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Objective: The aim of this study is to determine the interrater agreement in a clinical practice environment for the most commonly used magnetic resonance enterography (MRE) features of Crohn’s disease (CD). Methods: CD patients with MRE’s before and after treatment were retrospectively identified using search queries over a 7-year period (May 2017–September 2017). MRE features of CD comprising components of multiple CD scoring indices were scored by radiologists in the same segment of bowel. Agreement for nominal categorical and continuous variables was assessed using a κ and interclass correlation coefficients, respectively. Results: 80 scans comprised the study population. Moderate interrater agreement was seen in both the pre- and post-treatment MRE’s for presence of diffusion restriction (к = 0.43, 0.48; pre- and post-treatment), stricturing disease (к = 0.51, 0.52), overall degree of severity (к = 0.49, 0.59). Substantial agreement was seen in pre- and post-treatment scans for length of involvement (interclass correlation coefficient = 0.67, 0.61). The presence of mucosal ulceration had no agreement (к = −0.07, –0.042). Conclusion: Many MRE features of active CD comprising the major CD scoring indices are reproducible when interpreted by non-CD focused abdominal radiologists. However, the presence of mucosal ulcerations had no agreement and may need more investigation before including this feature as a driver in therapeutic decision making. Advances in knowledge: Demonstrates the unreliability of mucosal ulceration by non-CD focused abdominal radiologists, targeting a potential area for future education. Key Points The majority of MRE findings incorporated in to many CD scoring indices have fair to moderate inter-rater agreement even when read by non-MRE expert radiologists. Substantial agreement was seen in the length of involved bowel, but this feature is only incorporated in to one of the CD scoring indices. Presence of mucosal ulcerations had no interrater agreement in our study—a feature which is heavily weighted by several CD scoring indices. Research should be focused bridging those features which have poor interrater agreement.

BACKGROUND: Few studies have examined the metabolic consequences of short bowel syndrome (SBS) and its effects on body composition in adults. We hypothesized that body composition of SBS patients is altered compared to a normal age, race, and sex-matched population, regardless of parenteral nutrition (PN) dependence. AIM: To compare the body composition of adult patients with SBS to age, sex and race matched healthy controls. METHODS: Twenty patients with SBS underwent body composition analysis using the GE Lunar iDXA scanner. Patients were age, sex and race matched to controls from the National Health and Nutrition Examination Survey (1999–2004). Mean differences in body mass index, fat free mass, fat mass, percent body fat, visceral adipose tissue mass and volume, and bone mineral density were measured. Statistical analysis was performed using SAS 9.4 software. RESULTS: Fifty-five percent of subjects had a history of PN use and 30% were current PN users. Mean percent body fat for SBS patients was 35.1% compared to 30.9% for healthy controls (p=0.043). Fat free mass was reduced in SBS (p=0.007). Patients with reduced bone mass had a trend towards significantly more years of PN exposure compared to those with normal bone mass (p=0.0.094), and a trend towards older age (p=0.075). CONCLUSIONS: SBS is associated with increased percent body fat and reduced fat free mass, suggesting that improved dietary and therapeutic interventions are needed to restore normal metabolic indices and avoid risk for metabolic syndrome in SBS patients.

Background Inflammatory bowel disease (IBD) is a chronic luminal disease with genetic and environmental factors affecting phenotype. This study evaluated the relationship between CHRNA5, a nicotinic receptor subunit gene, and smoking in predicting IBD-related surgery as well as the relationship between CHRNA5 and nicotine dependence. Methods Participants completed a smoking questionnaire and were genotyped for CHRNA5 rs16969968. Demographic and clinical data were obtained from medical records. Wilcoxon, ANOVA, Chi square, and Fisher's exact tests were used for comparisons. Logistic regression was used to evaluate the effect of clinical and genetic predictors on surgery, stratified by disease subtype given paradoxical effects of smoking. Kaplan-Meier curves were used to examine the effect of smoking and genotype on time to surgery. (Significance: P AG > GG; P = 0.08]). Smoking and genotype were not independently associated with surgery in UC or CD. However, interaction between rs16969968 and smoking in predicting surgery was observed for both UC (OR = 2.72; P = 0.05) and CD (OR = 2.88; P = 0.1). CHRNA5 genotype, but not smoking, predicted time to surgery in patients with UC (P = 0.007) but not in patients with CD. The interaction between smoking and genotype was not significantly associated with time to surgery in UC or CD. Conclusions The CHRNA5 rs16969968 A variant interacts with smoking to influence IBD-related surgery. 10.1093/ibd/izx094_video1izx094.video15775248538001.