Anal fistula tracts generally do not harbour high levels of mucosa-associated microbiota. Crohn's anal fistulas do not seem to harbour specific bacteria. Alternative explanations for the persistence of anal fistula are needed.

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cells stained is scored 0e5, a maximum Quick score per sample of 8. Differences in expression between HC and CD samples were analysed using ManneWhitney U test. Results Colonic biopsies from 20 HC and 20 CD patients were stained for NLRP3, ASC, Pyrin and Caspase-1 protein expression. All four proteins were expressed in HC and CD tissue. There were significant differences in expression of all 4 proteins when HC and colonic CD samples were compared (Abstract PTU-116 Conclusion The NLRP3 inflammasome is expressed in normal, healthy GIT mucosa and is upregulated in colonic tissue from CD patients with active disease. This suggests the NLRP3 inflammasome may play a role in mucosal immunity in CD patients.Competing interests None declared.

Introduction Length of stay (LOS) following colorectal surgery has reduced due to enhanced recovery after surgery (ERAS) programs. Telemedicine has shown potential for patients to remotely access support, communicate progress with their medical team and enhance patient empowerment. We conducted a systematic review of smartphone applications for ERAS following colorectal surgery measuring patient outcomes and experience. Method The review was performed adhering to PRISMA guidelines, using search terms pertaining to ERAS, colorectal surgery, and mobile applications via electronic databases. All peer-reviewed English articles were assessed for inclusion and quality by two reviewers. A qualitative analysis was conducted to evaluate methodologies, patient experience, and outcomes. Results 206 abstracts were identified from which 5 articles (2 RCTs and 3 cohorts) were included in the analysis. Studies surveyed patient adherence to ERAS, LOS, readmission, intra and postoperative complications. Four studies recorded patient satisfaction, whilst one assessed quality of life and application validation. Conclusions The review highlights paucity in the use of smartphone applications after ERAS in colorectal surgery but demonstrates high patient satisfaction levels. Service delivery in the NHS has increasingly moved to a virtual platform during the coronavirus pandemic. More research and engagement in the development and use of smartphone applications would enhance care for patients.

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