidly and effectively reduced bacterial counts with no adverse effects on a broad range of functional and structural parameters on human colonic mucosa ex vivo. This represents a potentially powerful tool for exploring mecha- nisms of host-microbiome interactions similar to gnotobiotic ani- mal models. Brief exposure to ML:8 had comparable outcomes to control treated tissues and possibly less impact than iodine. These are early experiments but potential future clinical applica- tions of ML:8 include decolonisation for elective surgery, prior to faecal transplantation for C.difficile or for surgical sepsis e.g. perforated colon. Disclosure of interest F. Mcdermott: None Declared, D. Folan: None Declared, D. Winter: None Declared, M. Folan Conflict with: Company Director of Capstan Healthcare Ltd, A. Baird Conflict with: Company Director of Capstan Healthcare Ltd. OC-071 OESOPHAGEAL PHYSIOLOGY FINDINGS IN 80 PATIENTS WITH RECURRENT DYSPHAGIA POST-ACHALASIA TREATMENT: RETEST BEFORE RETREATING 1,2 JLS Ooi*, 1,3 R Hewett, 1 E Yazaki, 1 D Sifrim, 1,2 P Woodland. 1 Wingate Institute for Neurogastroenterology, Queen Mary University of London; 2 Gastroenterology, Royal London Hospital, Barts Health NHS Trust; 3 Gastroenterology, St George’s Healthcare NHS Trust, London, UK 10.1136/gutjnl-2015-309861.71 Introduction Achalasia is a relatively rare primary oesophageal motor disorder characterised by absent peristalsis and failure of relaxation of the lower oesophageal sphincter (LOS). The standards of treatment for achalasia are pneumatic bal- loon dilatation and surgical myotomy. Although 85–95% success at 2 years is reported with these procedures, in the longer term, dysphagia may return in over 50%, prompting consideration of re-treatment. The definition of recurrence is often based on symptom evaluation, particularly dysphagia. Treatment of dys- phagia in achalasia is targeted at the LOS, but in some patients dysphagia may be multifactorial and may not be improved by attempting to further lower LOS pressure. We aimed to evaluate the GI physiological findings of patients undergoing studies in our tertiary referral unit to investigate recurrence of dysphagia post-treatment. Method We interrogated our database for patients undergoing high resolution oesophageal manometry +/- 24-hour pH studies due to dysphagia post-treatment for achalasia between 2010– 2014. We recorded achalasia subtype, LOS relaxation pressure (known as integrated relaxation pressure, or IRP), and reflux study results if performed. Results 80 eligible patients (38 female; age range 11–83 years, median 46 years) were identified with recurrent dysphagia. All had high resolution oesophageal manometry performed, and 18 patients had 24-hour pH studies due to concomitant heartburn and/or regurgitation. 52 patients had undergone at least one previous pneumatic dilatation, 23 had undergone surgical myot- omy, and 5 had no response to Botox injection. 40 patients were found to have type 1 achalasia, 25 had type 2 achalasia, and 6 had type 3 achalasia. 9 patients had normal peristalsis unlikely to be consistent with a diagnosis of achalasia. 22 of the 80 patients had an IRP >15 mmHg (upper range of normal). 10 patients had a very low (<5 mmHg) IRP. 11 patients had pathological oesophageal acid exposure on 24-hour reflux testing. Conclusion We investigated a large cohort of patients with recurrent dysphagia post-treatment of achalasia. The most fre- quent achalasia subtype was type 1. Although 28% patients had high residual LOS pressures, a significant proportion of patients had findings not consistent with a need to re-treat with dilata- tion or myotomy (due to very low LOS pressure, gastro-oeso- phageal reflux disease, or possible incorrect diagnosis). These results highlight the need to carefully re-evaluate patients presenting with recurrent dysphagia after achalasia treat- ment before deciding on repeat therapy. Disclosure of interest None Declared. OG Surgical Free Papers OC-072 DOES ENDOSCOPIC DUODENAL-JEJUNAL EXCLUSION IMPROVE NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) IN PATIENTS WITH DIABESITY? 1,2 P Sen Gupta*, 3 RS Bajwa, 4 AA Roy, 5 D Butler, 5 J Ashmore, 3 SI Lee, 5 L Murray, 6 B McGowan, 7 RS Drummond, 8 B Hayee, 1 SA Amiel, 2 RE Ryder. 1 Diabetes, King’s College London (KCL), London; 2 Diabetes; 3 City Hospital, Birmingham; 4 Radiology, Barts Health NHS Trust; 5 KCL; 6 Guy’s and St Thomas’ NHS Trust, London; 7 Glasgow Royal Infirmary, Glasgow; 8 Gastroenterology, KCL, London, UK 10.1136/gutjnl-2015-309861.72 Introduction The rapidly increasing global prevalence of NAFLD paralleling the diabesity pandemic demands that new effective therapies are identified. The aim of this study was to investigate the impact of an endoscopic duodenal-jejunal liner (DJL) (endobarrier) with or without glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy on NAFLD. Method Adults with type 2 diabetes and obesity despite GLP- 1RA therapy (HbA1c ‡7.5%, BMI ‡35 kg/m 2 ) were randomised to (1) DJL+GLP1RA (liraglutide 1.2 mg daily) therapy; (2) DJL alone; (3) escalated dose liraglutide (1.8 mg daily). Descriptive statistics were performed (%frequency, mean ±SD, median (IQR)). Changes in weight, HbA1c (paired t-test) and non-inva- sive composite scores (NAFLD fibrosis score (NFS) and AST to platelet ratio index (APRI) score) were calculated over 3 months within groups (Wilcoxon test). A sub-group underwent magnetic resonance imaging (MRI) to evaluate hepatic fat fraction over 4 months of DJL implant (paired t-test). Hepatic fat fraction (HFF) was calculated by comparing the in-phase/ out-of-phase signal by 3 blinded independent assessors using 3 regions of interest in the liver. Results Of 40 patients (age 51.2 ± 10.0 years, 40.0% male, 60.0% Caucasian, baseline BMI 41.4 ± 4.9 kg/m 2 , HbA1c 78 ± 16 mmol/mol (9.3 ± 1.4%)), baseline ALT was 27 (17.8–41.0) IU/l, AST 21 (17.8–41.5) IU/l, ƔGT 35 (22.0–71.5) IU/l and 82.5% had a NFS regarded as at intermediate (65.0%) or high risk (17.5%) for fibrosis. Over 3 months, there was a reduction in weight by 7.3 ± 4.0 kg and in HbA1c by 14.5 ± 15.3 mmol/ mol (1.3 ± 1.4%), P < 0.0001. NFS reduced by 0.36 (–0.1 to Abstracts A36 Gut 2015;64(Suppl 1):A1–A584