Researcher’s Quest to Understand the Role of Diet & IBS

Hello Friends,

As part of IBS awareness month and the #IBelieveinyourStory campaign, I would like to introduce you to Dr. William Chey, a gastroenterologist and researcher at University of Michigan.

Dr. Chey has been on the forefront of IBS research in the US studying the role of the low FODMAP diet and IBS. In fact, Dr. Chey’s group at the University of Michigan published the first high quality randomized controlled trial looking at the low FODMAP diet in the US assessing its effect on quality of life and symptom control in IBS-D.

Dr. Chey and his colleagues’ work at U. Michigan will impact the future of IBS therapies and ultimately will improve the quality of life for those that suffer with IBS. Below you will find a “brief” synopsis of some of the exciting research (please forgive the medical jargon) accomplished and ongoing at University of Michigan, along with my comments in italics.

1. As previously mentioned, the first high quality US, randomized, controlled trial (RCT) comparing the low FODMAP diet to a modified NICE diet (a diet used in the UK for IBS treatment) in patients with IBS-D. The primary results of this study were published in the December 2016 issue of the American Journal of Gastroenterology. A second paper addressing the impact of the low FODMAP diet on quality of life has been submitted to Clinical Gastroenterology & Hepatology. Researchers at University of Michigan are also conducting a secondary analyses using samples obtained during this study to explore the potential mechanisms of benefit of the low FODMAP diet in IBS patients. They will present 2 analyses addressing serotonin SNPs (SNPs are one of most common type of genetic variation among people) and bile acid metabolism as oral presentations at DDW 2017 in Chicago. (Good news, I will be at DDW, one of the largest digestive disease conferences… and will take good notes!)
2. U. Michigan is about about two-thirds through a randomized, controlled trial which will assess the low FODMAP diet vs. psyllium in patients with fecal incontinence and loose stools.
3. Another study is underway looking at ways to optimize the FODMAP reintroduction in IBS patients who improve with the low FODMAP diet. This study is part of a 5 year plan that will ultimately attempt to identify and evaluate less restrictive versions of the low FODMAP diet. After  the first phase of studies are completed, researchers intend to use the preliminary data generated to apply for an NIH grant.
4. Researchers at U. Michigan are currently planning a project which will be the first to determine how behavioral therapies like hypnosis impact upon the microbiome and metabolome in patients with IBS. (Microbiome studies look at the microbes in our gut and metabolome studies additionally look at gut microbial metabolites.)
5. U. Michigan is also doing preliminary work to assess clinical outcomes in patients who receive instruction on the low FODMAP diet by traditional face to face visits or via tele-health.
6. In collaboration with Cedars Sinai Medical Center, U. Michigan & Cedars have developed a novel ehealth platform for individuals with GI symptoms called My GI Health. My GI Health utilizes best practice standards to collect information about a person’s GI symptoms, synthesize that information in history of present illness which can be shared with a health care provider, and provide tailored, high quality, evidence based medical education which can be experienced by user at a pace, time and location of their choosing. Research studies show that My GI Health collects a more complete and useful history of present illness than a doctor. U. Michigan and Cedars Sinai recently used My GI Health to conduct the largest study ever in over 70K  GI sufferers. Data from this study was featured at Digestive Diseases Week 2016 and 2017 and a number of manuscripts are currently in preparation.
7. Researchers at University of Michigan have also recently started a study to evaluate the potential value of confocal laser endomicroscopy (CLE), a magnification endoscopy based technique that allows real time evaluation of the lining of the GI tract at a cellular level, as a means of identifying patients who have sensitivities to certain types of food antigens. (This is super interesting! The endomicroscopy testing detect effects of food with direct contact with the GI tract. This likely will help develop more individualized and effective diets for those who experience symptoms with eating.) The first project hopes to identify what a normal CLE examination looks like in healthy persons. Researchers will compare these findings to CLE results from patients with meal related upper gastrointestinal symptoms. Once the researchers define what is normal and what is abnormal, they will perform studies to identify which foods cause symptoms and induce injury to the gut lining. This will allow creation of elimination diets which might be beneficial to patient with meal related symptoms.
8. U. Michigan researchers have also invented a novel, inexpensive, point of service glove which is equipped with pressure and electromyography sensors which allow a detailed assessment of the muscles involved with normal passage of stool from the rectum. (This is like a bedside anal manonetry test for those who may have had this test!) Preliminary studies demonstrate that the device, called Digital Manometry, provides similar information to laboratory based testing with equipment that requires a capital investment of $75-100K. U. Michigan is currently completing validation studies of Digital Manometry in patients with fecal incontinence.

Additionally, University of Michigan has also created a state of the art gastroenterology focused dietitian education program in an effort to educate more dietitians in the field of digestive health and nutrition. I will be speaking again at this program this year. We are in desperate need for dietitians with a strong understanding of digestive health and science-based nutrition interventions. U. Michigan is helping with this need. If you are a dietitian… consider signing up! Click here for more information and to register. 

Dr. Chey is a true maverick in the IBS world. His research is novel, exciting and WILL make a difference in the lives of those with IBS. And, he is truly a really nice person! 🙂 He puts up with my numerous questions, requests for quotes when I am writing a digestive health article and has helped me tremendously in my work.

I have donated to University of Michigan to help Dr. Chey’s lab continue their amazing work. If each an every one of you donated just $5 to Dr. Chey’s lab…together, we could raise over $25,000 or more!

Please consider being part of the IBS solution.

To donate to University of Michigan and support Dr. Chey’s research, click here.  

Thank you!!