(4) After taking antibiotics and probiotics for a week, stool frequency, stool consistency, abnormal rates, borborygmus frequency, extent

of abdominal pain were significantly improved compared to before. Fecal serine proteases activity decreased from 12.94∼54.77 (median 25.91) U/mg protein to 1.79∼17.82 (median 4.32) U/mg protein (P = 0.03). Conclusion: (1). Fecal serine proteases are not mainly secreted by overgrown Afatinib purchase bacteria in small intestinal of IBS-D patient. (2). Serine proteases are related with the occurring of abdominal pain in IBS-D patient. (3). Antibiotics and probiotics can decrease fecal serine proteases activity and improve IBS symptoms. Key Word(s): 1. IBS-D; 2. serine protease; 3. SIBO; 4. antibiotic; Presenting Author: JEFFEY GEORGE Corresponding Author: JEFFEY GEORGE Affiliations: Medical School Objective: Portal hypertensive gastropathy (PHG) is an important Metformin nmr source of gastrointestinal bleeding in patients with portal

hypertension. AIM -To assess the progression to severe portal hypertensive gastropathy (PHG) in patients with cirrhosis who were treated with maximum tolerated dose of propranalol, after variceal eradication to grade II or below. Methods: Cirrhotic patients (child A and B) presenting with upper gastrointestinal bleeding with endoscopic findings of mild or no PHG were followed up over 6 months after variceal eradication to assess the progression to severe PHG. Included patients were randomised to either maximum tolerated doses of propranalol (group A) or to no treatment (group B). Primary end point of the study were the development of gastrointestinal bleed, medchemexpress evidence of hepatic decompensation and death. Progression to severe PHG were compared between the two groups. Results: 56 patients (49 males) were enrolled (group A = 28, group B = 28). 8 patients were excluded from final analysis (gi bleed = 5, encephalopathy = 2, HCC = 1 including

4 deaths). 3 patients were lost to follow up, and 1 developed intolerance to propranalol. Mean dose of propranalol used was 60 mg per day. Progression to severe PHG in the fundus over 6 months was 23.8% in group A versus 15.8% in group B (p = 0.52). Severe PHG was noted in body in 14.3% in group A versus 21.1% in group B (p = 0.57). 23.8% in group A had progression to severe PHG compared with 15.8% in group B (p = 0.52). There was no statistically significant difference in the progression of PHG between the two groups (p = 0.43). Conclusion: In this short term study propranalol was found not to prevent the progression to severe portal hypertensive gastropathy in cirrhotic patients who had undergone endotherapy for esophageal varices. Key Word(s): 1. Propranalol; 2. PHG; 3.