P418 Are there racial disparities in the management of irritable bowel syndrome between secondary care ethnic minority and White British patients?

Introduction Irritable bowel syndrome (IBS) is a highly prevalent disorder of gut brain interaction best understood within a biopsychosocial framework. Recent studies in other healthcare systems have suggested racial disparities in the management of IBS. We aimed to investigate for racial disparities in the diagnosis and management of IBS including adherence to BSG guidelines between White British and Ethnic minority patients with IBS in a UK secondary care setting.Methods Consecutive Ethnic minority patients (N=68) from 12 different self-reported ethnic groups with a coded secondary care diagnosis of IBS at a gastroenterology department in a large UK teaching hospital were identified from electronic health records. Data on diagnostic pathways and access to treatments and adherence to BSG IBS guidelines were compared statistically with an equal number of age and gender matched white British controls (N=68). All statistical analysis was performed using SPSS 30. Statistical significance was defined by a p ≤0.05.Results Compared to age and gender matched White British controls, Ethnic Minority patients saw more clinicians (P=0.012) and required more outpatient appointments to make an IBS diagnosis (P=0.007). The diagnostic work-up of both groups was similar. There were disparities identified in the approach to treatment with ethnic minority patients less likely to be recommended second-line pharmacological treatment (27.9% vs. 8.8%, P=0.004) and Brain-Gut Behavioural Therapies (17.6% vs. 2.9%, p=0.005) compared to their White British counterparts. Across both groups, adherence to BSG guidelines in the diagnostic approach and treatment for IBS was low, with most patients not being recommended second line medical, dietary or behavioural treatment for their IBS.Conclusions These data suggest that the management of IBS in secondary care in the UK has not kept pace with advances in evidence-based treatments and BSG guidelines. Moreover, racial disparities, whether influenced by clinicians or patients, were seen between the two ethnic groups regarding the diagnosis and management of IBS. Further studies are necessary to determine the barriers contributing to these disparities, to influence future interventions and clinical training to address them.