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Introduction Meal studies are an important metabolic study design to assess fasting and post prandial gut hormone responses.Enteroendocrine cells are found throughout the gut, with the expression of gut hormones changing moving along the gut. Gastric inhibitory peptide (GIP) is expressed proximally whilst hormones glucagon like-peptide 1 (GLP-1) and peptide YY (PYY) are expressed more distally.Motility studies are to date mostly performed by invasive Methods such as intra-luminal manometry. This study combines non-invasive pre and post meal MRI scans with a metabolic meal study, to combine motility and hormone measurements.Methods Participants with bile acid diarrhoea (BAD) attended a single visit and underwent a fasting abdominal MRI and pre meal blood sample.Participants consumed a liquid mixed meal of set volume and then underwent a post meal MRI starting 20 mins post meal. Blood samples were collected pre and post each MRI scan and at 60-, 90- and 120-mins post meal.Motilent software was used to analyse cine MRI images. GIQUANT scores from Moitlent software, were utilised as a metric of duodenal motility. Blood samples were analysed with immunoassay and mass spectrometry.Results 4 participants with BAD have so far undergone analysis. Analysis showed the highest duodenal GIQUANT score in a participant who developed BAD post radiotherapy, who also had the highest post prandial response of distally expressed GLP-1 and PYY.One participant on 10mg mounjaro (tirzepatide) showed the slowest duodenal GIQUANT score, and lowest post-prandial levels of GLP-1 and PYY.Further meal and MRI measurements are undergoing analysis.Discussion This proof-of-concept design highlights the potential of combining these research modalities. In the case series performed so far, it highlights higher post prandial responses of distally expressed PYY and GLP-1 in patients with higher duodenal motility metrics. Further analysis will aim to model and confirm GIQUANT duodenal motility scores as a predictor of post prandial PYY and GLP-1 levels.This methodology will also be used to explore changes in GIQUANT motility scores in patients pre and post treatment responses in patients with gastro-motility disorders.Abstract P403 Figure 1