Functional Gastrointestinal Disorders Research
Functional gastrointestinal disorders, or FGIDs, affect more than a third of the US population. These conditions, though not associated with cancer or increased mortality, significantly reduce quality of life and work productivity. FGIDs also lead to billions of dollars in health care expenditures on an annual basis. Of the FGIDs, the irritable bowel syndrome, or IBS, is the most common. IBS is defined by the presence of typical symptoms, including abdominal pain and altered bowel habits (constipation, diarrhea, or a mixture of both).
In the past 20 years, we have made significant strides in diagnosing and treating patients with IBS. Our understanding of the underlying causes of IBS symptoms has grown at a remarkable rate. Particularly notable is the transition of our thinking of IBS as a primarily psychosomatic condition to one that results from a complex interplay between external factors like food and stress, genetic factors, gut factors like the microbiome, immune activation and permeability, and brain factors like mood and pain processing.
Treatment Philosophy for IBS patients
This increase in knowledge has led to a paradigm shift in the treatment of IBS patients. Twenty years ago, doctors and scientists would have scoffed at the suggestion of treating an IBS patient with the low FODMAP diet, probiotics, or antibiotics. Yet, in 2018, such treatments are effective, evidence-based options for IBS patients. Though we have made incredible strides in the laboratory and the clinic, we still have a long way to go. In the coming years, our group will work tirelessly to stay true to the mantra: “Lead not follow”.
- We will create and/or validate more holistic management models that incorporate not only medications but also diet and behavioral strategies.
- Through research conducted by our group and collaborations with other academic institutions and industry partners, we will identify biomarkers that will move the diagnosis of patients with FGIDs beyond symptoms alone. The ultimate goal is to accelerate the evolution of clinical care from the current model, which relies almost exclusively on symptoms to choose a treatment for a patient, to a “precision medicine” model in which the choice of therapy will be based upon symptoms combined with biomarkers, which will utilize genetics, microbiome, and metabolomics to choose the right therapy for the right patient.
- We will leverage technology to transform the way that doctors and patients interact and learn from one another. Using novel eHealth platforms, we will utilize big data to transform the clinical care landscape from empirical to precision medicine.
Meet the Team
Current Research Studies
- Determining the role of the low FODMAP diet for abdominal pain and bloating in patients with IBS and constipation.
- Conducting studies to determine the most efficient and effective means of reintroducing FODMAPs in patients who improve after excluding FODMAPs from their diet.
- Identifying biomarkers that will help health care providers to determine which IBS patients are most likely to improve with the low FODMAP diet.
- Conducting a clinical trial to compare the effectiveness of psyllium, prunes, and kiwi as treatments for chronic constipation. This will be the first US trial to evaluate kiwi for constipation.
- Determining whether breath testing identifies IBS patients who are more likely to improve with the non-absorbed antibiotic rifaximin.
- Determine the best test to identify patients with intestinal enzyme deficiencies – an enzyme called sucrase isolmaltase is responsible for breaking down table sugar and starch. Lack of this enzyme can cause symptoms that are identical to lactose intolerance and may be an unrecognized cause of IBS.
- Testing a novel IgG antibody test that can identify patients with food sensitivities.
- Assisting in the development of a novel prebiotic that alters the gut microbiome in a way that improves the symptoms of lactose intolerance.
- Exploring a magnification endoscopy technique called confocal laser endomicroscopy to identify food sensitivities in patients with upper and lower GI symptoms.
"I met Dr. Chey while working as a medical assistant in the Medical Procedures Unit (MPU) at UofM when I was in nursing school. I always had a "sensitive" stomach, most likely IBS, as diagnosed by other physicians throughout my childhood. The summer of 2006 was quite different, though. I could never be far from a bathroom, and I lost 10–15 lbs in a matter of just three months. I finally got up the courage to ask Dr. Chey for some advice. Lucky for me, he was doing a study on gastrointestinal disorders using a blood test. Turns out, I got paid $20 to be in the study, and I received my diagnosis of celiac disease, which has ultimately changed my life for the better. Most people wouldn't see this as a good thing, but I feel extremely fortunate to have discovered my diagnosis in just three short months, and I am able to control my symptoms on diet alone without any medications. I immediately felt like a completely new person, and my diagnosis has completely changed how I view gut health and what I am putting in my body. I am forced to read labels, and I live my life by eating whole, unprocessed foods. My energy levels have drastically improved, and I have also had improvements in my hemoglobin, iron, and cholesterol levels. Fast forward to twelve years later, and I am now a CRNA at UofM where I was lucky enough to run into Dr. Chey while providing anesthesia for his patients. Coming full circle, I can't tell him enough how grateful I am for his diagnosis so long ago that has completely hanged my life in the best way."
- FOOD: The Main Course to Digestive Health - First comprehensive training course for GI dietitians in the United States.
- Raise IBS Awareness - Raise awareness of IBS by watching and sharing this video.
- My GI Nutrition - A comprehensive low FODMAP diet educational website.
- What's the Big Deal with Gluten - A TED Ed video to help patients understand why wheat can cause gut distress. Lesson by William D. Chey, MD.
- Low FODMAP Diet and IBS - Learn about the favorable effect of a low FODMAP diet on IBS in two FOX 2 Detroit interviews with William D. Chey, MD and Lauren Van Dam, RD.
- A refurbished teaching kitchen for hands-on nutrition training.
- A mobile app that will help patients to assess their GI symptoms, determine whether their symptoms are related to meals, learn about the ESP low FODMAP program (Elimination, determine Sensitivities, Personalize the low FODMAP diet), and track their progress.
Your support will help Dr. Chey's group to transform the perception and advance the diagnosis and treatment of functional dyspepsia, chronic constipation, and IBS!
- Campaign goal: $250,000
- Amount to raise: $125,000
- Matching funds commitment: $125,000
How to Donate
To make a donation, please visit the William D. Chey Research Fund online giving page.
- Jones MP, Chey WD, Singh S, Gong H, Shringarpure R, Hoe N, Chuang E, Talley NJ. A biomarker panel and psychological morbidity differentiate the irritable bowel syndrome from health and provide novel pathophysiological leads. Aliment Pharmacol Ther 2014;39:426-437.
- Chey WD, Webster L, Sostek M, Lappalainen J, Barker PN, Tack J. Naloxegol for opioid-induced constipation in patients with noncancer pain. N Engl J Med 2014;25: 2387-2396. PMID: 24896818
- Webster L, Chey WD, Tack J, et al. Randomised clinical trial: long-term safety and tolerability of naloxegol in patients with pain and opioid-induced constipation. Aliment Pharmacol Ther 2014;40:771-9.
- Almario C, Chey WD, Kuang A, et al. Computer algorithm vs physician-documented history of presenting illness (HPI): Results of a blinded comparison. Am J Gastroenterol 2015;110:170–179. PMID: 25461620
- Menees S, Powell C, Kurlander J, Goel A, Chey WD. A Meta-analysis of the utility of C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin, and fecal lactoferrin to exclude inflammatory bowel disease in adults with IBS. Am J Gastroenterol 2015:110:1243-44. PMID: 25732419
- Heidelbaugh JJ, Stelwagon MA, Miller SA, Shea EP, Chey WD. The spectrum of constipation-predominant irritable bowel syndrome and chronic idiopathic constipation: US survey assessing symptoms, care seeking, and disease burden. Am J Gastroenterol 2015;110:580-7. PMID: 25781368
- Baker JR, Eswaran S, Saad R, Menees S, Fenner D, Chey WD. Improvement in abdominal symptoms after biofeedback therapy in patients with dyssynergic defecation. Clin Translational Gastroenterol 2015;6:e105. PMID: 26225863
- Eswaran S, Chey WD, Han-Markey T, Ball K, Jackson K. US, randomized, controlled trial comparing the low FODMAP diet vs. modified NICE guidelines in adults with IBS-D. Am J Gastroenterol 2016;111:1824-32.
- McRorie J, Chey WD. Fermented fiber supplements are no better than placebo for a laxative effect. Dig Dis Sci 2016;61:3140-46.
- Ford AC, Chey WD. Screening for celiac disease in irritable bowel syndrome: An updated systematic review and meta-analysis. Am J Gastroenterol 2017;112:65-76.
- Chey WY, Chang V, Hoellrich CM, Lubkin M, Corcoran D, Chang TM, Chey WD. Mega-cecum: An unrecognized cause of symptoms in some female patients with uro-gynecological symptoms and severe slow- transit constipation. Dig Dis Sci 2017;62:217-23.
- Chey WD, Lembo AJ, Phillips JA, Rosenbaum DP. Tenapanor treatment of patients with constipation-predominant irritable bowel syndrome: A phase 2, randomized, placebo-controlled efficacy and safety trial. Am J Gastroenterol 2017;112:763-74.
- Eswaran S, Chey WD, Jackson K, Pilai S, Chey SW, Han-Markey T. A Low FODMAP Diet improves quality of life, reduces activity impairment, and improves sleep quality in patients with irritable bowel syndrome and diarrhea: Results from a US randomized controlled trial. Clin Gastroenterol Hepatol 2017;15:1890-9.
- Chey WD, Dove LS, Andrae A, Covington PS. Early response predicts a sustained response to eluxadoline in patients with irritable bowel syndrome with diarrhea in two Phase 3 studies. Aliment Pharmacol Ther 2017;45:1319-28.
- Kurlander J, Chey WD, Morris C, Drossman D, et al. Development and validation of the Patient-Physician Relationship Scale (PPRS) among patients with irritable bowel syndrome. Neurogastroenterol Motil 2017;28:e13106.
- Chey SW, Chey WD, Saini SD, Weissman A, Harris L, Menees S. US primary care providers use of over-the-counter medications for gastroesophageal reflux disease and chronic constipation. J Managed Care 2017;9:116-21.
- Lenhart A, Ferch C, Shaw M, Chey WD. Use of dietary management in irritable bowel syndrome: Results of a survey of over 1500 U.S. gastroenterologists. J Neurogastroenterol Motil 2018, in press.
- Menees S, Almario CV, Spiegel BMR, Chey WD. Prevalence and predictors of bowel incontinence: Results from a population-based survey of over 71,000 Americans. Gastroenterology 2018, in press.
- Garcia-Etxebarria K, Zheng T, Bongfiglio F, Chey WD, et al. Increased prevalence of rare sucrase-isomaltase (SI) pathogenic variants in irritable bowel syndrome patients. Clin Gastroenterol Hepatol 2018, in press.
- Fodor A, Pimentel M, Chey WD, Lembo A, Golden PL, Isreal RJ, Carroll IM. Rifaximin is associated with modest, transient decreases in multiple taxa in the gut microbiota of patients with diarrhoea-predominant irritable bowel syndrome. Gut Microbes 2018, in press.
Editorials, Reviews, and Guidelines
- Greenberg ER, Chey WD. Defining the role of sequential therapy for H. pylori infection. Lancet 2013;381:180-2.
- Eswaran S, Goel A, Chey WD. What role does wheat play in the symptoms of irritable bowel syndrome? Gastroenterol Hepatol 2013;9:85-91.
- Chey WD. The role of food in the functional gastrointestinal disorders: Introduction to a manuscript series. Am J Gastroenterol 2013;108:694-7.
- Eswaran S, Muir J, Chey WD. Fiber and functional gastrointestinal disorders. Am J Gastroenterol 2013;108:718-27.
- Saad R, Chey WD. Breath testing for small intestinal bacterial overgrowth: maximizing test accuracy. Clin Gastroenterol Hepatol 2014;12(12):1964-1972.
- Eswaran S, Guenther A, Chey WD. Emerging therapies for chronic constipation and IBS-C. J Neurogastroenterol Motil 2014;20:141-51.
- Spencer M, Chey WD, Eswaran S. Dietary renaissance in IBS: Has food replaced medications as a primary treatment strategy? Curr Treat Options Gastroenterol 2014;12:424-40.
- Chey WD, Eswaran S, Kurlander J. Management of irritable bowel syndrome. JAMA, 2015;313(9):949-958.
- Mearin F, Lacy B, Chang L, Chey WD, Lembo A, Simren M, Spiller R. Bowel Disorders. Gastroenterology 2016;150:1393-1407.
- Chey WD. David Sun Lecture: Food - The main course to wellness and illness in patients with IBS. Am J Gastroenterol 2016;111:366-71.
- Gupta A, Chey WD. Breath testing for small intestinal bacterial overgrowth: A means to enrich rifaximin responders in IBS patients? Am J Gastroenterol 2016;111:305-6.
- Spencer M, Gutpta A, Van Dam L, Shannon C, Menees S, Chey WD. Artificial sweeteners: A systematic review and primer for gastroenterologists. J Neurogastroenterol Motil 2016;22:168-80.
- Chey WD, Whelan K. Dietary guidelines for irritable bowel syndrome are important for gastroenterologists, dietitians and people with irritable bowel syndrome. J Human Nutrition Dietetics 2016;29:547-8.
- Chey WD, Leontiadis G, Howden C, Moss S. American College of Gastroenterology Practice Guideline: Management of Helicobacter pylori infection. Am J Gastroenterol. 2017;112:211-38.
- Lenhart A, Chey WD. A systematic review of the effects of polyols in gastrointestinal health and irritable bowel syndrome. Adv Nutrition, 2017;8:587-96.
- Camilleri M, Ford AC, Mawe G, Dinning PG, Rao S, Chey WD, Lembo A, Fadok T, Chang L. Chronic Constipation. Nat Rev Dis Primers 2017, in press.
- Ford AC, Moayyedi P, Chey WD, Harris LA, Lacy BE, Saito YA, Quigley EMM. American College of Gastroenterology Monograph on the Management of IBS. Am J Gastroenterol Suppl. 2018, in press.
- Chey WD. Sucrase isomaltase deficiency: hiding in plain sight? J Gastroenterol Hepatol, 2018, in press.
- Staudacher H, Chey WD. Design of clinical trials assessing the efficacy of diet interventions for GI diseases. J Gastroenterol Hepatol. 2018, in press.
- Dolan R, Chey WD, Eswaran S. New insights on the low FODMAP diet for IBS. Exp Rev Gastroenterol Hepatol. 2018, in press.
- Chey WD. Foreword: The Complete low-FODMAP Diet. Shepherd & Gibson. The Experiment, New York, New York, 2013.
- Chey WD. Contributing Editor, Multi-Dimensional Clinical Profile for the Functional Gastrointestinal Disoders. 1st Edition. Ed: Rome Foundation, Raleigh, NC, 2014
- Chey WD. Contributing Editor, Rome IV: Functional Gastrointestinal Disorders. Disorders of Gut-Brain Interaction. 4th Edition, 2016
- Chey WD. Contributing Editor, Rome IV: Functional Gastrointestinal Disorders. Disorders of Gut-Brain Interaction. 4th Vol 2, Edition, 2016.
- Chey WD. Contributing Editor, Multi-Dimensional Clinical Profile for the Functional Gastrointestinal Disoders. 2nd Edition. Ed: Rome Foundation, Raleigh, NC, 2016.
- Chey WD. Contributing Editor, Functional Gastrointestinal Disorders: Disorders of Gut-Brain Interaction. Special Issue Gastroenterology; Vol 150, Number 6, May 2016.
- Chey WD. Contributing Editor, Rome IV: Diagnostic Algorithms for Common GI Symptoms. 2nd Edition, 2016.
- Chey WD. Contributing Editor, Rome IV: Pediatric Functional Gastrointestinal Disorders: Disorders for Gut-Brain Interaction, 1st Edition, 2016.
- Chey WD. Contributing Editor, Rome IV: Functional Gastrointestinal Disorders for Primary Care and Non-GI Clinicians. 1st Edition, 2016.
- Chey WD. Contributing Editor, Rome IV: Diagnostic Questionnaires and Tables for Investigators and Clinicians, 1st Edition, 2016.
- Chey WD. Foreword: A Teen’s Guide to Gut Health. Meltzer Warren R. The Experiment, New York, NY, 2017.
- Chey WD. Foreword: The IBS elimination diet and cookbook. Catsos P. Harmony Books, New York, 2017.