P260 Bile Acid Diarrhoea outside tertiary centres-how bad is BAD?

Abstract

17.1% of ultrasounds. Of patients with adequate imaging, 67 (46.9%) had pancreatic abnormalities detected; including 31 with chronic pancreatitis and 7 pancreaticobiliary cancers. 124 patients (68.1%) had nutritional blood tests sent. Of these, 65 (52.4%) had one or more abnormal result.103 patients (56.6%) received PERT; median initial dose 50000 IU/meal. 77 patients (66.4%) were referred to dietetics. 67 patients (81.7%) responded clinically to PERT. Patients with severe PEI were no more likely to respond than those with mild PEI (OR 1.28, 95% CI 0.40-4.03; p=0.68). Initial PERT dose was not associated with clinical response (OR 1.00, 95% CI 1.00-1.00; p=0.51), nor was referral to dietetics (OR 0.61, 95% CI 0.12-3.04; p=0.54). However, patients with abnormal pancreatic imaging or nutritional blood tests had four times the odds of responding to PERT than those with normal results (OR 4.77, p=0.03, and OR 4.12, p=0.04). Conclusions All patients diagnosed with PEI should be screened for malnutrition and undergo pancreatic imaging with CT or MRI. Abnormal results are common and may predict response to treatment.