pylori. More effective identification, elimination and/or management of risk factors will remain essential strategies

for reducing the incidence of peptic ulcer complications. In conclusion, the majority of patients with BPU present without dyspeptic symptoms. In contrast, even after healing of the ulcer, patients HSP inhibitor with a history of uncomplicated ulcers and ulcer symptoms have a significantly augmented symptom response to a standardized nutrient challenge test compared to patients with BPU. Lack of dyspeptic symptoms in patients with life-threatening BPU may reflect failure of augmented visceral sensation and result in them presenting later with complications rather than earlier with their primary disease. The data suggest that differences in the processing of upper gastrointestinal visceral afferents may play an important role in the clinical presentation of patients with complicated peptic ulcer. Based on our data it might be speculated that mechanisms that are involved

in the manifestation of symptoms in patients with functional dyspepsia may actually prevent the manifestation of ulcer complications as ulcers manifest check details with symptoms that trigger health care seeking and treatment before complications occur. This research has been funded by a project grant from the National Health and Medical Research Council of Australia, Grant Number 508110. Dr Montri Gururatsakul was supported by a NHMRC Postgraduate Masitinib (AB1010) Medical Scholarship. The authors would like to thank Dr Nancy Briggs for her help with Statistical analysis. No conflicts of interest exist. This

paper was presented in part as an oral presentation at Digestive Disease Week 2007, Washington, DC, May 2007. Gururatsakul M, Adam B, Liebregts T, Holloway RH, Talley NJ, Holtmann G. Differing clinical manifestations in complicated and uncomplicated peptic ulcer disease: Abdominal visceral sensory function may be a key. Gastroenterology 2007: 212: A43. “
“Madrid, Spain Adenoma and polyp detection rates (ADR and PDR, respectively) are important indicators of endoscopy quality, particularly in colorectal carcinoma screening. To assess the influence of the endoscopist’s experience on the ADR and PDR. In this study, 9635 colonoscopies were screened during a 5-year period. Only 5738 were finally analyzed due to exclusion criteria. The endoscopists were separated in three groups of experience according to the number of colonoscopies performed in the past (yearly and total). The number of polyps and adenomas, as well as the size and histology of these polyps were recorded. The ADR and PDR were similar regardless of the experience of the endoscopist, but those with more experience clearly found more polyps of less than 10 mm (P = 0.01) and of less than 3 mm (P < 0.0001). Most of the differences were due to a higher number of flat polyps detected by the experienced group.