Background: Endoscopy within 24 h of admission (early endoscopy) is a quality standard in acute upper gastrointestinal bleeding (AUGIB). We aimed to audit time to endoscopy outcomes and identify factors affecting delayed endoscopy (>24 h of admission). Methods: This prospective multicentre audit enrolled patients admitted with AUGIB who underwent inpatient endoscopy between November and December 2017. Analyses were performed to identify factors associated with delayed endoscopy, and to compare patient outcomes, including length of stay and mortality rates, between early and delayed endoscopy groups. Results: Across 348 patients from 20 centres, the median time to endoscopy was 21.2 h (IQR 12.0-35.7), comprising median admission to referral and referral to endoscopy times of 8.1 h (IQR 3.7-18.1) and 6.7 h (IQR 3.0-23.1), respectively. Early endoscopy was achieved in 58.9%, although this varied by centre (range: 31.0-87.5%, p ¼ 0.002). On multivariable analysis, lower Glasgow-Blatchford score, delayed referral, admissions between 7:00 and 19:00 hours or via the emergency department were independent predictors of delayed endoscopy. Early endoscopy was associated with reduced length of stay (median difference 1 d; p ¼ 0.004), but not 30-d mortality (p ¼ 0.344). Conclusions: The majority of centres did not meet national standards for time to endoscopy. Strategic initiatives involving acute care services may be necessary to improve this outcome.

PCCRC occurred in 12.1% of patients with CRC between 2003 and 2009. PCCRC was associated with female sex, older age, increased comorbidity, CRC of the right side of the colon, elective procedures, and colonoscopy volume. PCCRC was associated with worse outcomes.

PEUGIC occurs in 6.7 % of UGIC. PEUGIC was associated with GC, younger age, female gender, increasing comorbidity and deprivation, and a lack of alarm symptoms.

A 64-year-old woman presented with an increasing frequency of symptoms of heartburn and retrosternal pain over the last few months, and a constant and intense burning pain affecting her tongue tip, mouth and lips for the past 5 years. She found consuming hot drinks exacerbated the burning oral pain and chewing gum seemed to alleviate some of her symptoms. She thought these oral sensations were caused by frequently licking her finger tips to separate prints in her work in publishing. She had been previously diagnosed with gastro-oesophageal reflux disease (GORD), and her heartburn symptoms had been controlled until recently with lansoprazole 15 mg daily. Her past medical history included irritable bowel syndrome and depression, for which she had been treated with mebeverine and paroxetine for a number of years. She was a non-smoker and did not consume alcohol. Clinical examination was unremarkable with no oral lesions on examination. Her routine laboratory tests, including autoimmune serology, haematinics and thyroid function tests were all within normal limits. She underwent a gastroscopy, which revealed moderate reflux oesophagitis, and following commencing omeprazole 20 mg twice daily, her heartburn resolved. However, her oral burning symptoms were not affected and a diagnosis of burning mouth syndrome (BMS) was made. Following explanation and reassurance concerning the cause of her BMS symptoms, she chose not to receive treatment for this but to access cognitive behavioural therapy in the future if her symptoms worsened.

IntroductionThe Autologous Stem Cell Transplantation International Crohn's Disease (ASTIC) Trial is a randomised controlled trial co-sponsored by ECCO and EBMT and funded by the Broad Foundation that investigates immunoablation and hemopoietic stem cell transplantation (HSCT) in Crohn's disease (CD) over 1 year: all patients will have reached this endpoint by April 2013. Methods Patients with impaired quality of life due to active CD, despite ≥ 3 immunosuppressive agents all underwent mobilisation (iv cyclophosphamide 4 gm/M 2 over 2 days then filgrastim10µ/kg/ day) before randomisation to immediate (1 month) or delayed (13 months) HSCT. The conditioning regime was iv cyclophosphamide 50mg/kg per day for 4 days, anti-thymocyte globulin 2.5 mg/kg/day and methyl prednisolone 1mg/kg on days 3-5. The bone marrow was reconstituted by infusion of an unselected graft of 3-8 × 10 6 /kg CD34 +ve stem cells. Clinical (CDAI), endoscopic (SES-CD) quality of life and safety data are compared 1 year after mobilisation alone or after mobilisation and HSCT. Results As of Jan 2013, data are available on 34/45 patients. Following mobilisation and HSCT, the CDAI fell from 317 (median, IQR 244-407) to 157 (71-246, n = 17) vs 351 (313-446) and 298 (220-370, n = 17) with mobilisation alone. The aggregate lower GI SES-CD score was 13.0 (8.5-24.5) before and 3.0 (1.5-10.0) after HSCT compared to 13.0 (6.5-15.5) before and 6.5 (3.5-17.8) after mobilisation alone. Over the whole study to end 2012 there were 62 SAEs in 19 patients randomised to early transplantation (3.3 per patient) and 58 in 18 patients randomised to delayed transplantation (3.2 per patient). One patient died following HSCT. Final results of the study will be available to be presented for the first time at BSG 2013. Conclusion Immunoablation and HSCT appears to be an effective treatment for CD that may substantially reduce endoscopic evidence of disease but incurs significant toxicity. The final results of the trial will allow a rational evaluation of the effectiveness and safety of HSCT to be discussed at BSG 2013.